Therapeutic Dosing of Acenocoumarol: Proposal of a Population Specific Pharmacogenetic Dosing Algorithm and Its Validation in North Indians

@article{Rathore2012TherapeuticDO,
  title={Therapeutic Dosing of Acenocoumarol: Proposal of a Population Specific Pharmacogenetic Dosing Algorithm and Its Validation in North Indians},
  author={Saurabh Singh Rathore and Surendra Kumar Agarwal and Shantanu Pande and Sushil Kumar Singh and Tulika Mittal and Balraj Mittal},
  journal={PLoS ONE},
  year={2012},
  volume={7}
}
Objectives To develop a population specific pharmacogenetic acenocoumarol dosing algorithm for north Indian patients and show its efficiency in dosage prediction. Methods Multiple and linear stepwise regression analyses were used to include age, sex, height, weight, body surface area, smoking status, VKORC1 -1639 G>A, CYP4F2 1347 G>A, CYP2C9*2,*3 and GGCX 12970 C>G polymorphisms as variables to generate dosing algorithms. The new dosing models were compared with already reported algorithms and… 
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A novel acenocoumarol pharmacogenomic dosing algorithm for the Greek population of EU-PACT trial.
TLDR
Ethnic-specific dosing algorithm is suggested for better prediction of acenocoumarol dosage requirements in patients of Greek origin for better diagnosis and treatment decisions.
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An algorithm for dosing that included clinical factors (age, body mass index and concomitant drugs) and genetic variations of VKORC1, CYB2C9, CYP4F2 and APOE and developed, which correctly predicted the real stable dose of acenocoumarol in 59.8% of the cases.
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Age, body mass index (BMI), variation of CYP2C9, VKORC1, CYP4F2, and GGCX were the major determinants of acenocoumarol maintenance dose, accounting for 61.8 % of its variability.
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The variability in the stable ACN dose was better explained by a pharmacogenetic algorithm including clinical and genetic factors (CYP2C9, VKORC1, and APOE) than by a clinical algorithm, providing a more accurate dosage prediction.
Evaluation of genotype-guided acenocoumarol dosing algorithms in Russian patients
TLDR
Pat ethnicity and amiodarone intake are factors that must be considered when building future algorithms to find the perfect dosing formula of acenocoumarol maintenance doses in Russian patients.
Extrapolation of acenocoumarol pharmacogenetic algorithms.
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The genotyping of polymorphic variants in VKORC1 and CYP2C9, together with clinical and demographic parameters, can serve for more precise definition of the individual starting and maintenance doses of coumarin derivatives in each patient.
Genotype-guided therapy improves initial acenocoumarol dosing. Results from a prospective randomised study.
TLDR
Genotype-guided dosing was associated with a higher percentage of patients with steady dose than routine practice when starting oral anticoagulation with acenocoumarol, and the proportion of steadily antICOagulated patients remained significantly higher in PGx than standard care patients.
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