Prospective Genotyping For Total Hip or Knee Replacement Patients Receiving Warfarin (Coumadin)

Summary

Several human genes affect how medications are metabolized by the body. It is believed that knowledge of variations of these genes can help health care providers better manage an anticoagulation medicine called warfarin (Coumadin®)and as a result decrease patient problems with bleeding or the development of blood clots. This study was designed to evaluate if genetic testing can improve warfarin initiation better than usual care.

Timeline

Start

2006-09

Primary completion

2008-10

Completion

2008-10

Outcome

Missed primary endpoint

paper Endpoints did not achieve statistical significance, possibly due to the management of this study by a dedicated and experienced anticoagulation services team. PMID 20386359 ↗

paper In conclusion, gene-based dosing did not improve warfarin management as defined by INR dose response, using the described protocols for implementation. PMID 20386359 ↗

Publications

• Results McMillin GA, Melis R, Wilson A, Strong MB, Wanner NA, Vinik RG, Peters CL, Pendleton RC. Gene-based warfarin dosing compared with standard of care practices in an orthopedic surgery population: a prospective, parallel cohort study. Ther Drug Monit. 2010 Jun;32(3):338-45. doi: 10.1097/FTD.0b013e3181d925bb.

Drugs

Evaluation	Drug	Modality	Dose	Route
Subject	Warfarin	Small molecule	—	—

Indications