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Dosage of Drug for Anticoagulant to Be Determined by Genetics
August 22, 2007 at 4:51 PM
Drug News
Too much warfarin can cause severe bleeding, and too little can cause dangerous blood clots. Presently the physicians do not have an accurate guide as to much dosage of warafin a patient needs. He uses a trial and error method for the administration of the drug and then continually monitor a patients International Normalized Ratio (INR) value (a measure of how fast the blood clots), during treatment to tweak the dosage. The research is published in the issue of Blood, the journal of the American Society of Hematology.
For the first time, a group of St. Louis researchers combined the standard INR method with genetic testing to predict the therapeutic warfarin dose. Since warfarin is often prescribed after major orthopedic surgery to prevent blood clots in the legs, the study followed 92 adults undergoing either total hip or knee replacement at the Washington University Medical Center, who had never previously taken the anticoagulant.
Prior to warfarin treatment, the researchers collected blood samples and each patients medical history. The blood tests were used to examine variations in two genes, CYP2C9 and VKORC1, that may affect warfarin dosing. Variants in CYP2C9 impair the bodys breakdown of warfarin; variants in VKORC1 cause increased warfarin sensitivity. The patients were assigned initial doses of warfarin based on clinical factors and their genotype. The researchers followed the patients until successful treatment outcomes were achieved several weeks later.
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