Prediction models are the key to individualized drug therapy. Warfarin is a typical example of where pharmacogenetics could help the individual patient by modeling the dose, based on clinical factors and genetic variation in CYP2C9 and VKORC1. Clinical studies aiming to show whether pharmacogenetic warfarin dose predictions are superior to conventional initiation of warfarin are now underway. T...

SUMMARY BACKGROUND The Azorean population presents the highest standardized mortality rate for cardiovascular diseases (CVD) when compared to mainland Portugal and other populations. Since thrombosis is a common cause of CVD, we assessed four polymorphisms in three thrombotic risk genes - F5 (G1691A), F2 (G20210A) and MTHFR (C677T, A1298C), in 469 healthy blood donors from São Miguel Island ...

A 73-yr-old Korean man with permanent atrial fibrillation visited outpatient clinic with severely increased International Normalized Ratio (INR) values after taking a usual starting dosage of warfarin to prevent thromboembolism. We found out later from his blood tests that he had hyperthyroidism at the time of treatment initiation. His genetic analysis showed CYP2C9*1/*3 and VKORC1+1173TT genot...

Currently, there are very few guidelines linking the results of pharmacogenetic tests to specific therapeutic recommendations. Therefore, the Royal Dutch Association for the Advancement of Pharmacy established the Pharmacogenetics Working Group with the objective of developing pharmacogenetics-based therapeutic (dose) recommendations. After systematic review of the literature, recommendations w...

Coumarin derivatives, such as warfarin, acenocoumarol and phenprocoumon, are commonly prescribed as oral anticoagulants for the treatment of thromboembolic disorders. Therapy with coumarin derivatives is most effective when the international normalized ratio (INR) is kept within a narrow range. Prescribing of these drugs is difficult because of their narrow therapeutic window and the wide inter...

Warfarin is the most widely used oral anticoagulant for the treatment of thromboembolic disorders and for stroke prophylaxis. Warfarin is a problematic drug because it exhibits large interindividual variation in the required therapeutic dose, has a narrow therapeutic range, and shows multiple food and drug interactions. Its anticoagulant effect is monitored by measuring the international normal...

HyBeacon probes have been used to characterise SNPs in the CYP2C9 and VKORC1 genes associated with variations in the efficiency of warfarin metabolism. PCR amplification of genomic DNA and probe target melting analysis provided a robust and reliable method to differentiate polymorphic sequences at these loci. Probes capped with 5'-trimethoxystilbene were found to exhibit larger fluorescence dif...