Research Highlight: Increasing Effectiveness and Decreasing the Risks of Blood Thinners

Dr. Nibal Chamoun’s interdisciplinary research is making anticoagulants much safer.

By Irina du Quenoy

Being a faculty member at the School of Pharmacy nourishes her research, says Dr. Chamoun.

As agents that are used to prevent the formation of blood clots, anticoagulants obviously have myriad applications in the treatment of patients. “They’re used to treat and prevent serious complications for a wide range of common conditions,” says LAU School of Pharmacy Clinical Assistant Professor Nibal Chamoun. These include “stroke prevention, venous thromboembolic events, myocardial infarctions, hospital thromboprophylaxis … and the list goes on!”

The widespread use of anticoagulants in the treatment of serious conditions is complicated by the fact that they are “high risk medications that require patient-specific and disease-specific dosage and regimen adjustments,” Dr. Chamoun notes. Moreover, “if not used properly, they can result in serious bleeding complications.” It is this risky side of anticoagulants that has driven Dr. Chamoun’s research, inspiring her to continually search for ways to make anticoagulant therapy as safe as possible, through projects often carried out as part of a team with other researchers, often involving more than one institution both in and outside Lebanon. 

For example, when treating patients with chronic liver disease who are at risk of high bleeding and clotting, “clinicians traditionally opt to omit giving anticoagulant drugs for thromboprophylaxis because of what they see as a high risk of bleeding, which is actually a very subjective criterion,” Dr. Chamoun explains. “Our research [the results of which were recently published in Current Medical Research and Opinion] found that using the bleeding risk score developed by the International Medical Prevention Registry on Venous Thromboembolism (IMPROVE) gives the clinician an objective tool to decide whether or not to recommend anticoagulation prophylaxis.”

In another recent study, published by the Journal of Thrombosis and Thrombolysis, Dr. Chamoun and several coauthors demonstrated that “getting patients to the target level of blood thinning very quickly is not always a good thing,” in terms of the patient’s safety after they’ve been discharged from the hospital. “We found that using a slow and steady approach to thinning the blood with vitamin K antagonists, such as warfarin or acenocoumarol, is the safest way to go.”

LAU’s School of Pharmacy promotes a research approach in which faculty draw inspiration for their research from actual clinical practice.  At LAU Medical Center-Rizk Hospital, Dr. Chamoun practices pharmacy in the Cardiology and Cardiac Intensive Care units, a practice that is directly reflected in research she has recently published with the Journal Medical Libanais. In the paper, she explains, “we aggregated our experience with a series of patients who underwent the procedure,” focusing on patient follow-up and reviewing the literature on the “optimal antithrombotic therapy that should be offered to these patients to prevent complications.”

Being a faculty member at the SOP “nourishes my research,” Dr. Chamoun shares. “My students and patients are a driving force for me to be up-to-date and critical of the literature. And it is often through in-depth reading that I come upon unanswered questions that need further research.”

Moreover, she says, “practicing at LAU Medical Center-Rizk Hospital affords me the opportunity to work alongside experienced and skilled clinicians who have been wonderful to collaborate with. Collaboration with my colleagues from the LAU School of Pharmacy and the School of Medicine has definitely enriched my research experience and output.”