Simplified warfarin dose-response pharmacodynamic models

Seongho Kim, Adam E. Gaweda, Dongfeng Wu, Lang Li, Shesh N. Rai, Michael E. Brier

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Warfarin is a frequently used oral anticoagulant for long-term prevention and treatment of thromboembolic events. Due to its narrow therapeutic range and large inter-individual dose-response variability, it is highly desirable to personalize warfarin dosing. However, the complexity of the conventional kinetic-pharmacodynamic (K-PD) models hampers the development of the personalized dose management. To avert this challenge, we propose simplified PD models for warfarin dose-INR response relationship, which is motivated by ideas from control theory. The simplified models were further applied to longitudinal data of 37 patients undergoing anticoagulation treatment using the standard two-stage approach and then compared with the conventional K-PD models. Data analysis shows that all models have a similar predictive ability, but the simplified models are most parsimonious.

Original languageEnglish (US)
Article number1550001
JournalBiomedical Engineering - Applications, Basis and Communications
Volume27
Issue number1
DOIs
StatePublished - Feb 14 2015

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Keywords

  • Dose-response model
  • Kinetic-pharmacodynamics
  • Mixed-effects model
  • Standard two-stage approach

ASJC Scopus subject areas

  • Biophysics
  • Bioengineering
  • Biomedical Engineering

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