What question did this study set out to answer?

To determine whether pharmacogenetic-based dosing improves anticoagulation control compared to standard dosing during the initiation of warfarin therapy.

November 19, 2013New England Journal of MedicineOpen Access

A Randomized Trial of Genotype-Guided Dosing of Warfarin

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Why the study?

Does genotype-guided dosing of warfarin improve the percentage of time in the therapeutic INR range in patients initiating warfarin therapy?

Key Points

To determine whether pharmacogenetic-based dosing improves anticoagulation control compared to standard dosing during the initiation of warfarin therapy.
Randomized clinical trial comparing genotype-guided warfarin dosing against standard dosing regimens (ClinicalTrials.gov number, NCT01119300).
Assessed percentage of time spent within the therapeutic international normalized ratio (INR) range during the initiation phase of therapy.
Pharmacogenetic-based dosing achieved a higher percentage of time in the therapeutic INR range compared to standard dosing during warfarin initiation.

Structured PICO

Does genotype-guided dosing of warfarin improve the percentage of time in the therapeutic INR range in patients initiating warfarin therapy?

Population

Patients initiating warfarin therapy

Intervention

Genotype-guided (pharmacogenetic-based) dosing of warfarin

Comparator

Standard dosing of warfarin

Outcome

Percentage of time in the therapeutic INR rangesurrogate

Genotype-guided dosing of warfarin improves the time in therapeutic INR range during therapy initiation compared to standard dosing.

Discussion

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Implication

Supports genotype-guided warfarin dosing at initiation; confirms RCT benefit for TTR over standard dosing.

Cite This Study

Pirmohamed et al. (2013) studied this question.

synapsesocial.com/papers/69da216d0d540cafc58386b6 https://doi.org/10.1056/nejmoa1311386

Topics

Atrial fibrillation Persistent AF management Anticoagulation in AF

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A Randomized Trial of Genotype-Guided Dosing of Warfarin

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

A Randomized Trial of Genotype-Guided Dosing of Warfarin

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider