RT Journal Article
T1 Acenocoumarol Pharmacogenetic Dosing Algorithm versus Usual Care in Patients with Venous Thromboembolism: A Randomised Clinical Trial
A1 Tong, Hoi Yan
A1 Borobia, Alberto
A1 Quintana Díaz, Manuel
A1 Fabra, Sara
A1 González Viñolis, Manuel
A1 Fernández Capitán, Carmen
A1 Rodriguez Dávila, María
A1 Lorenzo, Alicia
A1 López Parra, Ana María
A1 Ruiz Giménez, Nuria
A1 Abad Santos, Francisco
A1 Suarez, Carmen
A1 Madridano, Olga
A1 Gómez Cerezo, Jorge
A1 Llamas, Pilar
A1 Baeza Richer, Carlos Ignacio
A1 Arroyo Pardo, Eduardo
A1 Carcas, Antonio J.
AB Patients with venous thromboembolism (VTE) require immediate treatment with anticoagulants such as acenocoumarol. This multicentre randomised clinical trial evaluated the effectiveness of a dosing pharmacogenetic algorithm versus a standard-of-care dose adjustment at the beginning of acenocoumarol treatment. We included 144 patients with VTE. On the day of recruitment, a blood sample was obtained for genotyping (CYP2C9*2, CYP2C9*3, VKORC1, CYP4F2, APOE). Dose adjustment was performed on day 3 or 4 after the start of treatment according to the assigned group and the follow-up was at 12 weeks. The principal variable was the percentage of patients with an international normalised ratio (INR) within the therapeutic range on day 7. Thirty-four (47.2%) patients had an INR within the therapeutic range at day 7 after the start of treatment in the genotype-guided group compared with 14 (21.9%) in the control group (p = 0.0023). There were no significant differences in the time to achieve a stable INR, the number of INRs within the range in the first 6 weeks and at the end of study. Our results suggest the use of a pharmacogenetic algorithm for patients with VTE could be useful in achieving target INR control in the first days of treatment.
AB Hoi Yan Tong
PB MDPI
SN 2077-0383
YR 2021
FD 2021-06-30
LK https://hdl.handle.net/20.500.14352/7415
UL https://hdl.handle.net/20.500.14352/7415
LA eng
NO This work was supported by a grant (TRA-010) from the Ministry of Health, Social Services and Equality of the Spanish Government and by the technical and financial support of IdiPAZ (Research Institute of La Paz University Hospital).
NO Ministerio de Sanidad, Servicios Sociales e Igualdad (España)
NO Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ)
DS Docta Complutense
RD 6 abr 2025