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Genetics May Help Fine-Tune Warfarin Dosage
Date:2/18/2009

1st century," Becker said. "Genetic testing added substantially to traditionally employed daily dose prediction methods, particularly among patients with low dose requirements."

The combination of patient-specific characteristics and genetic variations was able to minimize the likelihood of recommending excessively high and potentially dangerous doses of warfarin, Becker said.

"While the potential benefit of warfarin management algorithms that employ genetic testing has not been established, and therefore cannot be recommended in daily clinical practice, accumulating evidence is provocative and supports further research," he said.

Another expert cautioned that using genetics to establish drug doses is still a long way off, however.

"There is an important clinical need to develop better means of determining appropriate initial dosing of warfarin for each individual patient," said Dr. Gregg C. Fonarow, a professor of cardiology at the University of California, Los Angeles.

"However, as this study is retrospective, it could not evaluate outcomes, and recent clinical trials have failed to confirm the expected benefits of other pharmacogenetic algorithms for warfarin dosing [so] prospective clinical trials are required to determine the value, if any, of the findings in this study," he said.

More information

The U.S. National Library of Medicine has more on pharmacogenomics.



SOURCES: Russ Altman, M.D., Ph.D., professor, bioengineering, genetics and medicine, Stanford University School of Medicine, Stanford, Calif.; Teri Klein, Ph.D., senior research scientist in genetics, Stanford University School of Medicine, Stanford, Calif.; Richard C. Becker, M.D., professor, medicine, divisions of cardiology and hematology, Duke University School of Medicine, Durham, N.
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