Warfarin Pharmacogenetics in Pediatric Patients

儿科患者的华法林药物遗传学

• 批准号: 7942852
• 负责人: JOAN COX GILL
• 金额: $ 68.64万
• 依托单位: MEDICAL COLLEGE OF WISCONSIN
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-30 至 2012-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7942852
• 关键词: Accounting; Adult; Age; Age-Years; Algorithms; Anticoagulant therapy; Anticoagulation; Apolipoprotein E; Blood Clot; Blood coagulation; Body Surface Area; CYP2C9 gene; Cardiac Catheterization Procedures; Caring; Child; Childhood; Clinical Data; Clinical Trials; Comorbidity; Congenital Abnormality; Data; Development; Disease; Dose; Event; Gender; Genetic; Genotype; Goals; Growth; Guidelines; Hepatic; Human; Incidence; International; Joints; Knowledge; Maintenance; Measures; Metabolism; Multicenter Studies; Operative Surgical Procedures; Patients; Pattern; Pediatric Hospitals; Personal Communication; Pharmaceutical Preparations; Pharmacogenetics; Pharmacogenomics; Population; Prophylactic treatment; Prospective Studies; Publishing; Reaction; Recommendation; Relative (related person); Research; Research Design; Resources; Retrospective Studies; Risk; Safety; Supported Employment; Testing; Therapeutic; Time; Variant; Warfarin; Wisconsin; base; cohort; genetic variant; genome wide association study; heart valve replacement; improved; medical schools; operation; patient population; patient safety; programs; response; tertiary care; trend; young adult

The International Warfarin Pharmacogenetics Consortium recently published the results of their large retrospective study (IWPC, N Engl J Med 360:753-764, 2009). These data strongly support the employment of a pharmacogenetic-based warfarin dosing algorithm to improve warfarin safety. Use of the pharmacogenetic-based algorithm produced dose recommendations that were significantly closer to the stable therapeutic dose than did an algorithm based on clinical data alone or a fixed-dose approach. As another measure of benefit, the number of patients for which genotyping would yield a recommended dose that was within 20% of the actual therapeutic dose while the other algorithm or fixed-dose approach did not was 13. However, only 6% of the patients included in this large, multicenter study were under 40 years of age. The IWPC clearly stated that additional research was needed with respect to the development of a similar algorithm for children and young adults. The proposed research will fill this important knowledge gap.

国际华法林 药物遗传学联盟最近发表 他们的大型回顾性研究的结果 (IWPC，N Engl J Med 360：753-764，2009)。这些 数据有力支撑就业 基于药物遗传学的华法林剂量算法 提高华法林的安全性。使用 基于药物遗传学的算法产生的剂量 明显接近的建议 比算法稳定的治疗剂量 仅基于临床数据或固定剂量 方法。作为衡量效益的另一个指标， 需要进行基因分型的患者数量 产生的推荐剂量在 20% 以内 实际治疗剂量，而其他 算法或固定剂量方法没有 13。 然而，只有 6% 的患者被纳入其中。 大型、多中心研究均在 40 岁以下 年龄。 IWPC 明确指出，额外 需要对此进行研究 为儿童开发类似的算法 年轻人。拟议的研究将填补 这一重要的知识差距。