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Ju S, Gao Y, Cao X, Zhang XF, Yan CC, Liu FT. Association Between the Lower Extremity Deep Venous Thrombosis, the Warfarin Maintenance Dose, and CYP2C9*3, CYP2D6*10, and CYP3A5*3 Genetic Polymorphisms: A Case-Control Study. Genet Test Mol Biomarkers 2017; 21:539-546. [PMID: 28872889 DOI: 10.1089/gtmb.2017.0090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE This study explored the association between the CYP2C9*3/CYP2D6*10/CYP3A5*3 genetic polymorphisms with lower extremity deep venous thrombosis (LEDVT) and the warfarin maintenance dose. METHODS Five hundred thirty-six patients who were pathologically diagnosed with LEDVT after surgery were included in the LEDVT group. At the same time, 540 patients without LEDVT who underwent surgery were recruited as the control group. Patients were given warfarin at an initial dose of 2.5-3.0 mg. Blood samples were collected to detect the initial and stable international normalized ratio (INR) values. The warfarin maintenance dose was obtained if the INR remained within a range of 2.0-3.0 for 3 consecutive days. The genotype distribution and haplotype analysis of the CYP2C9*3/CYP2D6*10/CYP3A5*3 alleles were analyzed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) testing and SHEsis software, respectively. Logistic regression analysis was used to analyze the risk and protective factors for LEDVT. RESULTS The A/G genotypes, G/G genotypes, and G allele of CYP3A5*3 in the LEDVT group were observed with increased frequency compared with the control group. The LEDVT group displayed a higher ACG haplotype frequency, and lower ACA and ATA haplotype frequencies than the control group. Age, diabetes, low-density lipoprotein, CYP3A5*3 and the ACG haplotype were independent risk factors for LEDVT. High-density lipoprotein and the ACA haplotype were independent protective factors for LEDVT. The genotype distributions of the CYP2C9*3, CYP2D6*10, and CYP3A5*3 genetic polymorphisms were associated with the warfarin maintenance dose. CONCLUSION The CYP3A5*3 genetic polymorphism may be an important risk factor for LEDVT. Moreover, CYP2C9*3, CYP2D6*10, and CYP3A5*3 are associated with the warfarin maintenance dose.
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Affiliation(s)
- Shang Ju
- Department of Peripheral Vascular, Beijing University of Chinese Medicine Dongzhimen Hospital , Beijing, China
| | - Yu Gao
- Department of Peripheral Vascular, Beijing University of Chinese Medicine Dongzhimen Hospital , Beijing, China
| | - Xin Cao
- Department of Peripheral Vascular, Beijing University of Chinese Medicine Dongzhimen Hospital , Beijing, China
| | - Xiao-Fu Zhang
- Department of Peripheral Vascular, Beijing University of Chinese Medicine Dongzhimen Hospital , Beijing, China
| | - Cheng-Cheng Yan
- Department of Peripheral Vascular, Beijing University of Chinese Medicine Dongzhimen Hospital , Beijing, China
| | - Feng-Tong Liu
- Department of Peripheral Vascular, Beijing University of Chinese Medicine Dongzhimen Hospital , Beijing, China
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Dimitrova-Karamfilova A, Tzveova R, Chilingirova N, Goranova T, Nachev G, Mitev V, Kaneva R. Acenocoumarol Pharmacogenetic Dosing Algorithms and Their Application in Two Bulgarian Patients with Low Anticoagulant Requirements. Biochem Genet 2015; 53:334-50. [PMID: 26377995 DOI: 10.1007/s10528-015-9695-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Accepted: 09/05/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND The anticoagulant therapy with acenocoumarol is generally associated with a high risk of bleeding and thromboembolic events. PURPOSE We applied eight already existing acenocoumarol dosing algorithms to Bulgarian patients with low acenocoumarol dose requirements and investigated which of these algorithms would predict most precisely the dose anticoagulant. MATERIALS AND METHODS Two patients with Bulgarian origin were referred to the outpatient clinical laboratory of "St. Ekaterina" University