Can we improve monitoring of INR? DAWN User Group Meeting 2014 Jane - - PowerPoint PPT Presentation

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Can we improve monitoring of INR? DAWN User Group Meeting 2014 Jane - - PowerPoint PPT Presentation

Jan 23, 2023 218 likes •465 views

Can we improve monitoring of INR? DAWN User Group Meeting 2014 Jane Skov, Saied Ibrahim, Jrgen Jespersen and Leon Poller Good news High quality anticoagulant treatment is offered in many countries and in different settings, particularly

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Can we improve monitoring of INR?

DAWN User Group Meeting 2014

Jane Skov, Saied Ibrahim, Jørgen Jespersen and Leon Poller

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Good news

High quality anticoagulant treatment is offered in many countries and in different settings, particularly specialized clinics

RE-LY trial

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Historical background

Standardization of the prothrombin time began in 1962 WHO standardization scheme in 1983

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Narrow therapeutic window

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  • 2.0

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time

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  • Poller et al, Thromb Haemost 2009
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  • Poller et al, Thromb Haemost 2009
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Challenge:

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  • Poller, Jespersen and Ibrahim, JTH 2014
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  • Ibrahim, Jespersen and Poller, JTH 2013
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”Predicting clinical events”, presentation by Syd Stewart

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All clinical events

Ibrahim, Jespersen and Poller, JTH 2013

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Ibrahim, Jespersen and Poller, JTH 2013

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”Predicting clinical events”, presentation by Syd Stewart

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”Predicting clinical events”, presentation by Syd Stewart

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Taking up the challenge

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Prospective evaluation of VGR

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About 900 patients attending the clinic Usual care + VGR monitoring Usual care Randomisation Clinical events (EAA/ISTH evaluation form) TIR Average number of days between visits Number of high INRs and low INRs 1-year follow up divided into 3-month intervals

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Subgroup analysis

Patients new to anticoagulant treatment and patients in long-term treatment (> 6 months) Patients with arterial and venous thrombotic disease Younger and older patients

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Larger prospective trial

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