Warfarin Dosing: Do Genotype-Based Algorithms Improve Outcomes?

MedicalResearch.com Interview with:
David Ldr_david_l_brown. Brown, MD, FACC
Professor of Medicine
Cardiovascular Division
Washington University School of Medicine
St. Louis, MO 63110

MedicalResearch: What are the main findings of the study?

Dr. Brown: This meta-analysis of randomized controlled trials showed that using a genotype-based warfarin dosing algorithm did not improve the process or outcomes of anticoagulation compared to using a clinical dosing algorithm.

MedicalResearch: Were any of the findings unexpected?

Dr. Brown: The findings may be surprising to many clinicians and investigators since the genotypes used to adjust warfarin dosing in the included studies are responsible for approximately one-third of the variation in dose requirement among patients taking warfarin.

MedicalResearch: What should clinicians and patients take away from your report?

Dr. Brown: They should take away that although personalized medicine is an attractive concept, its implementation requires proof of patient benefit just like another new test, drug or procedure.

MedicalResearch: What recommendations do you have for future research as a result of this study? 

Dr. Brown: As new genetic polymorphisms are discovered and new algorithms are developed, they will need to be tested in appropriately sized trials to demonstrate clinical benefit.

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