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Genes affecting warfarin response—interactive or additive?
Author(s) -
Cavallari Larisa H.,
Duarte Julio D.
Publication year - 2015
Publication title -
the journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.92
H-Index - 116
eISSN - 1552-4604
pISSN - 0091-2700
DOI - 10.1002/jcph.425
Subject(s) - vkorc1 , vitamin k epoxide reductase , warfarin , dosing , cyp2c9 , genotype , pharmacology , medicine , biology , cohort , pharmacogenetics , genetics , gene , atrial fibrillation
Genotypes for cytochrome P450 (CYP) 2C9 and vitamin K epoxide reductase complex 1 (VKORC1) contribute significantly to the inter‐patient variability in warfarin dose requirements. These genotypes in addition to clinical factors explain approximately 50% of the dose variability in Europeans, but less in other populations. Thus, a large portion of the variability remains unexplained and has been the focus of on‐going research. Trials evaluating the clinical utility of genotype‐guided warfarin dosing have shown a benefit in Europeans, but not in an ethnically diverse cohort. Identifying and accounting for variants important in non‐European populations will likely be necessary before a benefit with genotype‐guided dosing will be realized in these populations.