Hospital for Cardiovascular Surgery and Cardiology, Sofia, Bulgaria. After obtaining written informed consent, both patients were genotyped for polymorphisms in genes for Cytochrome P450 2C9 (CYP2C9), Vitamin K epoxide reductase (VKORC1), Apolipoprotein E (APOE), and Cytochrome P450 4F2 (CYP4F2). RESULTS All applied acenocoumarol dosing algorithms predicted relatively similar doses of coumarin anticoagulant in both patients. However, van Schie et al.'s algorithm allowed more accurate calculation of the optimal dose in our patients with extremely low acenocoumarol requirements. Genotyping of selected polymorphic variants in CYP2C9 and VKORC1 showed that both patients were compound heterozygotes for CYP2C9 (CYP2C9*2/*3) and homozygotes for both variants in VKORC1 (VKORC1 1173 T/T, and VKORC1-1639 A/A). This combination of genotypes suggested high sensitivity to acenocoumarol leading to the low anticoagulant dose requirements (0.25 and 1 mg/day, respectively) needed to reach the target International Normalized Ratio of 2.5-3.5. CONCLUSIONS The genotyping of polymorphic variants in VKORC1 and CYP2C9, together with clinical and demographic parameters, can serve for more precise definition of the individual starting and maintenance doses of coumarin derivatives in each patient.
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Affiliation(s)
- Antoaneta Dimitrova-Karamfilova
- Department of Clinical Laboratory, University Hospital of Cardiovascular Surgery and Cardiology "St. Ekaterina"- Sofia, 52A Pencho Slaveykov bul., 1431, Sofia, Bulgaria
| | - Reni Tzveova
- Molecular Medicine Center, Department of Medical Chemistry and Biochemistry, Medical Faculty, Medical University - Sofia, 2 Zdrave str, 1431, Sofia, Bulgaria.
| | - Nezabravka Chilingirova
- Department of Clinical Laboratory, University Hospital of Cardiovascular Surgery and Cardiology "St. Ekaterina"- Sofia, 52A Pencho Slaveykov bul., 1431, Sofia, Bulgaria
| | - Teodora Goranova
- Molecular Medicine Center, Department of Medical Chemistry and Biochemistry, Medical Faculty, Medical University - Sofia, 2 Zdrave str, 1431, Sofia, Bulgaria
| | - Gencho Nachev
- Department of Cardiovascular Surgery, University Hospital of Cardiovascular Surgery and Cardiology "St. Ekaterina"- Sofia, 52A Pencho Slaveykov bul., 1431, Sofia, Bulgaria
| | - Vanio Mitev
- Molecular Medicine Center, Department of Medical Chemistry and Biochemistry, Medical Faculty, Medical University - Sofia, 2 Zdrave str, 1431, Sofia, Bulgaria
| | - Radka Kaneva
- Molecular Medicine Center, Department of Medical Chemistry and Biochemistry, Medical Faculty, Medical University - Sofia, 2 Zdrave str, 1431, Sofia, Bulgaria
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Pharmacogenetics of Coumarin Anticoagulant Therapy. ADVANCES IN PREDICTIVE, PREVENTIVE AND PERSONALISED MEDICINE 2015. [DOI: 10.1007/978-3-319-15344-5_11] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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van Schie RMF, Aoussar A, van der Meer FJM, de Boer A, Maitland-van der Zee AH. Evaluation of the effects of single-nucleotide polymorphisms in CYP3A4 and CYP4F2 on stable phenprocoumon and acenocoumarol maintenance doses. J Thromb Haemost 2013; 11:1200-3. [PMID: 23510058 DOI: 10.1111/jth.12195] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Indexed: 08/31/2023]
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van Schie RMF, Wessels JAM, Verhoef TI, Schalekamp T, le Cessie S, van der Meer FJM, Rosendaal FR, Visser LE, Teichert M, Hofman A, Buhre PNM, de Boer A, Maitland-van der Zee AH. Evaluation of the effect of genetic variations in GATA-4 on the phenprocoumon and acenocoumarol maintenance dose. Pharmacogenomics 2012; 13:1917-23. [DOI: 10.2217/pgs.12.174] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To investigate whether the phenprocoumon and acenocoumarol maintenance doses are influenced by genetic variations in GATA-4, a transcription factor of CYP2C9. Patients & methods: The influence of seven GATA-4 SNPs on the coumarin