Evidence map›Paper›PMID 37458773›Full record

ArticleEuropean journal of clinical pharmacology2023

Optimisation of warfarin-dosing algorithms for Han Chinese patients with CYP2C9*13 variants.

Dongxu Wang, Hualan Wu, Qing Zhang, Xiaoyue Zhou, Yang An, Anxu Zhao, Jia Chong, Shuanghu Wang, Fang Wang, Jiefu Yang and 2 more

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Article in European journal of clinical pharmacology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

12 authors.

Dongxu Wang *Cardiovascular Department, Beijing Hospital, National Centre of Gerontology, Beijing, 100730, China.
Hualan Wu *Cardiovascular Department, Beijing Hospital, National Centre of Gerontology, Beijing, 100730, China.
Qing ZhangCardiovascular Department, Beijing Hospital, National Centre of Gerontology, Beijing, 100730, China.
Xiaoyue ZhouCardiovascular Department, Beijing Hospital, National Centre of Gerontology, Beijing, 100730, China.
Yang AnCardiovascular Department, Beijing Hospital, National Centre of Gerontology, Beijing, 100730, China.
Anxu ZhaoCardiovascular Department, Beijing Hospital, National Centre of Gerontology, Beijing, 100730, China.
Jia ChongCardiovascular Department, Beijing Hospital, National Centre of Gerontology, Beijing, 100730, China.
Shuanghu WangLaboratory of Clinical Pharmacy, The Sixth Affiliated Hospital of Wenzhou Medical University, The People's Hospital of Lishui, Lishui, 323020, China.
Fang WangCardiovascular Department, Beijing Hospital, National Centre of Gerontology, Beijing, 100730, China.
Jiefu YangCardiovascular Department, Beijing Hospital, National Centre of Gerontology, Beijing, 100730, China.
Dapeng DaiThe Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Beijing Hospital, National Centre of Gerontology, Beijing, 100730, China.
Hao ChenCardiovascular Department, Beijing Hospital, National Centre of Gerontology, Beijing, 100730, China. dr.chenhaomd_bjh@vip.163.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundExisting pharmacogenetic algorithms cannot fully explain warfarin dose variability in all patients. CYP2C9*13 is an important allelic variant in the Han Chinese population. However, adjustment of warfarin dosing in CYP2C9*13 variant carriers remains unclear. To the best of our knowledge, this study is the first to assess the effects of adjusting warfarin dosages in Han Chinese patients harbouring CYP2C9*13 variants.

methodsIn total, 971 warfarin-treated Han Chinese patients with atrial fibrillation were enrolled in this study. Clinical data were collected, and CYP2C9*2, *3, *13 and VKORC1-1639 G > A variants were genotyped. We quantitatively analysed the effect of CYP2C9*13 on warfarin maintenance dose and provided multiplicative adjustments for CYP2C9*13 using validated pharmacogenetic algorithms.

resultsApproximately 0.6% of the Han Chinese population carried CYP2C9*13 variant, and the genotype frequency was between those of CYP2C9*2 and CYP2C9*3. The warfarin maintenance doses were significantly reduced in CYP2C9*13 carriers. When CYP2C9*13 variants were not considered, the pharmacogenetic algorithms overestimated warfarin maintenance doses by 1.03-1.16 mg/d on average. The actual warfarin dose in CYP2C9*13 variant carriers was approximately 40% lower than the algorithm-predicted dose. Adjusting the warfarin-dosing algorithm according to the CYP2C9*13 allele could reduce the dose prediction error.

conclusionOur study showed that the algorithm-predicted doses should be lowered for CYP2C9*13 carriers. Inclusion of the CYP2C9*13 variant in the warfarin-dosing algorithm tends to predict the warfarin maintenance dose more accurately and improves the efficacy and safety of warfarin administration in Han Chinese patients.

Indexed as

AnticoagulantsWarfarinAlgorithmsCytochrome P-450 CYP2C9Dose-Response Relationship, DrugEast Asian PeopleGenotypeHumansVitamin K Epoxide ReductasesAnticoagulantsCYP2C9 protein, humanCytochrome P-450 CYP2C9Vitamin K Epoxide ReductasesVKORC1 protein, humanWarfarinAlleleCYP2C9Gene polymorphismWarfarinWarfarin-dosing algorithm

Identifiers

PMID37458773

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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.