Warfarin Dosing According to the Genotype-guided Algorithm is Most Beneficial in Patients With Atrial Fibrillation: A Randomized Parallel Group Trial

Therapeutic Drug Monitoring
Ksenija Makar-AušpergerNada Bozina

Abstract

Observational studies have indicated potential benefits of CYP2C9- and VKORC1-guided dosing of warfarin but randomized clinical trials have resulted in contradictory findings. One of the reasons for contradiction may be the negligence of possible differences between warfarin indications. This study aims to determine efficacy and safety of genotype-guided and clinically guided dosing of warfarin in atrial fibrillation (AF), deep-vein thrombosis (DVT), and pulmonary embolism (PE) within the first 5 days after the introduction of therapy. In this single-center, single-blinded, randomized, controlled trial including patients of both sexes, ≥18 years of age, and diagnosed with AF, DVT, or PE, a total of 205 consecutive patients were allocated into the group where warfarin therapy was genotype-guided pharmacogenetics guided (PHG), and where it was adjusted according to the clinical parameters non pharmacogenetics guided (NPHG). Genotyping of CYP2C9*2, *3, and VKORC1 was performed using the real-time polymerase chain reaction method. The primary outcomes were the percentage of time in the therapeutic international normalized ratio (INR) (2.0-3.0) range and the percentage of patients who achieved a stable anticoagulation defined as the...Continue Reading

References

Oct 16, 1999·Nature·B FisslthalerR Busse
Feb 7, 2001·Chest·M N LevineC Kearon
Aug 15, 2001·Clinical Pharmacology and Therapeutics·R LoebsteinD Ezra
Oct 27, 2001·Circulation Research·I Fleming
Mar 7, 2003·Clinical Pharmacology and Therapeutics·Harumi TakahashiHirotoshi Echizen
Aug 15, 2003·The New England Journal of Medicine·Clive KearonUNKNOWN Extended Low-Intensity Anticoagulation for Thrombo-Embolism Investigators
Nov 26, 2003·Progress in Lipid Research·Arthur A SpectorNeal L Weintraub
Mar 23, 2004·The Journal of Histochemistry and Cytochemistry : Official Journal of the Histochemistry Society·Ahmed E EnayetallahDavid F Grant
Jul 3, 2004·BMJ : British Medical Journal·Munir PirmohamedAlasdair M Breckenridge
Dec 8, 2004·Archives of Biochemistry and Biophysics·Martin Spiecker, James K Liao
Sep 15, 2005·Clinical Medicine & Research·Michael A HillmanJames K Burmester
Feb 24, 2006·Hypertension·Ingrid Fleming, Rudi Busse
Dec 13, 2006·Thrombosis Research·Tong Yin, Toshiyuki Miyata
Jan 16, 2007·Drug Metabolism and Disposition : the Biological Fate of Chemicals·Tracy C DelozierJoyce A Goldstein
Jun 15, 2007·Pharmacogenetics and Genomics·Loes E VisserBruno H Ch Stricker
Nov 27, 2009·Pharmacogenetics and Genomics·Ryan P OwenRuss B Altman
Sep 9, 2011·Clinical Pharmacology and Therapeutics·J A JohnsonUNKNOWN Clinical Pharmacogenetics Implementation Consortium
Oct 22, 2013·JAMA : the Journal of the American Medical Association·UNKNOWN World Medical Association
Nov 21, 2013·The New England Journal of Medicine·Stephen E KimmelUNKNOWN COAG Investigators
Nov 21, 2013·The New England Journal of Medicine·Munir PirmohamedUNKNOWN EU-PACT Group
May 3, 2014·The New England Journal of Medicine·Stephen E KimmelUNKNOWN COAG Investigators
May 3, 2014·The New England Journal of Medicine·Larisa H CavallariMinoli A Perera
May 8, 2014·The New England Journal of Medicine·Anke H Maitland-van der ZeeUNKNOWN EU-PACT Group
Jul 18, 2015·Therapeutic Drug Monitoring·Kaitlyn ShawUNKNOWN CPNDS Clinical Recommendation Group
Jan 7, 2016·BMJ Quality Improvement Reports·Rebecca DyarBethannie McIntyre
Jan 24, 2017·Pharmacogenomics·Ming-Shien WenMing Ta Michael Lee

❮ Previous
Next ❯

Related Concepts

Related Feeds

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.

Atrial Filbrillation

Atrial fibrillation refers to the abnormal heart rhythm characterized by rapid and irregular beating of the atria. Here is the latest research.