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Optimization of warfarin dose by population-specific pharmacogenomic algorithm

The Pharmacogenomics Journal volume 12, pages 306–311 (2012)Cite this article

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Abstract

To optimize the warfarin dose, a population-specific pharmacogenomic algorithm was developed using multiple linear regression model with vitamin K intake and cytochrome P450 IIC polypeptide9 (CYP2C9*2 and *3), vitamin K epoxide reductase complex 1 (VKORC1*3, *4, D36Y and −1639 G>A) polymorphism profile of subjects who attained therapeutic international normalized ratio as predictors. New algorithm was validated by correlating with Wadelius, International Warfarin Pharmacogenetics Consortium and Gage algorithms; and with the therapeutic dose (r=0.64, P<0.0001). New algorithm was more accurate (Overall: 0.89 vs 0.51, warfarin resistant: 0.96 vs 0.77 and warfarin sensitive: 0.80 vs 0.24), more sensitive (0.87 vs 0.52) and specific (0.93 vs 0.50) compared with clinical data. It has significantly reduced the rate of overestimation (0.06 vs 0.50) and underestimation (0.13 vs 0.48). To conclude, this population-specific algorithm has greater clinical utility in optimizing the warfarin dose, thereby decreasing the adverse effects of suboptimal dose.

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Acknowledgements

This study was supported by the Ramanujan Fellowship, Department of Science and Technology (DST), Government of India, awarded to VK Kutala.

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Authors and Affiliations

  1. Department of Clinical Pharmacology and Therapeutics, Nizam's Institute of Medical Sciences, Hyderabad, India

    A Pavani, S M Naushad, Y Rupasree, T R Kumar & V K Kutala

  2. Department of Cardio-Thoracic Surgery, Nizam's Institute of Medical Sciences, Hyderabad, India

    A R Malempati & R C Mishra

  3. Department of Vascular Surgery, Nizam's Institute of Medical Sciences, Hyderabad, India

    R K Pinjala

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  1. A Pavani
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Correspondence to V K Kutala.

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Pavani, A., Naushad, S., Rupasree, Y. et al. Optimization of warfarin dose by population-specific pharmacogenomic algorithm. Pharmacogenomics J 12, 306–311 (2012). https://doi.org/10.1038/tpj.2011.4

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  • DOI: https://doi.org/10.1038/tpj.2011.4

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