Warfarin Pharmacogenetics in Pediatric Patients

《国际华法林》 最近发表的药物遗传学联盟 他们大型回溯性研究的结果 (IWPC，N Engl J Med 360：753-764,2009)。这些 数据有力地支持了一名 基于药物遗传学的华法林给药算法 以提高华法林的安全性。使用 基于药物遗传学的算法产生剂量 更接近于 稳定的治疗剂量比一个算法更好 仅基于临床数据或固定剂量 接近。作为收益的另一种衡量标准， 基因分型将对其产生影响的患者数量 产生的推荐剂量在20%以内 实际的治疗剂量，而另一个 算法或固定剂量法未得13例。 然而，只有6%的患者包括在这个 大型多中心研究在40年内 年龄。IWPC明确表示，额外的 需要就以下方面进行研究： 为儿童和儿童开发类似的算法 年轻人。拟议的研究将填补 这个重要的知识鸿沟。

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.