Key result
Novel Indian warfarin pharmacogenetic dosing algorithm correlates well with established Gage and IWPC models.
Why the study?
The study was conducted to develop and validate a warfarin pharmacogenetic dose optimization algorithm considering CPIC recommendations for Asian ethnicity populations.
Does a newly developed genotype-guided warfarin dosing algorithm accurately predict warfarin dose requirements in the Indian population?
Observational (n=300)
Does a newly developed genotype-guided warfarin dosing algorithm accurately predict warfarin dose requirements in the Indian population?
A newly developed pharmacogenetic warfarin dosing algorithm for the Indian population demonstrated good correlation with established Western algorithms and high accuracy in identifying patient sensitivity to warfarin.
Answers are grounded in this paper and cite their sources.
Should not yet change practice; leaves open need for prospective validation in Indians.
OBJECTIVES: A study was conducted to develop and validate the warfarin pharmacogenetic dose optimization algorithm considering the clinical pharmacogenetic implementation consortium (CPIC) recommendations for the Asian ethnicity population. METHODS: The present prospective observational study recruited warfarin-receiving patients. We collected a three ml blood sample for VKORC1, CYP2C9*2, CYP2C9*3, and CYP4F2 polymorphism assessment during the follow-up visits. Clinical history, sociodemographic and warfarin dose details were noted. RESULTS: The study recruited 300 patients (250 in derivation and 50 in validation timed cohort) receiving warfarin therapy. The baseline characteristics were similar in both cohorts. BMI, presence of comorbidity, VKORC1, CYP2C9*2, and CYP2C9*3 were identified as covariates significantly affecting the warfarin weekly maintenance dose (p<0.001 for all) and the same were included in warfarin pharmacogenetic dose optimization algorithm building. The algorithm built-in the present study showed a good correlation with Gage (r=0.57, p<0.0001), and IWPC (r=0.51, p<0.0001) algorithms, widely accepted in western side of the globe. The receiver operating characteristic curve analysis showed a sensitivity of 73 %, a positive predictive value of 96 %, and a specificity of 89 %. The algorithm correctly identified the validation cohort's warfarin-sensitive, intermediate reacting, and resistant patient populations. CONCLUSIONS: Validation and comparisons of the warfarin pharmacogenetic dose optimization algorithm have made it ready for the clinical trial assessment.
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Anand et al. (2023) conducted an observational in Patients receiving warfarin therapy (n=300). Warfarin pharmacogenetic dose optimization algorithm vs. Gage and IWPC algorithms was evaluated on Correlation with Gage and IWPC algorithms (r=0.57 (Gage), r=0.51 (IWPC), p=<0.0001). A newly developed warfarin pharmacogenetic dosing algorithm for the Indian population showed good correlation with Gage and IWPC algorithms.
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