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Genotype-guided versus traditional clinical dosing of warfarin in patients of Asian ancestry: a randomized controlled trial Syn, Nicholas L.; Wong, Andrea L.; Lee, Soo-Chin; Teoh, Hock-Luen; Yip, James W. L.; Seet, Raymond C.; Yeo, Wee T.; Kristanto, William; Bee, Ping-Chong; Poon, L. M.; Marban, Patrick; Wu, Tuck S.; Winther, Michael D.; Brunham, Liam R.; Soong, Richie; Tai, Bee-Choo; Goh, Boon-Cher

Abstract

Background: Genotype-guided warfarin dosing has been shown in some randomized trials to improve anticoagulation outcomes in individuals of European ancestry, yet its utility in Asian patients remains unresolved. Methods: An open-label, non-inferiority, 1:1 randomized trial was conducted at three academic hospitals in South East Asia, involving 322 ethnically diverse patients newly indicated for warfarin (NCT00700895). Clinical follow-up was 90 days. The primary efficacy measure was the number of dose titrations within the first 2 weeks of therapy, with a mean non-inferiority margin of 0.5 over the first 14 days of therapy. Results: Among 322 randomized patients, 269 were evaluable for the primary endpoint. Compared with traditional dosing, the genotype-guided group required fewer dose titrations during the first 2 weeks (1.77 vs. 2.93, difference −1.16, 90% CI −1.48 to −0.84, P 

Item Metadata

Title
Genotype-guided versus traditional clinical dosing of warfarin in patients of Asian ancestry: a randomized controlled trial
Creator
Syn, Nicholas L.; Wong, Andrea L.; Lee, Soo-Chin; Teoh, Hock-Luen; Yip, James W. L.; Seet, Raymond C.; Yeo, Wee T.; Kristanto, William; Bee, Ping-Chong; Poon, L. M.; Marban, Patrick; Wu, Tuck S.; Winther, Michael D.; Brunham, Liam R.; Soong, Richie; Tai, Bee-Choo; Goh, Boon-Cher
Contributor
University of British Columbia. Centre for Heart Lung Innovation
Publisher
BioMed Central
Date Issued
2018-07-10
Description
Background: Genotype-guided warfarin dosing has been shown in some randomized trials to improve anticoagulation outcomes in individuals of European ancestry, yet its utility in Asian patients remains unresolved. Methods: An open-label, non-inferiority, 1:1 randomized trial was conducted at three academic hospitals in South East Asia, involving 322 ethnically diverse patients newly indicated for warfarin (NCT00700895). Clinical follow-up was 90 days. The primary efficacy measure was the number of dose titrations within the first 2 weeks of therapy, with a mean non-inferiority margin of 0.5 over the first 14 days of therapy. Results: Among 322 randomized patients, 269 were evaluable for the primary endpoint. Compared with traditional dosing, the genotype-guided group required fewer dose titrations during the first 2 weeks (1.77 vs. 2.93, difference −1.16, 90% CI −1.48 to −0.84, P 
Subject
Pharmacogenetics; Pharmacogenomics; Precision medicine; CYP2C9; Cytochrome P450; VKORC1; Warfarin; Anticoagulants; Anticoagulation; Polymorphism
Genre
Article
Type
Text
Language
eng
Date Available
2018-07-10
Provider
Vancouver : University of British Columbia Library
Rights
Attribution 4.0 International (CC BY 4.0)
DOI
10.14288/1.0368868
URI
http://hdl.handle.net/2429/66459
Affiliation
Medicine, Faculty of; Other UBC; Non UBC; Medicine, Department of
Citation
BMC Medicine. 2018 Jul 10;16(1):104
Publisher DOI
10.1186/s12916-018-1093-8
Peer Review Status
Reviewed
Scholarly Level
Faculty
Copyright Holder
The Author(s).
Rights URI
http://creativecommons.org/licenses/by/4.0/
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Attribution 4.0 International (CC BY 4.0)