Acenocoumarol Pharmacogenetic Dosing Algorithm versus Usual Care in Patients with Venous Thromboembolism: A Randomised Clinical Trial

Patients with venous thromboembolism (VTE) require immediate treatment with anticoagulants such as acenocoumarol. This multicentre randomised clinical trial evaluated the effectiveness of a dosing pharmacogenetic algorithm versus a standard-of-care dose adjustment at the beginning of acenocoumarol t...

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Detalles Bibliográficos
Autores: Tong, Hoi Yan, Borobia, Alberto, Quintana Díaz, Manuel, Fabra, Sara, González Viñolis, Manuel, Fernández Capitán, Carmen, Rodriguez Dávila, María, Lorenzo, Alicia, López Parra, Ana María, Ruiz Giménez, Nuria, Abad Santos, Francisco, Suarez, Carmen, Madridano, Olga, Gómez Cerezo, Jorge, Llamas, Pilar, Baeza Richer, Carlos Ignacio, Arroyo Pardo, Eduardo, Carcas, Antonio J.
Tipo de recurso: artículo
Fecha de publicación:2021
País:España
Institución:Universidad Complutense de Madrid (UCM)
Repositorio:Docta Complutense
Idioma:inglés
OAI Identifier:oai:docta.ucm.es:20.500.14352/7415
Acceso en línea:https://hdl.handle.net/20.500.14352/7415
Access Level:acceso abierto
Palabra clave:611.1
Pharmacogenetics
Acenocoumarol
Venous thromboembolism
Clinical trial
Medicina
Sistema cardiovascular
32 Ciencias Médicas
2411.03 Fisiología Cardiovascular
Descripción
Sumario:Patients with venous thromboembolism (VTE) require immediate treatment with anticoagulants such as acenocoumarol. This multicentre randomised clinical trial evaluated the effectiveness of a dosing pharmacogenetic algorithm versus a standard-of-care dose adjustment at the beginning of acenocoumarol treatment. We included 144 patients with VTE. On the day of recruitment, a blood sample was obtained for genotyping (CYP2C9*2, CYP2C9*3, VKORC1, CYP4F2, APOE). Dose adjustment was performed on day 3 or 4 after the start of treatment according to the assigned group and the follow-up was at 12 weeks. The principal variable was the percentage of patients with an international normalised ratio (INR) within the therapeutic range on day 7. Thirty-four (47.2%) patients had an INR within the therapeutic range at day 7 after the start of treatment in the genotype-guided group compared with 14 (21.9%) in the control group (p = 0.0023). There were no significant differences in the time to achieve a stable INR, the number of INRs within the range in the first 6 weeks and at the end of study. Our results suggest the use of a pharmacogenetic algorithm for patients with VTE could be useful in achieving target INR control in the first days of treatment.

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