Back to Search
Start Over
Anticoagulation endpoints with clinical implementation of warfarin pharmacogenetic dosing in a real-world setting: A proposal for a new pharmacogenetic dosing approach.
- Source :
- Clinical Pharmacology & Therapeutics; May2017, Vol. 101 Issue 5, p675-683, 9p
- Publication Year :
- 2017
-
Abstract
- Achieving therapeutic anticoagulation efficiently with warfarin is important to reduce thrombotic and bleeding risks and is influenced by genotype. Utilizing data from a diverse population of 257 patients who received VKORC1 and CYP2C9 genotype-guided warfarin dosing, we aimed to examine genotype-associated differences in anticoagulation endpoints and derive a novel pharmacogenetic nomogram to more optimally dose warfarin. We observed significant differences across patients with 0, 1, or ≥2 reduced-function VKORC1 or CYP2C9 alleles, respectively, in time to achieve therapeutic international normalized ratio (INR) (7.8 ± 5.8, 7.2 ± 4.7, and 5.4 ± 4.6 days, P = 0.0004) and mean percentage of time in therapeutic range in the first 28 days (22.2, 27.8, and 32.2%, P = 0.0127) with use of existing pharmacogenetic algorithms. These data suggest that more aggressive dosing is necessary for patients with 0 to 1 VKORC1/CYP2C9 variants to more efficiently achieve therapeutic anticoagulation. Herein, we provide a novel kinetic/pharmacodynamic-derived dosing nomogram optimized for a heterogeneous patient population. [ABSTRACT FROM AUTHOR]
- Subjects :
- PHARMACOGENOMICS
WARFARIN
ANTICOAGULANTS
HEMORRHAGE risk factors
PHARMACOKINETICS
Subjects
Details
- Language :
- English
- ISSN :
- 00099236
- Volume :
- 101
- Issue :
- 5
- Database :
- Complementary Index
- Journal :
- Clinical Pharmacology & Therapeutics
- Publication Type :
- Academic Journal
- Accession number :
- 122560691
- Full Text :
- https://doi.org/10.1002/cpt.558