An acenocoumarol dose algorithm based on a South-Eastern European population

Abstract

We have developed and validated an accurate algorithm for prediction of the stable therapeutic dose of acenocoumarol in a Romania population.

Estimation and Validation of Acenocoumarol Dosing Algorithms In Bulgarian Patients with Cardiovascular Diseases

“…The combination of two polymorphisms in CYP2C9 and VKORC1 could explain between 25 and 40% (20-25% for VKORC1 and 5-15% for CYP2C9) of the variability in therapeutic doses of coumarins as acenocoumarol [15,16], whereas the combination of demographic, clinical and genetic factors explains 45-55% of the total variation in the optimal therapeutic dose [1,8,[17][18][19][20][21][22].…”

“…The pharmacokinetics and pharmacodynamics of this drug are affected by functional polymorphisms in both CYP2C9 and VKORC1 genes [10,11]. The polymorphic variants in both genes independently correlate with the clinical dose of acenocoumarol [12] and the time required to achieve an effective dose for stable anticoagulation [12][13][14].The combination of two polymorphisms in CYP2C9 and VKORC1 could explain between 25 and 40% (20-25% for VKORC1 and 5-15% for CYP2C9) of the variability in therapeutic doses of coumarins as acenocoumarol [15,16], whereas the combination of demographic, clinical and genetic factors explains 45-55% of the total variation in the optimal therapeutic dose [1,8,[17][18][19][20][21][22].There are several pharmacogenetic models found in the literature for predicting the optimal warfarin dose for various population groups. However, there are limited papers on optimal acenocoumarol dose.…”

Acenocoumarol Pharmacogenetic Dosing Algorithms and Their Application in Two Bulgarian Patients with Low Anticoagulant Requirements

“…We searched the pharmacogenetics-based models including clinical and genetic data by Pub Med and identified eight pharmacogenetic acenocoumarol dosing algorithms (Borobia et al 2012;Cerezo-Manchado et al 2013;Krishna Kumar et al 2013;Markatos et al 2008;Pop et al 2013;Rathore et al 2012;van Schie et al 2011;Wolkanin-Bartnik et al 2013). They included both clinical variables (such as age, gender, BMI, and others) and genetic factors such as polymorphic variants in the genes CYP2C9, VKORC1, ApoE, and CYP4F2.…”

“…The following data were included in the regression model: age, sex, body mass index (BMI), diagnosis of deep venous thrombosis (DVT), and diagnosis of atrial fibrillation (AF). The predicted acenocoumarol dose was then back-transformed (Pop et al 2013).…”

Genotype-phenotype correlations in patients treated with acenocoumarol / Corelaţii genotip-fenotip la pacienţii trataţi cu acenocumarol

“…), acute intercurrent pathologies (fever, sepsis, acute decompensated heart failure, diarrhea, etc. ), and concomitant medication (6,7).…”