Why the study?
Does a population-specific pharmacogenetic-based warfarin dosing algorithm improve dosing accuracy compared to the IWPC algorithm in Brazilian patients?
Does a population-specific pharmacogenetic-based warfarin dosing algorithm improve dosing accuracy compared to the IWPC algorithm in Brazilian patients?
A population-specific pharmacogenetic warfarin dosing algorithm improves dosing prediction accuracy for highly admixed Brazilian patients compared to standard general algorithms.
May enhance warfarin dosing accuracy in Brazilian patients; leaves open need for prospective outcome validation before clinical use.
BACKGROUND: The main aims of the present study were to develop a pharmacogenetic-based warfarin dosing algorithm and to validate it in a highly admixed population. MATERIALS & METHODS: We included two patient cohorts treated with warfarin (first cohort, n = 832; and second cohort, n = 133). RESULTS: Our algorithm achieved a determination coefficient of 40% including the variables age, gender, weight, height, self-declared race, amiodarone use, enzyme inducers use, VKORC1 genotypes and predicted phenotypes according to CYP2C9 polymorphisms. CONCLUSION: Data suggest that our developed algorithm is more accurate than the IWPC algorithm when the application is focused on patients from the Brazilian population. Population-specific derivation and/or calibration of warfarin dosing algorithms may lead to improved performance compared with general use dosing algorithms currently available. Original submitted 26 November 2014; Revision submitted 9 April 2015.
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Santos et al. (2015) studied this question.
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