Comparative Studies - Acenocoumarol vs. Warfarin
- Since warfarin with its longer half-life is believed to provide a stable international normalized ratio (INR) compared to shorter acting drugs, studies were carried out to compare the stability of INR with warfarin and acenocoumarol.
- One study found that acenocoumarol and warfarin are comparable in terms of stability of prothrombin time (PT)47 – indicating that the longer half-life of warfarin is not of great clinical significance.
- In other studies investigating the use of acenocoumarol and warfarin in atrial fibrillation, it has been seen that the stability of anticoagulant action of acenocoumarol was better than warfarin.2
- Acenocoumarol provides a greater INR stability compared to warfarin
- Acenocoumarol is twice as potent as warfarin
"…warfarin did not appear to be better than acenocoumarol in the performance of an Anticoagulation Clinic in terms of PTs within the therapeutic range per patient."47
Warfarin or acenocoumarol is better in the anticoagulant treatment of chronic atrial fibrillation?
Lengyel M; SPORTIF-III Altanulmány Vizsgálói. Orv Hetil. 2004 Dec 26;145(52):2619-21.
Study objective: Warfarin has been considered to provide more stable anticoagulant effect than acenocoumarol due to its longer half-life. The aim of this SPORTIF-III (Stroke Prevention Using Oral Thrombin Inhibitor in Atrial Fibrillation III) substudy was to compare acenocoumarol with warfarin in the same group of 74 patients, with chronic atrial fibrillation, who started with warfarin and then changed to acenocoumarol.
Methods: In this prospective study, patients received a 3 month treatment each with warfarin and acenocoumarol.
Conclusion: Acenocoumarol was found to provide greater INR stability, superior efficacy and safety compared to warfarin. Acenocoumarol was twice as potent as warfarin.
Results: The mean number of INR measurements per patient was 5.7 ± 1.2 and 5.4 ± 1.6 respectively for warfarin and acenocoumarol.
- The percentage of subtherapeutic values were not different between the treatments
- There was a good correlation between acenocoumarol and warfarin doses (r = 0.65, p < 0.001), the mean warfarin dose was 5.03 ± 1.99 mg, the mean acenocoumarol dose was 2.5 ± 1.3 mg, the warfarin to acenocoumarol dose ratio was computed to be 2.18 ± 0.78.
The anticoagulation effect stability was superior for acenocoumarol compared to warfarin and the warfarin to acenocoumarol dose ratio was 2.18.