The New England Journal of Medicine recently published an article, “A Randomized Trial of Genotype-Guided Dosing of Warfarin,” comparing the effect of genotype-guided dosing with that of standard dosing on anticoagulation control in patients starting warfarin therapy. A total of 455 patients was used in the trial where it was concluded that genotype-based dosing at the initiation of warfarin therapy increased the time in the therapeutic range and reduced the incidence of excessive anticoagulation, the time required to reach a therapeutic INR, the time required to reach a stable dose, and the number of adjustments in the dose of warfarin.
This also confirms an article by PGXL’s Dr. Mark Borgman, “Prospective Pilot Trial of PerMIT Versus Standard Anticoagulation Service Management of Patients Initiating Oral Anticoagulation,” The trial studies 26 subjects to compare genotype-based warfarin initiation and maintenance dosing with routine anticoagulation service management. The concluding data strengthened the case for prospective utilization of genotype information for warfarin therapy management. With more trials and findings resulting in genotype-testing benefits, clinical outcomes and patient benefits should hopefully improve in the future.