maintenance dose was investigated by performing an analysis of variance trend analysis, stratified for CYP2C9 genotypes. Results of the best-explaining SNP were validated in the Rotterdam Study cohort. Results: The largest dose differences were found for rs3735814 in patients using acenocoumarol and having the common allele for CYP2C9. The mean dosages decreased from 2.92 mg/day for the patients having the GATA-4 common alleles to 2.65 mg/day for the patients carrying one GATA-4 variant allele and to 2.37 mg/day for patients carrying two GATA-4 variant alleles (p = 0.004). Results could not be replicated in the validation cohort. For phenprocoumon, no significant effects were observed. Conclusion: Genetic variation in GATA-4 does not seem relevant for clinical implementation. Original submitted 31 August 2012; Revision submitted 12 October 2012
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Affiliation(s)
- Rianne MF van Schie
- Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht, The Netherlands
| | - Judith AM Wessels
- Department of Clinical Pharmacy & Toxicology, Leiden University Medical Center, Leiden, The Netherlands
| | - Talitha I Verhoef
- Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht, The Netherlands
| | - Tom Schalekamp
- Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht, The Netherlands
| | - Saskia le Cessie
- Department of Medical Statistics & Bioinformatics, Leiden University Medical Center, Leiden, The Netherlands and Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Felix JM van der Meer
- Department of Thrombosis & Hemostasis, Leiden University Medical Center, Leiden, The Netherlands and Medial, Medical-diagnostic Laboratories, Hoofddorp, The Netherlands
| | - Frits R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands and Department of Thrombosis & Hemostasis, Leiden University Medical Center, Leiden, The Netherlands
| | - Loes E Visser
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands and Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands and Department of Hospital Pharmacy, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Martina Teichert
- R&D Department, Royal Dutch Pharmacists Association, The Hague, The Netherlands and Scientific Institute for Quality of Healthcare (IQ healthcare), Radboud University Nijmegen, The Netherlands
| | - Albert Hofman
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Peter NM Buhre
- Star Medical Diagnostic Center, Rotterdam, The Netherlands
| | - Anthonius de Boer
- Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht, The Netherlands
| | - Anke-Hilse Maitland-van der Zee
- Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, PO Box 80 082, Utrecht University, 3508 TB Utrecht, The Netherlands
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Chouchana L, Languille E, Weiss N, Billaud EM, Lillo-Le Louet A. [Bleedings during vitamin K antagonist therapy associated with ciclosporin and rifampicin]. Presse Med 2012; 42:908-11. [PMID: 23069229 DOI: 10.1016/j.lpm.2012.07.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Revised: 07/18/2012] [Accepted: 07/24/2012] [Indexed: 11/16/2022] Open
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van Schie RMF, el Khedr N, Verhoef TI, Teichert M, Stricker BH, Hofman A, Buhre PN, Wessels JAM, Schalekamp T, le Cessie S, van der Meer FJM, Rosendaal FR, de Boer A, Maitland-van der Zee AH, Visser LE. Validation of the acenocoumarol EU-PACT algorithms: similar performance in the Rotterdam Study cohort as in the original study. Pharmacogenomics 2012; 13:1239-45. [DOI: 10.2217/pgs.12.101] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Aim: To evaluate the performance of the European Pharmacogenetics of Anticoagulant Therapy (EU-PACT) acenocoumarol dose algorithms in an independent data set. The EU-PACT trial investigates the added value of pretreatment genotyping for use of warfarin, phenprocoumon and acenocoumarol. Patients & methods: External validation was performed in the Rotterdam Study cohort using information about 707 acenocoumarol