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Warfarin pharmacogenomics in children
Author(s) -
Vear Susan I.,
Stein C. Michael,
Ho Richard H.
Publication year - 2013
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.24592
Subject(s) - pharmacogenomics , warfarin , medicine , vkorc1 , dosing , cyp2c9 , pharmacogenetics , therapeutic index , intensive care medicine , anticoagulant , pharmacology , drug , atrial fibrillation , genotype , biochemistry , chemistry , cytochrome p450 , metabolism , gene
Warfarin is the most commonly used oral anticoagulant worldwide. Warfarin has a narrow therapeutic index, requiring frequent monitoring of the INR to achieve therapeutic anticoagulation. The role of pharmacogenomics in warfarin disposition and response has been well established in adults, but remains unclear for pediatric patients. In this review, we focus on the important CYP2C9 and VKORC1 variants involved in warfarin response, our current understanding of warfarin disposition and pharmacogenomics, and recent warfarin pharmacogenetic studies in pediatric patients. Finally, we discuss the need for future pediatric studies and the clinical implications of developing pharmacogenetic‐based dosing algorithms in children. Pediatr Blood Cancer 2013;60:1402–1407. © 2013 Wiley Periodicals, Inc.