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Warfarin therapy is complex and often requires careful consideration of multiple patient specific factors during initiation and chronic management. Identification of genetic variants that influence warfarin response via pharmacogenetic testing provides an opportunity to enhance the quality of therapy. Many studies have attempted to identify how genetic testing can improve warfarin management. Due to the variability in the study results and the lack of clinical outcome data, the true benefits of pharmacogenetic testing for warfarin remain unclear. If genetic testing has been obtained or is readily available prior to warfarin initiation, it is reasonable to incorporate genetic variants into the decision making process for the initial and suspected maintenance warfarin dose. If genetic testing is not readily available, initiating and managing warfarin using clinical characteristics alone compares similarly to pharmacogenetic based algorithm. The true impact of genetic testing on clinical outcomes requires further investigation.

Update on Genetic Testing and Warfarin