users. R2, which measures the strength of correlation between the predicted and observed acenocoumarol dose, mean absolute error and mean squared error were calculated to evaluate the performance of the original algorithm. Results: Validation resulted in a R2 of 52.7 and 12.9% compared with an R2 of 52.6 and 17.8% in the original study for the genotype-guided and nongenotype-guided dose algorithm, respectively. For the genotype-guided dose algorithm, the mean absolute error was 0.48 mg/day and the mean squared error was 0.38 (mg/day)2. For the nongenotype-guided dose algorithm, the mean absolute error was 0.62 mg/day and the mean squared error was 0.63 (mg/day)2. Conclusion: The EU-PACT acenocoumarol algorithm performs just as accurately in this study as in the original study, which implies applicability in various populations. Original submitted 4 April 2012; Revision submitted 31 May 2012
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Affiliation(s)
- Rianne MF van Schie
- Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Nadia el Khedr
- Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Talitha I Verhoef
- Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Martina Teichert
- R&D Department, Royal Dutch Pharmacists Association, The Hague, The Netherlands and Scientific Institute for Quality of Healthcare (IQ healthcare), Radboud University Nijmegen, The Netherlands
| | - Bruno H Stricker
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands and Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands and Department of Medical Informatics, Erasmus Medical Center, Rotterdam, The Netherlands and Inspectorate of Health Care, The Hague, The Netherlands
| | - Albert Hofman
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Peter N Buhre
- Star Medical Diagnostic Center, Rotterdam, The Netherlands
| | - Judith AM Wessels
- Department of Clinical Pharmacy & Toxicology, Leiden University Medical Center, Leiden, The Netherlands
| | - Tom Schalekamp
- Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Saskia le Cessie
- Department of Medical Statistics & Bioinformatics, Leiden University Medical Center, Leiden, The Netherlands and Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Felix JM van der Meer
- Department of Thrombosis & Hemostasis, Leiden University Medical Center, Leiden, The Netherlands and Medial, Medical-Diagnostic Laboratories, Hoofddorp, The Netherlands
| | - Frits R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands and Department of Thrombosis & Hemostasis, Leiden University Medical Center, Leiden, The Netherlands
| | - Anthonius de Boer
- Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Anke-Hilse Maitland-van der Zee
- Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, PO Box 80 082, 3508 TB, Utrecht, The Netherlands
| | - Loes E Visser
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands and Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands and Department of Hospital Pharmacy, Erasmus Medical Center, Rotterdam, The Netherlands
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Evaluation of subcutaneous forms in the improvement of pharmacokinetic profile of warfarin. Int J Pharm 2012; 431:33-8. [DOI: 10.1016/j.ijpharm.2012.03.053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2012] [Revised: 03/26/2012] [Accepted: 03/27/2012] [Indexed: 11/18/2022]
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van Schie RMF, Babajeff AMV, Schalekamp T, Wessels JAM, le Cessie S, de Boer A, van der Meer FJM, van Meegen E, Verhoef TI, Rosendaal FR, Maitland-van der Zee AH. An evaluation of gene-gene interaction between the CYP2C9 and VKORC1 genotypes affecting the anticoagulant effect of phenprocoumon and acenocoumarol. J Thromb Haemost 2012; 10:767-72. [PMID: 22409277 DOI: 10.1111/j.1538-7836.2012.04694.