Replacement of traditional prothrombin time monitoring with the new Fiix prothrombin time increases the efficacy of warfarin without increasing bleeding. A review article

Páll Torfi Önundarson*, Ragnar Palsson, Daniel M. Witt, Brynja R. Gudmundsdottir

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

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Abstract

The antithrombotic effect of vitamin K antagonists (VKA) depends on controlled lowering of the activity of factors (F) II and X whereas reductions in FVII and FIX play little role. PT-INR based monitoring, however, is highly influenced by FVII, which has the shortest half-life of vitamin K-dependent coagulation factors. Hence, variability in the anticoagulant effect of VKA may be partly secondary to an inherent flaw of the traditional monitoring test itself. The Fiix prothrombin time (Fiix-PT) is a novel test that is only sensitive to reductions in FII and FX and is intended to stabilize the VKA effect. Two clinical studies have now demonstrated that when warfarin is monitored with the Fiix-PT based normalized ratio (Fiix-NR) instead of PT-INR, anticoagulation is stabilized and less testing and fewer dose adjustments are needed. Furthermore, the relative risk of thromboembolism was reduced by 50–56% in these studies without an increase in major bleeding.

Original languageEnglish
Article number72
Pages (from-to)72
JournalThrombosis Journal
Volume19
Issue number1
DOIs
Publication statusPublished - 15 Oct 2021

Bibliographical note

Publisher Copyright:
© 2021, The Author(s).

Supported by the RANNIS technology development fund (The Icelandic Center for Research, [email protected]). The funding source had no contribution to the scientific work or writing of the text.

Other keywords

  • Fiix
  • Monitoring
  • Oral anticoagulation
  • Prothrombin time
  • Warfarin

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