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Warfarin Dose Model for the Prediction of Stable Maintenance Dose in Indian Patients

Lookup NU author(s): Dr Peter Avery, Professor Farhad Kamali

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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).


Abstract

© 2017, © The Author(s) 2017. The main aim of this study was to screen various genetic and nongenetic factors that are known to alter warfarin response and to generate a model to predict stable warfarin maintenance dose for Indian patients. The study comprised of 300 warfarin-treated patients. Followed by extensive literature review, 10 single-nucleotide polymorphisms, that is, VKORC1-1639 G>A (rs9923231), CYP2C9*2 (rs1799853), CYP2C9*3 (rs1057910), FVII R353Q (rs6046), GGCX 12970 C>G (rs11676382), CALU c.*4A>G (rs1043550), EPHX1 c.337T>C (rs1051740), GGCX: c.214+597G>A (rs12714145), GGCX: 8016G>A (rs699664), and CYP4F2 V433M (rs2108622), and 5 nongenetic factors, that is, age, gender, smoking, alcoholism, and diet, were selected to find their association with warfarin response. The univariate analysis was carried out for 15 variables (10 genetic and 5 nongenetic). Five variables, that is, VKORC1-1639 G>A, CYP2C9*2, CYP2C9*3, age, and diet, were found to be significantly associated with warfarin response in univariate analysis. These 5 variables were entered in stepwise and multiple regression analysis to generate a prediction model for stable warfarin maintenance dose. The generated model scored R2 of.67, which indicates that this model can explain 67% of warfarin dose variability. The generated model will help in prescribing more accurate warfarin maintenance dosing in Indian patients and will also help in minimizing warfarin-induced adverse drug reactions and a better quality of life in these patients.


Publication metadata

Author(s): Gaikwad T, Ghosh K, Avery P, Kamali F, Shetty S

Publication type: Article

Publication status: Published

Journal: Clinical and Applied Thrombosis/Hemostasis

Year: 2018

Volume: 24

Issue: 2

Pages: 353-359

Print publication date: 01/03/2018

Online publication date: 04/01/2017

Acceptance date: 02/04/2016

ISSN (print): 1076-0296

ISSN (electronic): 1938-2723

Publisher: Sage Publications Inc.

URL: https://doi.org/10.1177/1076029616683046

DOI: 10.1177/1076029616683046


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