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Warfarin anticoagulation superior to phenprocoumon
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ISTH 2009
Treatment with warfarin led to better anticoagulant control compared with phenprocoumon, according to the results of a randomized controlled trial.
Phenprocoumon (Liquamar, Organon) has been discontinued in the United States.
Yvonne van Leeuwen, PhD, of the department of clinical epidemiology at the Leiden University Medical Center in the Netherlands, presented the results of a study comparing warfarin with phenprocoumon at the XXII Congress of the International Society on Thrombosis and Hemostasis.
The trial included patients who were initiating anticoagulant therapy and those already assigned the vitamin K antagonist acenocoumarol who were switching to a new therapy. Patients were randomly assigned to warfarin (n=250) or phenprocoumon (n=254). An equal numbers of patients initiating therapy and switching therapies were assigned to each of the treatment regimens.
Follow-up was until the end of treatment or six months. The primary outcome measure was the percentage of time spent within therapeutic ranges.
Overall, the mean percentage of time spent within the therapeutic ranges was 74.6% for those assigned warfarin compared with 65.3% for those assigned phenprocoumon. The difference between treatments was greater in patients switching therapies (78.3% for patients assigned to warfarin vs. 57.6% for patients assigned to phenprocoumon) than in those patients initiating therapy (70.5% vs. 73.7%).
“We were surprised about the effects in ‘switchers’ because it is not seen in patients initiating oral anticoagulant treatment,” van Leeuwen said. “We were especially surprised about the high percent of time spent above the target range in phenprocoumon patients.”
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