Key result
A pharmacogenetic algorithm including CYP2C9, VKORC1, and APOE explained 56.6% of the variability in stable acenocoumarol dose, correctly classifying 67% of patients within a 20% deviation.
Why the study?
Does a pharmacogenetic dosing algorithm improve the accuracy of stable acenocoumarol dose prediction compared to a clinical algorithm in patients with atrial fibrillation or venous thromboembolism?
Observational (n=164)
Does a pharmacogenetic dosing algorithm improve the accuracy of stable acenocoumarol dose prediction compared to a clinical algorithm in patients with atrial fibrillation or venous thromboembolism?
A pharmacogenetic algorithm incorporating CYP2C9, VKORC1, and APOE polymorphisms improves the accuracy of acenocoumarol dose prediction compared to clinical factors alone.
May refine acenocoumarol dosing predictions; hypothesis-generating pending randomized outcome trials.
AIM: To develop an acenocoumarol (ACN) dosing algorithm for patients with atrial fibrillation or venous thromboembolism, considering the influence on the stable ACN dose of clinical factors and gene polymorphisms, including CYP2C9*2/*3, VKORC1, CYP4F2*3, ABCB1, APOE, CYP2C19*2/*17, and GGCX. METHODS AND RESULTS: A retrospective observational study was carried out to obtain clinical and pharmacogenetic dose algorithms by multiple linear regression of results in a cohort of 134 patients under treatment with a stable ACN dose for atrial fibrillation or venous thromboembolism and to test them in an independent validation cohort of 30 patients.The pharmacogenetic dosing algorithm included CYP2C9, VKORC1, and APOE, which explained 56.6% of the variability in the stable ACN dose. Lower deviation from the stable dose and increased accuracy were shown by the pharmacogenetic algorithm, which correctly classified 67% of patients with a deviation of up to 20%. CONCLUSION: The variability in the stable ACN dose was better explained by a pharmacogenetic algorithm including clinical and genetic factors (CYP2C9, VKORC1, and APOE) than by a clinical algorithm, providing a more accurate dosage prediction.
No takes yet. Share an insight, caveat, or question.
Jiménez‐Varo et al. (2014) conducted an observational in Atrial fibrillation or venous thromboembolism (n=164). Pharmacogenetic dosing algorithm vs. Clinical algorithm was evaluated on Variability in the stable acenocoumarol dose. A pharmacogenetic algorithm including CYP2C9, VKORC1, and APOE explained 56.6% of the variability in stable acenocoumarol dose, correctly classifying 67% of patients within a 20% deviation.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: