Key result
A 10 mg loading dose of warfarin compared to 5 mg did not significantly increase the proportion of patients with a therapeutic INR on day five when requiring two consecutive measures (RR 0.86).
Why the study?
Do specific warfarin loading doses or regimens improve time to stable INR and reduce adverse events in patients newly initiated on warfarin?
Population
1,340 patients newly initiated on warfarin (pooled from 11 RCTs)
Comparison
Various warfarin initiation strategies vs Alternative warfarin initiation strategies
Design
Systematic_review
Authors
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10 mg warfarin loading does not hasten therapeutic INR by day 5 versus 5 mg; challenges higher-dose initiation and supports lower-dose optimization trials.
Systematic Review (n=1,340)
Do specific warfarin loading doses or regimens improve time to stable INR and reduce adverse events in patients newly initiated on warfarin?
Relative Risk: 0.86 (95% CI 0.62–1.19)
p-value: p=0.37
There remains considerable uncertainty regarding the optimal loading dose (10 mg vs 5 mg) for warfarin initiation, though lower or age-adjusted doses appear more appropriate in elderly patients.
Heneghan et al. (2010) conducted a systematic review in Patients commencing anticoagulation with warfarin (n=1,340). 10 mg warfarin loading dose vs. 5 mg warfarin loading dose was evaluated on Proportion of patients with therapeutic INR at day 5 (two consecutive INRs) (RR 0.86, 95% CI 0.62 to 1.19, p=0.37). A 10 mg loading dose of warfarin compared to 5 mg did not significantly increase the proportion of patients with a therapeutic INR on day five when requiring two consecutive measures (RR 0.86).
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