Development of a pharmacogenetic-guided warfarin dosing algorithm for Puerto Rican patients.
Enviado por Carmen Lydia Cadilla el
Título | Development of a pharmacogenetic-guided warfarin dosing algorithm for Puerto Rican patients. |
Publication Type | Journal Article |
Year of Publication | 2012 |
Autores | Ramos, AS, Seip, RL, Rivera-Miranda, G, Felici-Giovanini, ME, Garcia-Berdecia, R, Alejandro-Cowan, Y, Kocherla, M, Cruz, I, Feliu, JF, Cadilla, C, Renta, JY, Gorowski, K, Vergara, C, Ruaño, G, Duconge, J |
Journal | Pharmacogenomics |
Volume | 13 |
Issue | 16 |
Pagination | 1937-50 |
Date Published | 2012 Dec |
ISSN | 1744-8042 |
Palabras clave | Adult, Aged, Aged, 80 and over, Algorithms, Anticoagulants, Aryl Hydrocarbon Hydroxylases, Dose-Response Relationship, Drug, Female, Hispanic Americans, Humans, Male, Middle Aged, Mixed Function Oxygenases, Prospective Studies, Regression Analysis, Vitamin K Epoxide Reductases, Warfarin |
Abstract | AIM: This study was aimed at developing a pharmacogenetic-driven warfarin-dosing algorithm in 163 admixed Puerto Rican patients on stable warfarin therapy. PATIENTS & METHODS: A multiple linear-regression analysis was performed using log-transformed effective warfarin dose as the dependent variable, and combining CYP2C9 and VKORC1 genotyping with other relevant nongenetic clinical and demographic factors as independent predictors. RESULTS: The model explained more than two-thirds of the observed variance in the warfarin dose among Puerto Ricans, and also produced significantly better 'ideal dose' estimates than two pharmacogenetic models and clinical algorithms published previously, with the greatest benefit seen in patients ultimately requiring <7 mg/day. We also assessed the clinical validity of the model using an independent validation cohort of 55 Puerto Rican patients from Hartford, CT, USA (R(2) = 51%). CONCLUSION: Our findings provide the basis for planning prospective pharmacogenetic studies to demonstrate the clinical utility of genotyping warfarin-treated Puerto Rican patients. |
DOI | 10.2217/pgs.12.171 |
Alternate Journal | Pharmacogenomics |
PubMed ID | 23215886 |
PubMed Central ID | PMC3538136 |
Grant List | #8U54MD007587 / MD / NIMHD NIH HHS / United States #SC2HL110393 / HL / NHLBI NIH HHS / United States 2G12-RR003051 / RR / NCRR NIH HHS / United States G12 MD007600 / MD / NIMHD NIH HHS / United States G12 RR003051 / RR / NCRR NIH HHS / United States G12-MD007600 / MD / NIMHD NIH HHS / United States SC2 HL110393 / HL / NHLBI NIH HHS / United States U54 MD007587 / MD / NIMHD NIH HHS / United States |