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Pharmacogenomics J ; 20(5): 687-694, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32024944

RESUMO

A total of 263 warfarin naive patients with indications to long-term anticoagulation were included in prospective multicenter study and randomized into Pharmacogenetics and Standard dosing groups. The loading warfarin dose in Pharmacogenetics group was calculated by Gage algorithm and corrected starting on day 5 of treatment according to INR. In Standard dosing group warfarin initial dose was 5 mg and starting on day 3 of treatment it was titrated according to INR. Pharmacogenetics dosing in comparison with prescription of starting dose of 5 mg decreased major bleedings (0 vs. 6, p = 0.031), time to target INR (11 [9-14] vs. 17 [15-24] days, p = 0.046), and frequency of INR fluctuations ≥4.0 (11% vs. 30.9%, p = 0.002). The advantages of the pharmacogenetics dosing were mainly achieved due to the patients with increased warfarin sensitivity.


Assuntos
Anticoagulantes/administração & dosagem , Coagulação Sanguínea/efeitos dos fármacos , Citocromo P-450 CYP2C9/genética , Variantes Farmacogenômicos , Vitamina K Epóxido Redutases/genética , Varfarina/administração & dosagem , Idoso , Anticoagulantes/efeitos adversos , Citocromo P-450 CYP2C9/metabolismo , Cálculos da Dosagem de Medicamento , Monitoramento de Medicamentos , Feminino , Genótipo , Humanos , Coeficiente Internacional Normatizado , Masculino , Pessoa de Meia-Idade , Farmacogenética , Fenótipo , Estudos Prospectivos , Federação Russa , Fatores de Tempo , Resultado do Tratamento , Vitamina K Epóxido Redutases/metabolismo , Varfarina/efeitos adversos
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