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Genetic polymorphisms and major bleeding risk during vitamin K antagonists treatment: The BLEEDS case-cohort.
Pharmacotherapy
June 2024
Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
Background: Major bleeding occurs annually in 1%-3% of patients on vitamin K antagonists (VKAs), despite close monitoring. Genetic variants in proteins involved in VKA response may affect this risk.
Aim: To determine the association of genetic variants (cytochrome P450 enzymes 2C9 [CYP2C9] and 4F2 [CYP4F2], gamma-glutamyl carboxylase [GGCX]) with major bleeding in VKA users, separately and combined, including vitamin K epoxide reductase complex subunit-1 (VKORC1).
The effect of COVID-19 vaccination on anticoagulation stability in adolescents and young adults using vitamin K antagonists.
Thromb Res
August 2023
Department of Hematology, Erasmus MC, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands; Thrombosis Service Star-shl, Rotterdam, the Netherlands. Electronic address:
Article Synopsis
- - The study investigated how COVID-19 vaccination affects anticoagulation stability in adolescents and young adults (AYAs) who use vitamin K antagonists (VKAs) for blood thinning, revealing a 20.8% decrease in INRs within the therapeutic range after the first vaccination.
- - Among the 101 AYAs included, there was a notable increase in supratherapeutic INRs (16.8%) after the first vaccination, while results after the second vaccination showed no significant changes compared to pre-vaccination levels.
- - Although the stability of anticoagulation was reduced post-vaccination, the study concluded that this change was likely not clinically significant, as complications from bleeding were less frequent and no severe issues
Bleeding Complications in a Patient After the Unexpected Interaction between Valproic Acid and Phenprocoumon.
Curr Drug Saf
November 2023
Department of Clinical Pharmacy, Isala Hospital, Zwolle, The Netherlands.
Background: Phenprocoumon is a vitamin K antagonist that is widely prescribed in Europe and Latin America for the prophylaxis and treatment of thromboembolic events.
Case Presentation: A 90-year-old female was admitted to our hospital with tonic-clonic seizures, possibly due to dementia syndrome. Valproic acid (VPA) was prescribed for the treatment of seizures.
Phytochemical Comparison of Medicinal Cannabis Extracts and Study of Their CYP-Mediated Interactions with Coumarinic Oral Anticoagulants.
Med Cannabis Cannabinoids
February 2023
Division of Pharmaceutical Biology, University of Basel, Basel, Switzerland.
Introduction: Treatment with cannabis extracts for a variety of diseases has gained popularity. However, differences in herb-drug interaction potential of extracts from different plant sources are poorly understood. In this study, we provide a characterization of cannabis extracts prepared from four cannabis chemotypes and an in vitro assessment of their Cytochrome P450 (CYP)-mediated herb-drug interaction profiles.
View Article and Find Full Text PDFVitamin-K-antagonist phenprocoumon versus direct oral anticoagulants in patients with atrial fibrillation: a real-world analysis of German claims data.
BMJ Open
January 2023
Institute of General Practice, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
Objectives: Direct oral anticoagulants (DOACs) were introduced based on randomised controlled trials (RCTs) comparing them to vitamin-K-antagonist (VKA) warfarin. In Germany, almost exclusively phenprocoumon is used as VKA. RCTs with phenprocoumon being absent we analysed the benefits and harms of DOACs and phenprocoumon for patients with atrial fibrillation (AF) in a real-world setting.
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