ArticleNaunyn-Schmiedeberg's archives of pharmacology2026
Real-world clinical validation study: individualized warfarin dosing strategy integrating genetic polymorphisms and Bayesian.
Article in Naunyn-Schmiedeberg's archives of pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
This study aims to evaluate the clinical efficacy and safety of Bayesian pharmacogenomic-guided dosing. In this study, sixty patients enrolled from January 2022 to December 2023 were assigned to either a Bayesian pharmacogenomic-guided dosing group (n = 30) or a conventional dosing group (n = 30). The Bayesian pharmacogenomic-guided dosing group received warfarin maintenance doses optimized by clinical pharmacists using a pharmacokinetic-pharmacodynamic model that incorporated demographic, clinical, and genetic variables. Patients in the conventional dosing group received warfarin dose adjustments based on clinical judgment and international normalized ratio (INR). During a 3-month follow-up, both groups were monitored for the following parameters: daily warfarin dose (mg/day), INR, time to first therapeutic INR, time to stable anticoagulation, percentage of time in target range, and safety outcomes. The Bayesian pharmacogenomic-guided dosing group outperformed the conventional group across all efficacy endpoints. The Bayesian pharmacogenomic-guided dosing group achieved a significantly shorter time to first therapeutic INR than the conventional group (7.71 ± 3.95 days vs. 19.18 ± 9.08 days, P < 0.01). The rates of achieving stable anticoagulation were significantly higher in the Bayesian pharmacogenomic-guided dosing group than in the conventional group (within 2 weeks: 50.0% vs. 10.0%, P < 0.01; within 3 weeks: 90.0% vs. 33.3%, P < 0.01). Compared to the conventional group, the percentage of time in target range was significantly higher in the Bayesian pharmacogenomic-guided dosing group over 30 days (86.8% vs. 16.77%, P < 0.001). Safety analysis showed that the incidence of adverse events was significantly lower in the Bayesian pharmacogenomic-guided dosing group (3.33% vs. 40.0%, P < 0.01). No major bleeding events occurred in either group. Relative to empirical management, Bayesian pharmacogenomic-guided dosing not only enhanced anticoagulation precision but also accelerated the achievement of therapeutic targets. These findings support the implementation of model-informed precision dosing strategies in clinical practice.
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