Effect of warfarin sodium therapy on excretion of 4‐carboxy‐L‐glutamic acid in scleroderma, dermatomyositis, and myositis ossificans progressiva

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Abstract
The effect of warfarin sodium on excretion of calcium, phosphorus, and 4‐carboxy‐L‐glutamic acid (Gla) was studied in 5 patients with ectopic calcification (2 with scleroderma, 1 with dermatomyositis, and 2 with myositis ossificans progressiva). Warfarin reduced urinary excretion of Gla in all patients, but no changes in calcium and phosphorus excretion or in objective parameters of calcinosis were observed during 6–36 months of treatment. Two patients experienced hemorrhagic complications during therapy, emphasizing a hazard of long‐term anticoagulation treatment. Since ectopic calcium deposits contain Gla‐rich protein, suppression of Gla synthesis by warfarin sodium over a longer period may prevent deposition and allow removal of existing calcinosis deposits.