Improved Dosing of Vitamin-K Antagonists: Does Genotype Hold the Key?

In two EU-PACT trials, the incremental value of including genotype information in initial dosing algorithms was modest at best.

Findings from small studies have suggested that genotype-guided dosing algorithms can increase the effectiveness and safety of warfarin-type oral anticoagulants. Now, the European Pharmacogenetics of Anticoagulant Therapy (EU-PACT) group presents two analyses of data from three multicenter, randomized, controlled trials in patients with atrial fibrillation or venous thromboembolism. Investigators used point-of-care tests to genotype for CYP2CP*2, CYP2C9*3, and VKORC1. In the intervention groups, anticoagulant dosing for the first 5 to 7 days of treatment was based on an algorithm that included patient genotype information; in the control groups, the initial dosing algorithms did not include genotype.

In a warfarin trial involving 455 patient…

Reviewing Author

Joel M. Gore, MD

Disclosures

Grant/Research SupportNIH–National Heart, Lung, and Blood Institute

Joel M. Gore, MD

Disclosures

Grant/Research SupportNIH–National Heart, Lung, and Blood Institute

Improved Dosing of Vitamin-K Antagonists: Does Genotype Hold the Key?

Topics

Reviewing Author