What is the clinical evidence from this study?

Study design: Meta-Analysis. Population: Thromboembolic disorders, kidney transplantation, and oncological conditions (n=4111). Intervention: VKORC1 and CYP2C9 variant alleles vs. Wild-type individuals. Primary outcome: Weekly warfarin maintenance dose (MD -20.68 mg/week, 95% CI -35.66 to -5.70, p=0.0068).

What does this research mean for the field?

Carriers of VKORC1 or CYP2C9 variant alleles in the Saudi population require a significantly lower weekly warfarin maintenance dose compared to wild-type individuals. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

January 21, 2026CureusOpen Access

Clinical Pharmacogenomic Variants Among the Saudi Population and Their Impact on Drug Response: A Review of Saudi-Based Evidence

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Key result

VKORC1 or CYP2C9 variant carriers require ~21 mg/week less maintenance warfarin versus wild-type Saudi patients.

MD -20.68 mg/week
95% CI -35.66 to -5.70
P=0.0068
n=4,111

Why the study?

The Saudi Arabian population has distinctive characteristics and high consanguinity rates but remains underrepresented in global pharmacogenomic dosing algorithms.

Do pharmacogenomic variants (such as VKORC1 and CYP2C9) reduce warfarin dose requirements and impact drug response in the Saudi Arabian population?

Population

4,111 Saudi Arabian participants across 16 studies

Comparison

Pharmacogenomic variant carriers vs non-carriers

Design

Systematic review and meta-analysis

Authors

AAAyman AlqurainNorthern Border University TAThamer I AlshridhaQassim University SAShahad Al-OtaibiBuraydah Colleges

Discussion

Member takes

Implication

Supports incorporating genotyping into Saudi anticoagulation guidelines; extends prior evidence to this population.

Study Design

Type

Meta-Analysis (n=4,111)

Structured PICO

Do pharmacogenomic variants (such as VKORC1 and CYP2C9) reduce warfarin dose requirements and impact drug response in the Saudi Arabian population?

Population

16 studies encompassing 4,111 Saudi Arabian participants investigating thromboembolic disorders, kidney transplantation, and oncological conditions. The demographic profile reflected a middle-aged population.

Intervention

Pharmacogenomic variant carrier status (e.g., VKORC1, CYP2C9, CYP2C19, CYP3A5)

Comparator

Wild-type genotype

Outcome

Drug dose requirements (specifically weekly warfarin dose), plasma concentrations, therapeutic efficacy, or toxicity eventssurrogate

Main Result

Effect estimate: MD -20.68 mg/week (95% CI -35.66 to -5.70)

p-value: p=0.0068

VKORC1 and CYP2C9 variants significantly reduce warfarin dose requirements in the Saudi population, supporting the integration of genotyping into local anticoagulation guidelines.

Limitations

Significant statistical heterogeneity was observed, particularly within warfarin studies (I2 > 90%)
Mathematical conversion of dosing regimens and estimation of means from medians introduces a potential source of methodological uncertainty
Four included studies were adjudicated as having a serious risk of bias
Limited number of studies available for certain outcomes
Significant statistical heterogeneity (I² > 90%) in warfarin studies
Methodological uncertainty from mathematical conversion of dosing regimens and estimation of means from medians
Four studies had serious risk of bias due to insufficient control of confounding variables and issues with intervention classification
Some studies deviated significantly from Hardy-Weinberg Equilibrium

Cite This Study

Alqurain et al. (2026) conducted a meta-analysis in Thromboembolic disorders, kidney transplantation, and oncological conditions (n=4,111). VKORC1 and CYP2C9 variant alleles vs. Wild-type individuals was evaluated on Weekly warfarin maintenance dose (MD -20.68 mg/week, 95% CI -35.66 to -5.70, p=0.0068). Carriers of VKORC1 or CYP2C9 variant alleles required a significantly lower weekly warfarin maintenance dose (MD -20.68 mg/week) compared to wild-type individuals in the Saudi population.

synapsesocial.com/papers/6a12d5f78f1bac20a09e62cd https://doi.org/10.7759/cureus.101993

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January 21, 2026CureusOpen Access

Clinical Pharmacogenomic Variants Among the Saudi Population and Their Impact on Drug Response: A Review of Saudi-Based Evidence

View Full Paper

Ask AI

Bookmark

Key result

VKORC1 or CYP2C9 variant carriers require ~21 mg/week less maintenance warfarin versus wild-type Saudi patients.

MD -20.68 mg/week
95% CI -35.66 to -5.70
P=0.0068
n=4,111

Why the study?

The Saudi Arabian population has distinctive characteristics and high consanguinity rates but remains underrepresented in global pharmacogenomic dosing algorithms.

Do pharmacogenomic variants (such as VKORC1 and CYP2C9) reduce warfarin dose requirements and impact drug response in the Saudi Arabian population?

Population

4,111 Saudi Arabian participants across 16 studies

Comparison

Pharmacogenomic variant carriers vs non-carriers

Design

Systematic review and meta-analysis

Authors

AAAyman AlqurainNorthern Border University TAThamer I AlshridhaQassim University SAShahad Al-OtaibiBuraydah Colleges

Discussion

Member takes

Implication

Supports incorporating genotyping into Saudi anticoagulation guidelines; extends prior evidence to this population.

Study Design

Type

Meta-Analysis (n=4,111)

Structured PICO

Do pharmacogenomic variants (such as VKORC1 and CYP2C9) reduce warfarin dose requirements and impact drug response in the Saudi Arabian population?

Population

Intervention

Pharmacogenomic variant carrier status (e.g., VKORC1, CYP2C9, CYP2C19, CYP3A5)

Comparator

Wild-type genotype

Outcome

Drug dose requirements (specifically weekly warfarin dose), plasma concentrations, therapeutic efficacy, or toxicity eventssurrogate

Main Result

Effect estimate: MD -20.68 mg/week (95% CI -35.66 to -5.70)

p-value: p=0.0068

VKORC1 and CYP2C9 variants significantly reduce warfarin dose requirements in the Saudi population, supporting the integration of genotyping into local anticoagulation guidelines.

Limitations

Significant statistical heterogeneity was observed, particularly within warfarin studies (I2 > 90%)
Mathematical conversion of dosing regimens and estimation of means from medians introduces a potential source of methodological uncertainty
Four included studies were adjudicated as having a serious risk of bias
Limited number of studies available for certain outcomes
Significant statistical heterogeneity (I² > 90%) in warfarin studies
Methodological uncertainty from mathematical conversion of dosing regimens and estimation of means from medians
Four studies had serious risk of bias due to insufficient control of confounding variables and issues with intervention classification
Some studies deviated significantly from Hardy-Weinberg Equilibrium

Cite This Study

synapsesocial.com/papers/6a12d5f78f1bac20a09e62cd https://doi.org/10.7759/cureus.101993

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