Evidence map›Paper›PMID 32270628›Full record

ArticleClinical and translational science2020

Impact of CYP2C9-Interacting Drugs on Warfarin Pharmacogenomics.

Saaket Agrawal, Meredith S Heiss, Remington B Fenter, Tatiana V Abramova, Minoli A Perera, Jennifer A Pacheco, Maureen E Smith, Laura J Rasmussen-Torvik, Alfred L George

Open access · goldAbstract read
In one paragraph

Article in Clinical and translational science, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
2.1field-weighted citation impact, top 14% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 19 citations in OpenAlex.

  1. Article
  2. Article
  3. Genomic Impacts of Biological Exposures.Journal of developmental biology · 2026
    Review
  4. Article
  5. Article
  6. Article
  7. Article
  8. Drug Interactions Affecting Oral Anticoagulant Use.Circulation. Arrhythmia and electrophysiology · 2022
    Review
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Saaket Agrawal *Department of Pharmacology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Meredith S Heiss *Graduate Program in Genetic Counseling, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Remington B FenterGraduate Program in Genetic Counseling, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Tatiana V AbramovaDepartment of Pharmacology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Minoli A PereraDepartment of Pharmacology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Jennifer A PachecoCenter for Genetic Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Maureen E SmithCenter for Genetic Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Laura J Rasmussen-TorvikDepartment of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Alfred L GeorgeDepartment of Pharmacology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Northwestern University · US

Funding

Northwestern University Clinical and Translational Science Institute (NUCATS)UL1TR001422 · NCATS · NORTHWESTERN UNIVERSITY AT CHICAGO · PI D'AQUILA, RICHARD · 2015 to 2023
$56.8M
African American Cardiovascular pharmacogenetic CONsorTium (ACCOuNT): discovery and translationU54MD010723 · NIMHD · NORTHWESTERN UNIVERSITY AT CHICAGO · PI MELTZER, DAVID O, PERERA, MINOLI A · 2016 to 2020
$9.5M
Health disparity in pharmacogenomics: African American SNPs and drug metabolismR01MD009217 · NIMHD · UNIVERSITY OF CHICAGO · PI PERERA, MINOLI A · 2014 to 2018
$2.0M
NCATS NIH HHS UL1 TR001422NIMHD NIH HHS R01 MD009217NIMHD NIH HHS U54 MD010723
6 · The paper itself

Abstract

Precise dosing of warfarin is important to achieve therapeutic benefit without adverse effects. Pharmacogenomics explains some interindividual variability in warfarin response, but less attention has been paid to drug-drug interactions in the context of genetic factors. We investigated retrospectively the combined effects of cytochrome P450 (CYP)2C9 and vitamin K epoxide reductase complex (VKORC)1 genotypes and concurrent exposure to CYP2C9-interacting drugs on long-term measures of warfarin anticoagulation. Study participants predicted to be sensitive responders to warfarin based on CYP2C9 and VKORC1 genotypes, had significantly greater international normalized ratio (INR) variability over time. Participants who were concurrently taking CYP2C9-interacting drugs were found to have greater INR variability and lesser time in therapeutic range. The associations of INR variability with genotype were driven by the subgroup not exposed to interacting drugs, whereas the effect of interacting drug exposure was driven by the subgroup categorized as normal responders. Our findings emphasize the importance of considering drug interactions in pharmacogenomic studies.

Indexed as

AgedAnticoagulantsAtrial FibrillationBlood CoagulationCytochrome P-450 CYP2C9Dose-Response Relationship, DrugDrug InteractionsFemaleHumansInternational Normalized RatioMaleMiddle AgedPharmacogenomic VariantsRetrospective StudiesVitamin K Epoxide ReductasesWarfarinAnticoagulantsCYP2C9 protein, humanCytochrome P-450 CYP2C9Vitamin K Epoxide ReductasesVKORC1 protein, humanWarfarin

Identifiers

PMID32270628
PMCPMC7485961
OpenAlexW3015197892

What OpenQuestion holds

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Registered trials

None linked

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.