CYP2C9 and VKORC1 genotype-guided individualized warfarin therapy in Chinese patients with acute pulmonary thromboembolism: a randomized controlled clinical study

被引:0
作者
Jin, Heng [1 ]
Jiang, Feng [2 ]
Wei, Jun [1 ]
Yao, Ying [1 ]
Yuan, Hengjie [3 ]
Yu, Muming [1 ]
Qi, Anlong [1 ]
Chai, Yanfen [1 ]
机构
[1] Tianjin Med Univ, Gen Hosp, Dept Emergency Med, Tianjin 300052, Peoples R China
[2] Tianjin Med Univ, Gen Hosp, Dept Ophthalmol, Tianjin 300052, Peoples R China
[3] Tianjin Med Univ, Gen Hosp, Dept Pharm, Tianjin 300052, Peoples R China
来源
INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE | 2017年 / 10卷 / 03期
关键词
Genotype-guided; warfarin; CYP2C9; VKORC1; individualized anticoagulant therapy; pulmonary embolism; DOSING ALGORITHM; GENETIC-VARIANTS; PHARMACOGENETICS; METAANALYSIS; TRIAL; ANTICOAGULATION; ASSOCIATION; METABOLISM; EMBOLISM; OUTCOMES;
D O I
暂无
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
To investigate efficacy and safety of genotype-guided individualized anticoagulant therapy with warfarin for acute pulmonary thromboembolism (APTE) patients in Han Chinese. Patients enrolled were randomly divided into genotype-guided group and control group. The genotype of VKORC1 and CYP2C9 for all the patients was analyzed using PCR and biochip technology. The warfarin dosages in genotype-guided group on 1-3 days were determined by dosing algorithm on platform (http://www.warfarindosing.org), while the dosage in control group was 3 mg/24 h. From the 4th day, dosages were modulated according to international normalized ratio (INR) and clinical conditions. Therapy lasted for 12 weeks. Record INR values frequently. The average time to reach INR target range 2-3 (T-f) in genotype-guided group was significantly shorter compared with control group (P < 0.001). The average time to reach stable warfarin dosage (T-s) in genotype-guided group was significantly less than that of control group (P < 0.001). The percentage of patients reaching stable warfarin dose within 3 weeks (67.8%) was higher in genotyping-guided group than that in control group (P < 0.001). However, during weeks 4 to 12, it showed no significant difference except for week 5. Occurrence rate of INR > 4 and bleeding events showed no statistical difference. INR fluctuation (f(INR)) at initial therapy was more apparent in control group than that in genotype-guided group. CYP2C9 and VKORC1 genotype-guided method could be more efficient than normal dosing method. The data here supplied evidence for supporting the individual therapy of warfarin in clinic for Han Chinese.
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页码:5595 / 5602
页数:8
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