Pharmacogenetics of warfarin dosing in patients of African and European ancestry.
Pharmacogenomics
; 19(17): 1357-1371, 2018 11.
Article
in En
| MEDLINE
| ID: mdl-30345882
ABSTRACT
Despite the introduction of direct acting oral anticoagulants, warfarin remains the most commonly prescribed oral anticoagulant. However, warfarin therapy is plagued by the large inter- and intrapatient variability. The variability in dosing fueled research to identify clinical and genetic predictors and develop more accurate dosing algorithms. Observational studies have demonstrated the significant impact of single nucleotide polymorphisms in CYP2C9 and VKORC1 on warfarin dose in patients of European ancestry and African-Americans. This evidence supported the design and conduct of clinical trials to assess whether genotype-guided dosing results in improved anticoagulation control and outcomes. The trial results have shown discordance by race, with pharmacogenetic algorithms improving dose and anticoagulation control among European ancestry patients compared with African-American patients. Herein, we review the evidence from observational and interventional studies, highlight the need for inclusion of minority race groups and propose the need to develop race specific dosing algorithms.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Warfarin
/
Black People
/
White People
/
Anticoagulants
Type of study:
Observational_studies
/
Prognostic_studies
Limits:
Humans
Language:
En
Journal:
Pharmacogenomics
Journal subject:
FARMACOLOGIA
/
GENETICA MEDICA
Year:
2018
Document type:
Article
Affiliation country:
United States