Role of pharmacodiagnostic of CYP2C9 variants in the optimization of warfarin therapy in Malaysia: a 6-month follow-up study

1. A retrospective study was conducted to explore the importance of CYP2C9 genotyping for the initiation and maintenance therapy of warfarin in clinical practice. A total of 191 patients on warfarin therapy in a local hospital were recruited after written informed consent. Their medical records were...

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Main Authors: Ngow, Harris Abdullah, Teh , Lay Kek, Langmia, I. M., Lew, W. L., Harun, R., Ismail, R., Salleh, Mohd Zaki
Format: Article
Language:English
Published: Informa Plc. 2008
Subjects:
Online Access:http://irep.iium.edu.my/5015/
http://irep.iium.edu.my/5015/1/Xenobiotica_Warfarin_Study.pdf
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author Ngow, Harris Abdullah
Teh , Lay Kek
Langmia, I. M.
Lew, W. L.
Harun, R.
Ismail, R.
Salleh, Mohd Zaki
author_facet Ngow, Harris Abdullah
Teh , Lay Kek
Langmia, I. M.
Lew, W. L.
Harun, R.
Ismail, R.
Salleh, Mohd Zaki
author_sort Ngow, Harris Abdullah
building IIUM Repository
collection Online Access
description 1. A retrospective study was conducted to explore the importance of CYP2C9 genotyping for the initiation and maintenance therapy of warfarin in clinical practice. A total of 191 patients on warfarin therapy in a local hospital were recruited after written informed consent. Their medical records were reviewed and no intervention of warfarin dose was performed. 2. A total of 5 ml of blood were taken from each subject for DNA extraction and identification of 1, 2, 3 and 4 CYP2C9 alleles, using a nested-allele-specific-multiplex-polymerase chain reaction (PCR). Half the patients were Malays and the remaining were Chinese. 3. Two genotypes were detected; 93.2% had CYP2C9 1/1 and 6.8% were CYP2C9 1/3. Warfarin doses were higher in patients with CYP2C91/1. Patients with the 1/3 genotype experienced a higher rate of serious and life-threatening bleeding; 15.4 versus 6.2 per 100 patients per 6 months. 4. The observation clearly highlights the inadequacy of the current dosing regimens and the need to move toward a more individualized approach to warfarin therapy. Prospective clinical studies are now being conducted to assess dosing algorithms that incorporate the contribution of the genotype to allow the individualization of warfarin dose.
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spelling iium-50152013-06-10T08:03:25Z http://irep.iium.edu.my/5015/ Role of pharmacodiagnostic of CYP2C9 variants in the optimization of warfarin therapy in Malaysia: a 6-month follow-up study Ngow, Harris Abdullah Teh , Lay Kek Langmia, I. M. Lew, W. L. Harun, R. Ismail, R. Salleh, Mohd Zaki RC Internal medicine RM Therapeutics. Pharmacology 1. A retrospective study was conducted to explore the importance of CYP2C9 genotyping for the initiation and maintenance therapy of warfarin in clinical practice. A total of 191 patients on warfarin therapy in a local hospital were recruited after written informed consent. Their medical records were reviewed and no intervention of warfarin dose was performed. 2. A total of 5 ml of blood were taken from each subject for DNA extraction and identification of 1, 2, 3 and 4 CYP2C9 alleles, using a nested-allele-specific-multiplex-polymerase chain reaction (PCR). Half the patients were Malays and the remaining were Chinese. 3. Two genotypes were detected; 93.2% had CYP2C9 1/1 and 6.8% were CYP2C9 1/3. Warfarin doses were higher in patients with CYP2C91/1. Patients with the 1/3 genotype experienced a higher rate of serious and life-threatening bleeding; 15.4 versus 6.2 per 100 patients per 6 months. 4. The observation clearly highlights the inadequacy of the current dosing regimens and the need to move toward a more individualized approach to warfarin therapy. Prospective clinical studies are now being conducted to assess dosing algorithms that incorporate the contribution of the genotype to allow the individualization of warfarin dose. Informa Plc. 2008 Article PeerReviewed application/pdf en http://irep.iium.edu.my/5015/1/Xenobiotica_Warfarin_Study.pdf Ngow, Harris Abdullah and Teh , Lay Kek and Langmia, I. M. and Lew, W. L. and Harun, R. and Ismail, R. and Salleh, Mohd Zaki (2008) Role of pharmacodiagnostic of CYP2C9 variants in the optimization of warfarin therapy in Malaysia: a 6-month follow-up study. Xenobiotica, 38 (6). pp. 641-651. ISSN 0049-8254 http://informahealthcare.com/doi/abs/10.1080/00498250801999087%20 10.1080/00498250801999087
spellingShingle RC Internal medicine
RM Therapeutics. Pharmacology
Ngow, Harris Abdullah
Teh , Lay Kek
Langmia, I. M.
Lew, W. L.
Harun, R.
Ismail, R.
Salleh, Mohd Zaki
Role of pharmacodiagnostic of CYP2C9 variants in the optimization of warfarin therapy in Malaysia: a 6-month follow-up study
title Role of pharmacodiagnostic of CYP2C9 variants in the optimization of warfarin therapy in Malaysia: a 6-month follow-up study
title_full Role of pharmacodiagnostic of CYP2C9 variants in the optimization of warfarin therapy in Malaysia: a 6-month follow-up study
title_fullStr Role of pharmacodiagnostic of CYP2C9 variants in the optimization of warfarin therapy in Malaysia: a 6-month follow-up study
title_full_unstemmed Role of pharmacodiagnostic of CYP2C9 variants in the optimization of warfarin therapy in Malaysia: a 6-month follow-up study
title_short Role of pharmacodiagnostic of CYP2C9 variants in the optimization of warfarin therapy in Malaysia: a 6-month follow-up study
title_sort role of pharmacodiagnostic of cyp2c9 variants in the optimization of warfarin therapy in malaysia: a 6-month follow-up study
topic RC Internal medicine
RM Therapeutics. Pharmacology
url http://irep.iium.edu.my/5015/
http://irep.iium.edu.my/5015/
http://irep.iium.edu.my/5015/
http://irep.iium.edu.my/5015/1/Xenobiotica_Warfarin_Study.pdf