口服抗凝药的近期研究进展
近年来，口服抗凝药取得了重大进展，同时也存在一些问题。2015年3月在《Trends in pharmacological sciences》(药理学趋势)杂志刊登了一篇文章，对近期口服抗凝药的研究进展进行了介绍。华法林仍然是目前常用的抗凝药，但是在剂量方面存在非常大的个体差异，且治疗范围较窄。华法林的剂量依赖于个体的遗传因素和环境因素。最近的两项随机对照试验(RCT)在剂量依赖的基因型方面给出了不同的结论，文章对这些不同的结论的原因进行了解释。文章还对新一代口服抗凝剂进行了介绍，并指出它们的效果与华法
近年来，口服抗凝药取得了重大进展，同时也存在一些问题。2015年3月在《Trends in pharmacological sciences》(药理学趋势)杂志刊登了一篇文章，对近期口服抗凝药的研究进展进行了介绍。
华法林仍然是目前常用的抗凝药，但是在剂量方面存在非常大的个体差异，且治疗范围较窄。华法林的剂量依赖于个体的遗传因素和环境因素。最近的两项随机对照试验(RCT)在剂量依赖的基因型方面给出了不同的结论，文章对这些不同的结论的原因进行了解释。文章还对新一代口服抗凝剂进行了介绍，并指出它们的效果与华法林类似，但下一步的工作是需要通过临床试验评价它们的安全性。
Trends Pharmacol Sci. 2015 Mar;36(3):153-63. doi: 10.1016/j.tips.2015.01.003. Epub 2015 Feb 17.
Oral anticoagulation: a critique of recent advances and controversies.
Pirmohamed M1, Kamali F2, Daly AK2, Wadelius M3.
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Abstract
There have recently been significant advances in the field of oral anticoagulation, but these have also led to many controversies. Warfarin is still the commonest drug used for clotting disorders but its use is complicated owing to wide inter-individual variability in dose requirement and its narrow therapeutic index. Warfarin dose requirement can be influenced by both genetic and environmental factors. Two recent randomized controlled trials (RCTs) came to different conclusion regarding the utility of genotype-guided dosing; we critically explore the reasons for the differences. The new generation of oral anticoagulants have been demonstrated to be as efficacious as warfarin, but further work is needed to evaluate their safety in real clinical settings.
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