Ming-Shien Wen1,2, Kuan-Cheng Chang3,4, Tsong-Hai Lee1,5, Ying-Fu Chen6,7, Kuo-Chun Hung1,2, Yeu-Jhy Chang1,5, Chia-Wei Liou1,8, Jin-Jer Chen3,4, Chien-Hung Chang1,5, Chao-Yung Wang1,2, Jiann-Shing Jeng8, Hui-Ping Chuang9, Ying-Ting Chen9, Chien-Hsiun Chen9, Jer-Yuarn Wu9, Yuan-Tsong Chen9, Ming Ta Michael Lee9,10. 1. College of Medicine, Chang Gung University, Taoyuan, Taiwan. 2. Division of Cardiology, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan. 3. Division of Cardiology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan. 4. Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan. 5. Stroke Center & Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan. 6. Division of Cardiovascular Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. 7. Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. 8. Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan. 9. Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan. 10. Genomic Medicine Institute, Geisinger Health System, Danville, PA 17822, USA.
Abstract
AIM: This study aimed to determine clinical utility of genotype-guided dosing for warfarin in Han-Chinese. METHODS: A total of 320 patients were randomly assigned International Warfarin Pharmacogenetic Consortium algorithm, Taiwan algorithm and optimal clinical care arms. The primary outcome of the study was the percentage of time in the therapeutic range during the first 90 days of treatment. RESULTS: The percentage of time in the therapeutic range of the clinical care group in the first 2 weeks was significantly higher than the algorithm groups. This difference was no longer observed after 4 weeks. No difference in excessive anticoagulation (international normalized ratio ≥4.0) and adverse events was observed. CONCLUSION: Genotype-guided dosing did not provide significant benefit. Loading dose with frequent international normalized ratio monitoring could provide sufficient control of anticoagulation.
RCT Entities:
AIM: This study aimed to determine clinical utility of genotype-guided dosing for warfarin in Han-Chinese. METHODS: A total of 320 patients were randomly assigned International Warfarin Pharmacogenetic Consortium algorithm, Taiwan algorithm and optimal clinical care arms. The primary outcome of the study was the percentage of time in the therapeutic range during the first 90 days of treatment. RESULTS: The percentage of time in the therapeutic range of the clinical care group in the first 2 weeks was significantly higher than the algorithm groups. This difference was no longer observed after 4 weeks. No difference in excessive anticoagulation (international normalized ratio ≥4.0) and adverse events was observed. CONCLUSION: Genotype-guided dosing did not provide significant benefit. Loading dose with frequent international normalized ratio monitoring could provide sufficient control of anticoagulation.
Authors: Gary Tse; Mengqi Gong; Guangping Li; Sunny Hei Wong; William K K Wu; Wing Tak Wong; Leonardo Roever; Alex Pui Wai Lee; Gregory Y H Lip; Martin C S Wong; Tong Liu Journal: Br J Clin Pharmacol Date: 2018-06-21 Impact factor: 4.335
Authors: Marcus Fernando S Praxedes; Maria Auxiliadora P Martins; Aline O M Mourão; Karina B Gomes; Edna A Reis; Renan P Souza; Emílio Itamar F Campos; Daniel D Ribeiro; Manoel Otávio C Rocha Journal: Eur J Clin Pharmacol Date: 2019-11-12 Impact factor: 2.953