Pharmacogenetic testing for clopidogrel and warfarin holds promise for individualizing therapy, though its clinical utility remains limited pending results from ongoing large randomized trials.
Does pharmacogenetic testing improve the safety and efficacy of clopidogrel and warfarin therapy?
While pharmacogenetic testing for clopidogrel and warfarin is technologically feasible and supported by guidelines, its routine clinical implementation awaits definitive evidence from ongoing large randomized trials.
PURPOSE OF REVIEW: To review the most promising genetic markers associated with the variability in the safety or efficacy of warfarin and clopidogrel and highlight the verification and validation initiatives for translating clopidogrel and warfarin pharmacogenetic tests to clinical practice. RECENT FINDINGS: Rapid advances in pharmacogenetics, continuous decrease in genotyping cost, development of point-of-care devices and the newly established clinical genotyping programs at several institutions hold the promise of individualizing clopidogrel and warfarin based on genotype. Guidelines have been established to assist clinicians in prescribing clopidogrel or warfarin dose based on genotype. However, the clinical utility of clopidogrel and warfarin is still limited. Accordingly, large randomized clinical trials are underway to define the role of clopidogrel and warfarin pharmacogenetics in clinical practice. SUMMARY: Pharmacogenetics has offered compelling evidence toward the individualization of clopidogrel and warfarin therapies. The rapid advances in technology make the clinical implementation of clopidogrel and warfarin pharmacogenetics possible. The clinical genotyping programs and the ongoing clinical trials will help in overcoming some of the barriers facing the clinical implementation of clopidogrel and warfarin pharmacogenetics.
Shahin et al. (Fri,) conducted a review in Patients requiring clopidogrel or warfarin therapy. Pharmacogenetic testing was evaluated. Pharmacogenetic testing for clopidogrel and warfarin holds promise for individualizing therapy, though its clinical utility remains limited pending results from ongoing large randomized trials.