Trial reportBlood2007
Genetic-based dosing in orthopedic patients beginning warfarin therapy.
Trial report in Blood, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 66 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
66 citing papers in PubMed, 3 syntheses or guidelines pooled it, 178 citations in OpenAlex.
- Influence of CYP2C9 and VKORC1 on patient response to warfarin: a systematic review and meta-analysis.PloS one · 2012Pooled it
- Genetic testing before anticoagulation? A systematic review of pharmacogenetic dosing of warfarin.Journal of general internal medicine · 2009Pooled it
- Influence of CYP2C9 genotype on warfarin dose requirements--a systematic review and meta-analysis.European journal of clinical pharmacology · 2009Pooled it
- Warfarin loading dose guided by pharmacogenetics is effective and safe in cardioembolic stroke patients - a randomized, prospective study.The pharmacogenomics journal · 2019Trial
- Trial
- Genetics informatics trial (GIFT) of warfarin to prevent deep vein thrombosis (DVT): rationale and study design.The pharmacogenomics journal · 2012Trial
- Evaluation of methods for achieving stable INR in healthy subjects during a multiple-dose warfarin study.European journal of clinical pharmacology · 2012Trial
- Warfarin dosing algorithm using clinical, demographic and pharmacogenetic data from Chinese patients.Journal of thrombosis and thrombolysis · 2011Trial
- Ability of VKORC1 and CYP2C9 to predict therapeutic warfarin dose during the initial weeks of therapy.Journal of thrombosis and haemostasis : JTH · 2010Trial
- Genetic and environmental factors determining clinical outcomes and cost of warfarin therapy: a prospective study.Pharmacogenetics and genomics · 2009Trial
- Pharmacogenetic predictors of statin-mediated low-density lipoprotein cholesterol reduction and dose response.Circulation. Cardiovascular genetics · 2008 · on this mapTrial
- Contribution of age, body weight, and CYP2C9 and VKORC1 genotype to the anticoagulant response to warfarin: proposal for a new dosing regimen in Chinese patients.European journal of clinical pharmacology · 2007Trial
- Ethnic Diversity and Warfarin Pharmacogenomics.Frontiers in pharmacology · 2022Review
- In-vivo design feedback and perceived utility of a genetically-informed smoking risk tool among current smokers in the community.BMC medical genomics · 2021Article
- Variants inInternational journal of general medicine · 2021Article
- A Simple Formula for Predicting the Maintenance Dose of Warfarin with Reference to the Initial Response to Low Dosing at an Outpatient Clinic.Internal medicine (Tokyo, Japan) · 2020Article
- Precision dosing of warfarin: open questions and strategies.The pharmacogenomics journal · 2019Review
- Pharmacogenomics of CYP2C9: Functional and Clinical Considerations.Journal of personalized medicine · 2017Review
- Identification of two novel genes SLC15A2 and SLCO1B3 associated with maintenance dose variability of warfarin in a Chinese population.Scientific reports · 2017Article
- Article
6 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors at 3 institutions in 1 country.
Funding
Abstract
High variability in drug response and a narrow therapeutic index complicate warfarin therapy initiation. No existing algorithm provides recommendations on refining the initial warfarin dose based on genetic variables, clinical data, and international normalized ratio (INR) values. Our goal was to develop such an algorithm. We studied 92 patients undergoing primary or revision total hip or knee replacement. From each patient we collected a blood sample, clinical variables, current medications, and preoperative and postoperative laboratory values. We genotyped for polymorphisms in the cytochrome P450 (CYP) 2C9 and vitamin K epoxide reductase (VKORC1) genes. Using stepwise regression, we developed a model for refining the warfarin dose after the third warfarin dose. The algorithm explained four fifths of the variability in therapeutic dose (R(2)(adj) of 79%). Significant (P > .05) predictors were INR value after 3 doses (47% reduction per 0.25-unit rise), first warfarin dose (+7% per 1 mg), CYP2C9*3 and CYP2C9*2 genotype (-38% and -17% per allele), estimated blood loss (interacting with INR(3)), smoking status (+20% in current smokers), and VKORC1 (-11% per copy of haplotype A). If validated, this model should provide a safer, more effective process for initiating warfarin therapy.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.