What question did this study set out to answer?

To assess the effect of daily low-dose oral vitamin K supplementation on reducing fluctuations in international normalized ratios (INRs) in patients receiving warfarin therapy.

November 23, 2005Pharmacotherapy The Journal of Human Pharmacology and Drug Therapy

Low‐Dose Vitamin K to Augment Anticoagulation Control

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Why the study?

Does daily low-dose oral vitamin K supplementation reduce variations in the international normalized ratios (INRs) in patients taking warfarin with unexplained fluctuations?

Key Points

To assess the effect of daily low-dose oral vitamin K supplementation on reducing fluctuations in international normalized ratios (INRs) in patients receiving warfarin therapy.
Retrospective analysis conducted in an outpatient anticoagulation clinic within a private hematology practice.
Evaluated 8 patients (3 men, 5 women, aged 45–79 years) experiencing unexplained INR fluctuations who received daily oral vitamin K starting at 100 µg/day.
INR fluctuations decreased across nearly all patients, showing a significant reduction in INR standard deviation (p < 0.05).
The percentage of INRs within 0.2 units of the target range increased from 32% to 57% (a 76% relative increase), accompanied by a similar improvement in time in therapeutic range.

Structured PICO

Does daily low-dose oral vitamin K supplementation reduce variations in the international normalized ratios (INRs) in patients taking warfarin with unexplained fluctuations?

Population

8 patients (3 men, 5 women), aged 45-79 years, receiving anticoagulant therapy with warfarin, whose INRs had been fluctuating for reasons not associated with identifiable changes in diet, warfarin dosage, activity level, illness, or changes in drug therapy.

Intervention

Daily supplementation with oral vitamin K, starting with 100 microg/day

Comparator

Pre-supplementation period (baseline)

Outcome

Variations in the international normalized ratios (INRs) / INR standard deviationsurrogate

Daily low-dose oral vitamin K supplementation may improve INR stability and time in therapeutic range in warfarin-treated patients with unexplained INR fluctuations.

Limitations

Small series of selected patients
Retrospective analysis

Discussion

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Implication

May support low-dose vitamin K for INR stability in select warfarin patients; hypothesis-generating and requires randomized confirmation before practice change.

Cite This Study

Reese et al. (2005) studied this question.

synapsesocial.com/papers/6a74c35254045e727a090f45 https://doi.org/10.1592/phco.2005.25.12.1746

Topics

Anticoagulation in AF

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Implication

May support low-dose vitamin K for INR stability in select warfarin patients; hypothesis-generating and requires randomized confirmation before practice change.

Low‐Dose Vitamin K to Augment Anticoagulation Control

Key Points

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Topics

Low‐Dose Vitamin K to Augment Anticoagulation Control

Key Points

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider