Validation of VKORC1 and CYP2C9 genotypes on interindividual warfarin maintenance dose: a prospective study in Chinese patients

Abstract

A pharmacogenetics-based dosing algorithm has been developed for improvement in the time to reach the stable dosing of warfarin. This model may be useful in helping the clinicians to prescribe warfarin with greater safety and efficiency.

Accuracy assessment of pharmacogenetic algorithms for warfarin dose prediction in Chinese patients

“…Algorithms were selected based on the following criteria: the algorithms that included nongenetic or genetic variables not available in our study, and included only a minority of clinical variables, and were based on relatively small clinical populations were excluded; algorithms that were derived from Asian with the consideration of race of each algorithm made up of at least 15% Asians in original populations, and algorithms validated best in Asians were included. This process identified eight algorithms [12][13][14][15][16][17][18][19]. The characteristics and equations of selected algorithms are listed in Supporting Information Tables II and III. Collection of subjects and clinical data.…”

“…Low arterial oxygen saturation <95% and a history of 3 febrile episodes in the preceding year were reported to predict a high CBF in a cohort of Kenyan children with SCD [13]. Reports have also shown a significant correlation between CBF velocities and stroke and age, hemoglobin concentration, and white count [8,14].…”

“…For Chinese patients, the optimal INR might be set at 1.6-2.5, in contrast to the 2.0-3.0 range set in most studies [11]. Several pharmacogenetic algorithms, based on a variety of clinical and genetic parameters including the CYP2C9 and VKORC1 genes as variables, have been proposed based on Asian populations [12][13][14]. Comparison of warfarin dose predictive pharmacogenetic algorithms can be performed to determine the optimal algorithm for our Chinese population.…”

“…In the interest of determining an accurate predictive pharmacogenetic algorithm to promote rational treatment, especially for Chinese outliers, we attempted to assess the predictive ability of published warfarin pharmacogenetic dosing algorithms in Mainland Han Chinese [12][13][14][15][16][17][18][19].…”

Simultaneous Use of Amiodarone Influences Warfarin Maintenance Dose but Is Not Associated with Adverse Events

“…However, this classification is considered adequate in the literature for large studies focusing on the identification of patients on stable doses. 21,[32][33][34][35][36] ■■ Conclusions Simultaneous use of amiodarone influences the warfarin maintenance dose, but it is not associated with adverse events in chronic anticoagulation therapy. Furthermore, no significant interactions with known polymorphisms that modulate warfarin metabolism were identified for the amiodarone effect.…”