What is warfarin?
Warfarin is a narrow therapeutic index oral anticoagulant commonly prescribed to prevent blood clot formation and reduce the risk of stroke, deep vein thrombosis, and pulmonary thromboembolism. It is especially crucial for the patients with atrial fibrillation, mechanical heart valves, and history of clotting disorders.
Warfarin dosing challenges
Since warfarin is a narrow therapeutic index drug, the optimal doses vary significantly among individual patients. The warfarin metabolism is also altered by genetic factors (VKORC1, and CYP2C9), diet, BMI, concomitant drug interaction, etc. Overdosing of warfarin can lead to some serious bleeding complications while underdosing leads to the risk of blood clots.
Pharmacogenetics of warfarin
Pharmacogenetics explains how patients’ genetic makeup can alter the drug response. Understanding the individual patients’ genotype can help tailor the accurate warfarin dose for them, optimizing the dose and reducing the adverse effects.
Our algorithm
Our team has developed two algorithms, one is non-genetic based i.e. clinically guided (alone) and the other is pharmacogenetically guided algorithm. These two algorithms integrate the latest scientific research findings and clinical evidence (reference section of this webpage). The pharmacogenetic algorithm takes into the account a common significant SNP genotypes i.e., VKORC1 (rs9923231), CYP2C9*2, and CYP2C9*3; in addition to the BMI and comorbidity presence (diabetes and/or hypothyroidism) while the clinical algorithm-based warfarin dose calculation requires only comorbidity presence and BMI [clinical findings].
Benefits of using our algorithms
Improved safety and efficacy: Our algorithms help reduce adverse effects of warfarin dosing (bleeding and thromboembolism) by tailoring warfarin dose based on the significant genetic, clinical, and non-genetic factors.
Streamlined treatment: Our algorithms streamline the dosing process, allowing the healthcare providers to make informed decisions quickly and effectively.
Cost effectiveness: Warfarin dose optimization can lead to cost savings by minimizing the PT/INR tests, hospitalization due to adverse events, etc.
Disclaimer: Our algorithms are based on our recent research. Healthcare providers should use their clinical judgement and consider the patient-specific factors when making treatment decisions.
Join us on this journey of advancing precision medicine in warfarin therapy. Explore our resources, learn more about warfarin pharmacogenetics, and discover how precision medicine can improve the patient outcomes.