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Master Thesis

La warfarine est-elle plus stable que la fluindione ? : étude rétrospective en soins premiers (étude STAB-AVK)

Abstract : Introduction: Vitamin K antagonists (VKA) are widely used in primary care. In France, fluindione accounted for 82% of the VKA prescribed in 2016 compared to 13% for warfarin. However, warfarin is the standard molecule elsewhere in the world and, thanks to its longer half-life, should be more suitable for chronic treatment. The objectives of our study were to compare these two molecules on their long-term pharmacological stability and on the frequency of biological checks of the International Normalized Ratio (INR). Method: A retrospective study based on data from an Orne (France) laboratory was conducted, regarding adult patients treated with fluindione or warfarin from January 1st, 2014 to December 31st, 2016, regardless of the indication. Treatment stability was assessed by the time in therapeutic range (TTR), calculated using the Rosendaal method from the INRs measured in routine practice. Comparisons between the two groups were lead using multilevel linear regression with univariate and then multivariate analysis with ajustment on age, gender and kidney function. Results: 204 patients were included, 170 treated with fluindione and 34 with warfarin. The mean TTR with fluindione was 68.0% versus 72.0% with warfarin (p=0.085). The mean time between two INRs was 22.8 days with fluindione versus 31.1 days with warfarin (p=0.049). Conclusion: Compared to fluindione, warfarin seems to present benefit in terms of quality of life for patients. We encourage to use warfarin over that of fluindione in primary care.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02482707
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Submitted on : Tuesday, February 18, 2020 - 11:28:14 AM
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  • HAL Id : dumas-02482707, version 1

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Thanh-Tam Quach Hiep. La warfarine est-elle plus stable que la fluindione ? : étude rétrospective en soins premiers (étude STAB-AVK). Médecine humaine et pathologie. 2019. ⟨dumas-02482707⟩

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