Key result
CYP2C9 genotype-guided warfarin therapy increased time in the therapeutic range (80.4% vs 63.4%, P<0.001) and reduced minor bleeding (3.2% vs 12.5%, P<0.02) compared to a standard algorithm.
Why the study?
Does CYP2C9 genotype-guided warfarin prescribing improve the efficacy and safety of anticoagulation compared to a standard algorithm in patients requiring warfarin?
Population
191 patients requiring warfarin anticoagulation (n=191)
Comparison
Warfarin dosing guided by CYP2C9… vs Warfarin dosing guided by a validated standard…
Design
RCT, Randomly assigned
Authors
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Supports CYP2C9-guided warfarin dosing in practice; confirms RCT-level benefits for anticoagulation control.
RCT (n=191)
Randomized
Does CYP2C9 genotype-guided warfarin prescribing improve the efficacy and safety of anticoagulation compared to a standard algorithm in patients requiring warfarin?
Absolute Event Rate: 80.4% vs 63.4%
p-value: p=<0.001
CYP2C9 genotype-guided warfarin dosing significantly reduces the time to therapeutic INR and stable anticoagulation while increasing time in therapeutic range and reducing minor bleeding compared to standard dosing.
Caraco et al. (2007) conducted an RCT in Patients requiring warfarin anticoagulation (n=191). CYP2C9 genotype-adjusted warfarin algorithm vs. Validated algorithm ('average-dose' protocol) was evaluated on Time within the therapeutic range (p=<0.001). CYP2C9 genotype-guided warfarin therapy increased time in the therapeutic range (80.4% vs 63.4%, P<0.001) and reduced minor bleeding (3.2% vs 12.5%, P<0.02) compared to a standard algorithm.
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