Warfarin is an effective, commonly prescribed anticoagulant used to treat and prevent thrombotic events. Because of historically high rates of drug-associated adverse events, warfarin remains underprescribed. Further, interindividual variability in therapeutic dose mandates frequent monitoring until target anticoagulation is achieved. Genetic polymorphisms… (More)
High variability in drug response and a narrow therapeutic index complicate warfarin therapy initiation. No existing algorithm provides recommendations on refining the initial warfarin dose based on genetic variables, clinical data, and international normalized ratio (INR) values. Our goal was to develop such an algorithm. We studied 92 patients undergoing… (More)
The risk of venous thromboembolism (VTE) is higher after the total hip or knee replacement surgery than after almost any other surgical procedure; warfarin sodium is commonly prescribed to reduce this peri-operative risk. Warfarin has a narrow therapeutic window with high inter-individual dose variability and can cause hemorrhage. The genetics-informatics… (More)
that the pET be used to monitor patients receiving oral enzyme replacement therapy, which is a major drawback for the clinical application of the pET. On the other hand, the antigenic substrate in the pET seems to be equally stable in relation to elastase 1. Only elastase concentrations determined with the pET in stools stored at 4 °C for 48 h were… (More)
BACKGROUND The application of pharmacogenetic results requires demonstrable correlations between a test result and an indicated specific course of action. We developed a computational decision-support tool that combines patient-specific genotype and phenotype information to provide strategic dosage guidance. This tool, through estimating quantitative and… (More)
Availability of the human genome sequence offers the promise of personalized medicine through pharma-cogenomics. Warfarin, a member of the coumarin family of oral anticoagulants used to prevent and treat thromboembolic disorders and one of the top 20 prescribed medications in the US, is an ideal drug for applying the principles of pharmacogenetics. Warfarin… (More)
Warfarin's monopoly on oral anticoagulation therapy, as well as that of other vitamin K antagonists derived from coumarin, is over. Two new classes of drugs, oral direct thrombin inhibitors (DTI) 1 and oral direct factor Xa inhibitors (DFXaI), are steadily obtaining regulatory approval for prevention of thromboembolic events in patients who have atrial… (More)
Use of recombinant factor VIIa for hip surgery in a patient with factor-VII deficiency: A case report.