Coagulation monitoring of VKA treatment and the benefits of INR self-testing

• Due to a narrow therapeutic window, individually varying half-lives and nutrition-dependent blood levels of available VKAs, coagulation monitoring is key to ensure an effective and safe therapy for you
• Coagulation is measured using the International Normalized Ratio (INR) value, and regular monitoring of the INR level is important to determine if your anticoagulant treatment dose needs to be adjusted
• INR self-testing with CoaguChek enables you to monitor your INR at home and share your results with your doctor, meaning therapy decisions can be made with minimal disruption to your everyday life

Anticoagulant treatment can be prescribed for a number of different conditions. Understanding your treatment and the tools available can help you gain better control of your anticoagulation therapy. Coagulation monitoring is an essential part of treatment, and the use of INR self-testing can help you to spend less time on appointments and more time on what matters to you.

The human body has a complex mechanism called coagulation that causes blood to clot if a wound occurs. Under normal circumstances, this is desirable, as it allows the body to heal itself. Yet in some clinical conditions, coagulation can cause unwanted blood clots that may lead to complications and can be life-threatening. Oral anticoagulants, such as warfarin and phenprocoumon, are used to prevent blood clots and are often referred to as "blood thinners".

Anticoagulants are commonly prescribed for the following conditions:^1-3

• Atrial fibrillation (irregular heartbeat)
• Mechanical heart valves
• Stroke
• Venous thromboembolism
• Thrombophilia (tendency to cause blood clots)
• Moderate-to-high degree of mitral valve stenosis

When prescribed anticoagulation therapy, such as the use of a vitamin K antagonist (VKA), taking the correct dose is crucial for effective treatment. The correct dose is established by measuring how long it takes your blood to clot. This is called the International Normalized Ratio (INR).⁴ An INR of 1 is normal in healthy individuals who are not taking anticoagulants.⁵ An INR of 2 means that your blood takes twice as long to clot as normal.⁵

The therapeutic INR range for patients on anticoagulation therapy can vary depending on the indication VKAs are prescribed for. However, the target range is commonly between 2.0–3.0.^5-7 If the INR is too low, there is an increased risk of blood clots that can lead to stroke.^8,9 If the INR is too high, there is an increased risk of bleeding.⁸ Regularly monitoring INR levels is important to help determine if your dose needs to be adjusted. Your doctor will provide you with a target INR range. For people taking VKAs, which include warfarin, the target INR typically ranges from 2 to 3, but may be different depending on the patient and his or her condition.^5-7

Considerations

• VKAs belong to the group of most frequently used drugs worldwide¹⁰
• Must be regularly monitored¹⁰
• May be prescribed for a period of weeks, months, or lifelong

How it's administered

• Oral tablet

Available VKAs

• Warfarin
• Phenprocoumon
• Acenocoumarol

It is important to keep your blood clotting time within the range prescribed by your doctor. You may need to take your anticoagulant for a few weeks, months, or even for the rest of your life. But no matter how long, your levels need to be regularly measured, and that’s where INR self-testing is a great benefit.

At-home testing with an INR machine can give you better control of your medication than testing at a laboratory or doctor’s office, with more time in your therapeutic range.^11-16 INR monitoring at home only requires a drop of blood, and results are available in about a minute.¹⁷ Results can either be reported to your doctor or nurse, who will adjust your dose for you, or you can learn how to adjust the dose yourself. Have peace of mind that you know your INR value when needed, at home or away.

The CoaguChek® INRange and CoaguChek® XS systems are easy-to-use INR self-testing meters that give you fast and accurate results without having to visit the clinic.^18,19 Your doctor will be able to receive and monitor your results, so when your dose does need changing, you can find out sooner.

More freedom: Test your INR anywhere and anytime with immediate results that are comparable to those you would get from the lab.^18-19  At-home INR testing can lead to fewer visits to the laboratory, no waiting for test results, and fewer calls or visits to your doctor for dose adjustment decisions.^11,20,21

More control: Gain better control of your anticoagulation therapy. Compared to having your INR values tested in the laboratory or anticoagulation clinic, INR self-testing can also lead to more time in your therapeutic range and fewer incidents of very high or low INR values.^12,15,16,22

Better care: Studies show that INR self-testing can lead to improved health and quality of life and better treatment satisfaction.^{11-13,15,23-26}