Moderate effect of GGCX polymorphisms on patients warfarin dosage requirement- a meta-analysis

Objective: Association studies on the effects of GGCX gene polymorphisms on warfarin stable dose have shown conflicting results. The aim of this study is to quantitatively summarize whether GGCX gene polymorphisms have potential roles in warfarin dose requirement. Methods: Publications were searched in PubMed, Medline and ISI Web of Knowledge and chosen by exact inclusion and exclusion criteria. A meta-analysis was conducted by using Revman 5.0 software to determine the association between common polymorphisms of the three genes and warfarin dose requirement. Results: Data were extracted from 13 publications with 4167 patients enrolled. Two common polymorphisms (rs699664, rs12714145) of GGCX were included for further meta-analyses. Comparing to rs699664AA geontype carriers, rs699664GG genotype carriers requered higer 3% [95% CI: 2% 4%, P-valus < 0.0001] warfarin dose. The warfarin dosage requirement showed no significant difference between rs699664GG and rs699664GA genotype carriers, P=0.51. Compared to rs12714145AA carriers, the GG and GA genotype carriers needed 5% (95% CI, 1% 9%; P = 0.01) and 4% (95% CI, 1% 8%; P = 0.02) lower warfarin dosage, respectively. The warfarin dosage requirement showed no significant difference between GG and GA genotype carriers, P=0.12. Conclusion: Our study showed that GGCX polymorphisms were significantly associated with warfarin dose requirement. These polymorphisms should be considered in future warfarin personalized treatment.