Why admixture matters in genetically-guided therapy: missed targets in the COAG and EU-PACT trials.
Year: 2015
Type: letter
Abstract: The long-awaited results from 2 major randomized clinical trials of warfarin pharmacogenetics (i.e., COAG and EU-PACT: ClinicalTrial.gov identifiers {type:clinical-trial,attrs:{text:NCT00839657,term_id:NCT00839657}}NCT00839657 and {type:clinical-trial,attrs:{text:NCT01119300,term_id:NCT01119300}}NCT01119300, respectively) were recently published (1–2). These studies were aimed at demonstrating the clinical utility of guiding individual warfarin dosing by genotyping patients in order to attain a better control of anticoagulation over the first 4 weeks of therapy. To that end, the respective mean percentages of time within the therapeutic INR range (primary outcome) in the two arms of each study (i.e., treatments guided by a pharmacogenetic-driven regression model in one arm and the standard clinical algorithm in the other) were independently compared by the authors of these two studies after dosing patients, accordingly. The COAG trial findings suggested non-superiority (but also non-inferiority) of the pharmacogenetic-guided warfarin dosing method over standard clinical procedures to dosing in terms of ensuring the stability of patients on warfarin during the first 4 weeks of therapy.
Source: PubMed
Language: English
Subfield: Pharmacology
Domain: Life Sciences
Open Access status: green
Awards: System for DNA-Guided Optimization and Personalization of Statin Therapy, Pharmacogenetics of Warfarin in Puerto Rican Patients using a Physiogenomics Appr, A Genomic Approach to Warfarin Dose Prescription in Admixed Caribbean Hispanics., Center for Collaborative Research in Health Disparities, Center for Collaborative Research in Health Disparities
OpenAlex ID: W2138751355