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Previous studies have provided contradictory results regarding the interaction between the CYP2C9 and VKORC1 genotypes affecting various outcome measures. OBJECTIVES We aimed to provide a definite answer regarding the question whether there exists a gene-gene interaction between the CYP2C9 and VKORC1 genotypes affecting the anticoagulant effect of phenprocoumon and acenocoumarol. PATIENTS/METHODS The EU-PACT cohort dataset, which contains data on 624 phenprocoumon and 471 acenocoumarol patients, was used. Patient characteristics, pharmacogenetic data, International Normalized Ratios (INRs) and dosages were available. We investigated whether there was an interaction between the CYP2C9 and VKORC1 genotypes affecting the maintenance dose, time to severe over-anticoagulation and time to achieve stability during the first 180 days of phenprocoumon and acenocoumarol therapy, in addition to the effect of the separate genotypes. The interaction effect was investigated by adding the product term of the CYP2C9 and VKORC1 genotype classes for four different commonly used CYP2C9 classifications to the linear regression model - for the outcome measure maintenance dose - or to the Cox regression models - for the outcome measures time to severe over-anticoagulation and time to achieve stability. RESULTS No significant interactions - all P-values above 0.23 for phenprocoumon and 0.30 for acenocoumarol - were observed for all outcome measures. CONCLUSIONS There are no interactions between the CYP2C9 and VKORC1 genotypes affecting the maintenance dose, time to severe over-anticoagulation and time to achieve stability for phenprocoumon and acenocoumarol.
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Affiliation(s)
- R M F van Schie
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands
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A new warfarin dosing algorithm including VKORC1 3730 G > A polymorphism: comparison with results obtained by other published algorithms. Eur J Clin Pharmacol 2012; 68:1167-74. [DOI: 10.1007/s00228-012-1226-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2011] [Accepted: 01/14/2012] [Indexed: 11/27/2022]
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Verstuyft C, Delavenne X, Rousseau A, Robert A, Tod M, Diquet B, Lebot M, Jaillon P, Becquemont L. A Pharmacokinetic–Pharmacodynamic Model for Predicting the Impact of CYP2C9 and VKORC1 Polymorphisms on Fluindione and Acenocoumarol During Induction Therapy. Clin Pharmacokinet 2012; 51:41-53. [DOI: 10.2165/11595560-000000000-00000] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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12
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Vitamin K antagonists in children with heart disease: height and VKORC1 genotype are the main determinants of the warfarin dose requirement. Blood 2011; 119:861-7. [PMID: 22130800 DOI: 10.1182/blood-2011-07-365502] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Managing vitamin K antagonist (VKA) therapy is challenging in children because of a narrow therapeutic range and wide inter- and intra-individual variability in dose response. Only a few small studies have investigated the effect of nongenetic and genetic factors on the dose response to VKAs in children. In a cohort study including 118 children (median age 9 years; range, 3 months-18 years) mostly with cardiac disease, we evaluated by multivariate analysis the relative contribution of nongenetic factors and VKORC1/CYP2C9/CYP4F2 genotypes on warfarin (n = 83) or fluindione (n = 35) maintenance dose and the influence of these factors on the time spent within/above/below the range. The results showed that height, target international normalized ratio and VKORC1 and CYP2C9 genotypes were the main determinants of warfarin dose requirement, accounting for 48.1%, 4.4%, 18.2%, and 2.0% of variability, respectively, and explaining 69.7% of the variability. Our model predicted the warfarin dose within 7 mg/wk in 86.7% of patients. None of the covariates was associated with the time spent above or below the international normalized ratio range. Whether this model predicts accurately the effective maintenance dose is currently being investigated.
