Will there be a role for genotyping in warfarin therapy?

Esteban Gandara, Philip S. Wells

Research output: Contribution to journalReview articlepeer-review

8 Scopus citations

Abstract

Purpose of review: In North America warfarin is the current standard for oral anticoagulation therapy in the treatment and/or prophylaxis of different thrombotic conditions. In daily clinical practice a significant proportion of patients on long-term warfarin therapy fail to stabilize within their target therapeutic range leading to a resultant increased risk of thromboembolism or bleeding. Various authors and agencies advocate the role of genetic testing to guide warfarin dosing. Recent findings: Evidence regarding the clinical efficacy and cost-effectiveness of genotype-based warfarin dosing has been conflicting, although some recent studies have suggested a potential benefit in certain subgroups. Summary: More evidence is needed before the wide adoption of genotype-based warfarin dosing. Future studies should be designed to address outcomes such as major bleeding or recurrent thrombosis, and allow economic evaluations.

Original languageEnglish
Pages (from-to)439-443
Number of pages5
JournalCurrent Opinion in Hematology
Volume17
Issue number5
DOIs
StatePublished - Sep 2010
Externally publishedYes

Keywords

  • evidence-based
  • genetic testing
  • maintenance dose
  • nomograms
  • randomized trials
  • warfarin

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