Assessing the Clinical Benefits of a Pharmacogenetics-Guided Dosing Regiment for Calculating Warfarin Maintenance Dose

Summary

Interethnic differences in warfarin dose requirements in the Asian population have been well described. Our previous studies showed that warfarin maintenance doses in our multi-ethnic population were closely related to patient demographics and genetic polymorphisms in cytochrome(CYP)P4502C9 and vitamin K epoxide reductase complex subunit 1(VKORC1). A retrospective regression model combining these predictors accounts for 57.8% of the variability in warfarin dose.

Timeline

Start

2006-08

Primary completion

2016-08

Completion

2017-08

Outcome

Met primary endpoint

paper fewer dose titrations during the first 2 weeks (1.77 vs. 2.93, difference -1.16, 90% CI -1.48 to -0.84, P < 0.001 for both non-inferiority and superiority). PMID 29986700 ↗

Publications

• Wong HJ, Teo YN, Teo YH, Syn NL, Wong AL, Teoh HL, Seet RCS, Lee SC, Goh BC, Sia CH. Subgroup analysis of genotype guided vs traditional warfarin dosing in Asian patients from an open label randomized trial. Sci Rep. 2026 Jan 2;16(1):3670. doi: 10.1038/s41598-025-33831-9.
• Syn NL, Wong AL, Lee SC, Teoh HL, Yip JWL, Seet RC, Yeo WT, Kristanto W, Bee PC, Poon LM, Marban P, Wu TS, Winther MD, Brunham LR, Soong R, Tai BC, Goh BC. Genotype-guided versus traditional clinical dosing of warfarin in patients of Asian ancestry: a randomized controlled trial. BMC Med. 2018 Jul 10;16(1):104. doi: 10.1186/s12916-018-1093-8.

Drugs

Indications

No indication recorded.