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October 1, 2013Pharmacogenomics52 citations

Impact of Genotype-Guided Dosing on Anticoagulation Visits for Adults Starting Warfarin: A Randomized Controlled Trial

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DJDaniel E JonasJEJames P. EvansHMHoward L. McLeod

Structured PICO

Does genotype-guided warfarin dosing reduce anticoagulation visits or improve time in therapeutic range in adults starting warfarin?

P
Population
109 adults starting warfarin
I
Intervention
Initial warfarin dosing determined by an algorithm containing genetic (VKORC1 and CYP2C9) plus clinical information
C
Comparator
Initial warfarin dosing determined by an algorithm containing only clinical information
O
Outcome
Number of anticoagulation visits and time in therapeutic range (TTR) over 90 dayssurrogate

Genotype-guided warfarin dosing did not significantly improve time in therapeutic range or reduce the number of anticoagulation visits compared to clinical dosing alone.

Limitations

  • Trial was not powered to detect anything but large differences for utilization and health outcomes

Abstract

AIM: This study aimed to assess the effectiveness of genotype-guided warfarin dosing. PATIENTS TTR: 0.40 vs 0.43, p = 0.59). Fewer emergency visits, hospitalizations, major hemorrhagic events, thrombotic events and deaths occurred in the genetic plus clinical group than in the clinical only group, but these differences were not statistically significant. CONCLUSION: Genotype-guided dosing did not decrease the number of anticoagulation visits or improve TTR. Our trial was not powered to detect anything but large differences for utilization and health outcomes.

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Cite This Study

Jonas et al. (2013) studied this question.

synapsesocial.com/papers/6a1cbb077a95e6b4c589a87dhttps://doi.org/10.2217/pgs.13.145
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