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Marusic S, Gojo-Tomic N, Franic M, Bozina N. Therapeutic efficacy of acenocoumarol in a warfarin-resistant patient with deep venous thrombosis: a case report. Eur J Clin Pharmacol 2011; 65:1265-6. [PMID: 19652960 DOI: 10.1007/s00228-009-0710-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2009] [Accepted: 07/21/2009] [Indexed: 11/28/2022]
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van Schie RM, Wessels JA, le Cessie S, de Boer A, Schalekamp T, van der Meer FJ, Verhoef TI, van Meegen E, Rosendaal FR, Maitland-van der Zee AH. Loading and maintenance dose algorithms for phenprocoumon and acenocoumarol using patient characteristics and pharmacogenetic data. Eur Heart J 2011; 32:1909-17. [DOI: 10.1093/eurheartj/ehr116] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
- Rianne M.F. van Schie
- Study coordinating Centre, Department of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, PO Box 80 082, 3508 TB Utrecht, The Netherlands
| | - Judith A.M. Wessels
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, The Netherlands
| | - Saskia le Cessie
- Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, Leiden, The Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Anthonius de Boer
- Study coordinating Centre, Department of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, PO Box 80 082, 3508 TB Utrecht, The Netherlands
| | - Tom Schalekamp
- Study coordinating Centre, Department of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, PO Box 80 082, 3508 TB Utrecht, The Netherlands
| | - Felix J.M. van der Meer
- Department of Thrombosis and Haemostasis, Leiden University Medical Center, Leiden, The Netherlands
| | - Talitha I. Verhoef
- Study coordinating Centre, Department of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, PO Box 80 082, 3508 TB Utrecht, The Netherlands
| | - Erik van Meegen
- Medial, medical-diagnostic laboratories, Hoofddorp, The Netherlands
| | - Frits R. Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Thrombosis and Haemostasis, Leiden University Medical Center, Leiden, The Netherlands
| | - Anke-Hilse Maitland-van der Zee
- Study coordinating Centre, Department of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, PO Box 80 082, 3508 TB Utrecht, The Netherlands
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Ho WK. Treatment of Venous Thromboembolism in Older People. JOURNAL OF PHARMACY PRACTICE AND RESEARCH 2010. [DOI: 10.1002/j.2055-2335.2010.tb00566.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Harada T, Ariyoshi N, Shimura H, Sato Y, Yokoyama I, Takahashi K, Yamagata SI, Imamaki M, Kobayashi Y, Ishii I, Miyazaki M, Kitada M. Application of Akaike information criterion to evaluate warfarin dosing algorithm. Thromb Res 2010; 126:183-90. [DOI: 10.1016/j.thromres.2010.05.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2009] [Revised: 05/12/2010] [Accepted: 05/14/2010] [Indexed: 10/19/2022]
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Namazi S, Azarpira N, Hendijani F, Khorshid MB, Vessal G, Mehdipour AR. The impact of genetic polymorphisms and patient characteristics on warfarin dose requirements: A cross-sectional study in Iran. Clin Ther 2010; 32:1050-60. [DOI: 10.1016/j.clinthera.2010.06.010] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2010] [Indexed: 11/29/2022]
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Personalisierte Medizin durch individuelle Genome. MED GENET-BERLIN 2010. [DOI: 10.1007/s11825-010-0216-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Zusammenfassung
Die dynamische Entwicklung in der Sequenziertechnologie hat die technischen Kosten sowie die Zeit, die benötigt wird, ein individuelles Genom zu entschlüsseln, so dramatisch reduziert, dass die komplette Sequenzierung persönlicher Genome für Privatpersonen und Gesundheitssysteme finanzierbar wird. Die breite Verfügbarkeit individueller Genome wird die Medizin weiter in Richtung einer informationsbasierten Wissenschaft treiben und die Bedeutung der informationswissenschaftlichen Techniken erhöhen.
