UBC Faculty Research and Publications

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, LM; Marban, Patrick; Wu, Tuck S; Winther, Michael D; Brunham, Liam R; Soong, Richie; Tai, Bee-Choo; Goh, Boon-Cher


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 

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