What is it about?

The results suggest that a pharmacogenetic algorithm (which takes into account Vitamin K epoxide reductase complex 1, VKORC1, and Cytochrome P450 2C9, CYP2C9, genotype status) helps to improve anticoagulation control in patient populations of Chinese ancestry but not African American ancestry.

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Why is it important?

Warfarin is a notoriously difficult to administer because dose requirements are highly variable between patients (it can easily range from 0.5 to 7mg - a 14-fold difference). Ethnicity influences the outcomes because, at a population level, it is a determinant of pharmacogenetic allele frequencies, and also affects the inheritance of haplotype structures.

Perspectives

It's interesting that a Monte Carlo based simulation was used. This is useful and insightful given the absence of any published randomized controlled trials of genotype-guided dosing of warfarin in Asians, as of 2015. Therefore, this paper is also a demonstration of a useful strategy (in silico simulations) for pre-clinical work. https://www.linkedin.com/in/nicholassyn

Mr Nicholas Li-Xun Syn
National University Cancer Institute, Singapore

Read the Original

This page is a summary of: Pharmacogenetic versus clinical dosing of warfarin in individuals of Chinese and African-American ancestry, Pharmacogenetics and Genomics, October 2015, Wolters Kluwer Health,
DOI: 10.1097/fpc.0000000000000165.
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