1. A Randomized Trial of Pharmacogenetic Warfarin Dosing in Naïve Patients with Non-Valvular Atrial Fibrillation.
- Author
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Pengo, Vittorio, Zambon, Carlo-Federico, Fogar, Paola, Padoan, Andrea, Nante, Giovanni, Pelloso, Michela, Moz, Stefania, Frigo, Anna Chiara, Groppa, Francesca, Bozzato, Dania, Tiso, Enrico, Gnatta, Elisa, Denas, Gentian, Padayattil Jose, Seena, Padrini, Roberto, Basso, Daniela, and Plebani, Mario
- Subjects
WARFARIN ,DRUG dosage ,ATRIAL fibrillation ,PHARMACOGENOMICS ,CLINICAL trials ,PATIENTS - Abstract
Genotype-guided warfarin dosing have been proposed to improve patient’s management. This study is aimed to determine whether a CYP2C9- VKORC1- CYP4F2-based pharmacogenetic algorithm is superior to a standard, clinically adopted, pharmacodynamic method. Two-hundred naïve patients with non-valvular atrial fibrillation were randomized to trial arms and 180 completed the study. No significant differences were found in the number of out-of-range INRs (INR<2.0 or >3.0) (p = 0.79) and in the mean percentage of time spent in the therapeutic range (TTR) after 19 days in the pharmacogenetic (51.9%) and in the control arm (53.2%, p = 0.71). The percentage of time spent at INR>4.0 was significantly lower in the pharmacogenetic (0.7%) than in the control arm (1.8%) (p = 0.02). Genotype-guided warfarin dosing is not superior in overall anticoagulation control when compared to accurate clinical standard of care. Trial Registration: ClinicalTrials.gov [ABSTRACT FROM AUTHOR]
- Published
- 2015
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