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Pharmacogénétique et antivitamine K aujourd’hui : un débat ouvert. Rev Med Interne 2010; 31:361-8. [DOI: 10.1016/j.revmed.2009.07.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2009] [Revised: 06/03/2009] [Accepted: 07/08/2009] [Indexed: 11/22/2022]
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Kurnik D, Loebstein R, Halkin H, Gak E, Almog S. 10 years of oral anticoagulant pharmacogenomics: what difference will it make? A critical appraisal. Pharmacogenomics 2009; 10:1955-65. [DOI: 10.2217/pgs.09.149] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Since the first report on warfarin pharmacogenetics in 1999, genetic variants have emerged as an important predictor of warfarin maintenance doses before therapy is initiated, raising expectations of greatly improved clinical outcomes. However, much of the information on warfarin sensitivity conveyed by genetic variants is captured by early international normalized ratio values traditionally used to guide dose titration. Thus, inclusion of early international normalized ratios in prediction models reduces the contribution of genetics. Moreover, in large population cohorts, genetics explained only 20–30% of variance in warfarin doses. Finally, even pharmacogenetic prediction models did not predict doses reliably in the majority of at-risk patients with warfarin requirements at the low or high end of the dose range. Currently, the clinical utility and cost–effectiveness of pharmacogenetic-based dosing are being assessed in large prospective trials in various settings. In the interim, enthusiasm for warfarin pharmacogenetics should not supersede strict adherence to traditional measures used to optimize coumarin anticoagulation.
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Affiliation(s)
- Daniel Kurnik
- Division of Clinical Pharmacology and Toxicology, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ronen Loebstein
- Division of Clinical Pharmacology and Toxicology, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Hillel Halkin
- Division of Clinical Pharmacology and Toxicology, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eva Gak
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Danek Gertner Institute of Human Genetics, Sheba Medical Center, Tel Hashomer, Israel
| | - Shlomo Almog
- Division of Clinical Pharmacology and Toxicology, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Sipeky C, Lakner L, Szabo M, Takacs I, Tamasi V, Polgar N, Falus A, Melegh B. Interethnic differences of CYP2C9 alleles in healthy Hungarian and Roma population samples: Relationship to worldwide allelic frequencies. Blood Cells Mol Dis 2009; 43:239-42. [DOI: 10.1016/j.bcmd.2009.05.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2009] [Revised: 05/22/2009] [Accepted: 05/26/2009] [Indexed: 10/20/2022]
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Tan B, Zhang YF, Chen XY, Zhao XH, Li GX, Zhong DF. The effects of CYP2C9 and CYP2C19 genetic polymorphisms on the pharmacokinetics and pharmacodynamics of glipizide in Chinese subjects. Eur J Clin Pharmacol 2009; 66:145-51. [PMID: 19847408 DOI: 10.1007/s00228-009-0736-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2009] [Accepted: 09/21/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To study the effects of CYP2C9 and CYP2C19 genetic polymorphisms on the pharmacokinetics and pharmacodynamics of glipizide. METHODS Eighteen healthy male subjects were divided into three groups according to their genotypes: group I, CYP2C9*1/*1 and CYP2C19 extensive metabolizers (EMs); group II, CYP2C9*1/*1 and CYP2C19 poor metabolizers (PMs); and group III, CYP2C9*1/*3 and CYP2C19 EMs. After a single dose of a 5-mg glipizide tablet, plasma concentrations of glipizide for a 36-h period were determined. Meanwhile, plasma glucose levels and plasma insulin levels were determined from 0 to 4 h after dosing. RESULTS The area under the plasma concentration-time curve (AUC(0-infinity)) was 2.0-fold higher and the oral clearance was 51.1% lower in group III than in group I. The change in fasting insulin level within 1 h (DeltaAUEC(insulin0-1h)) in group III was 3.8-fold higher than that in group I. The glipizide parameters in group II exhibited similar tendencies to those in group III. CONCLUSIONS These results suggest that CYP2C9 polymorphism significantly influences the pharmacokinetics and pharmacodynamics of glipizide, which needs to be considered in clinical practice. CYP2C19 polymorphism exhibits a tendency to influence the effects of glipizide, to a certain extent similarly to CYP2C9 polymorphism.
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Affiliation(s)
- Bo Tan
- Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China
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