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Oral anticoagulation with warfarin is significantly influenced by steroids and CYP2C9 polymorphisms in children with cancer
Author(s) -
Ruud Ellen,
Holmstrøm Henrik,
Bergan Stein,
Wesenberg Finn
Publication year - 2008
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.21133
Subject(s) - cyp2c9 , warfarin , medicine , concomitant , dosing , pharmacogenetics , cancer , anticoagulant , therapeutic index , pharmacology , oncology , genotype , drug , genetics , cytochrome p450 , atrial fibrillation , metabolism , biology , gene
Clinical management of warfarin therapy is complex, and dosing algorithms do not include genetic factors or interactions with other drugs for warfarin dose determinations. We evaluated the interaction of warfarin and CYP2C9 polymorphisms and concomitant corticosteroids in 29 children with cancer. Children with heterozygous polymorphisms of CYP2C9 achieved target INR sooner and more frequently had INR above the target level, compared to children without mutations. Children on concomitant steroids had significantly lower warfarin requirements. Thus, awareness of CYP2C9 genotype and steroid‐induced responsiveness to warfarin may be important when administrating oral anticoagulation in children. Pediatr Blood Cancer 2008;50:710–713. © 2007 Wiley‐Liss, Inc.