Clinical Pharmacy Services & Research, Department of Pharmacy, Kaiser Permanente Colorado, Aurora, CO 80011, USA.
Hematol Oncol Clin North Am. 2010 Aug;24(4):717-26, viii. doi: 10.1016/j.hoc.2010.05.010.
Although warfarin has been the mainstay of oral anticoagulation therapy for decades, evidence-based methods for improving the quality of warfarin therapy remain underused. The arrival of new anticoagulants that do not require routine laboratory monitoring and lack the significant dietary and drug interaction potential that are seen with warfarin is an important evolutionary step in the management of thromboembolic disease. However, it will be years before the efficacy and long-term safety of these new agents are defined. Newer oral anticoagulants will be more expensive than generic warfarin. This article examines various approaches to optimize the clinical use of warfarin. For patients able to achieve stable anticoagulation control, warfarin remains an important therapeutic option, delivering similar clinical outcomes at a fraction of the cost to the health care system.
尽管华法林作为口服抗凝治疗的主要药物已经有几十年的历史，但在提高华法林治疗质量方面，仍缺乏循证医学方法。新型抗凝药物的出现是血栓栓塞性疾病管理的重要进步，这些药物无需常规实验室监测，且与华法林相比，其潜在的饮食和药物相互作用也较小。然而，这些新型药物的疗效和长期安全性仍需多年时间才能明确。新型口服抗凝药物的价格将高于华法林仿制药。本文探讨了优化华法林临床应用的各种方法。对于能够达到稳定抗凝控制的患者，华法林仍然是一种重要的治疗选择，其临床疗效与成本均优于新型抗凝药物。
