Pharmacogenetic impact of VKORC1 and CYP2C9 allelic variants on warfarin dose requirements in a hispanic population isolate

ABSTRACT: Warfarin is the most prescribed oral anticoagulant worldwide. Because of the complexity of warfarin therapy, we attempted to dissect genetic from bioenviron mental factors influencing warfarin dose responses in individuals of a genetic isolate of Hispanic ancestry. A total of 191 patients with standard values of international normalized ratio were recruited. Three groups with a significantly different warfarin dose response were identified, that is, sensitive (2.28 + 0.50 mg/d), intermediate (4.2 + 0.76 mg/d), and resistant (7.40 + 1.54 mg/d; Tukey test, P < .001). Age had a significant inverse correlation with warfarin dose (P < .001; effective dose diminished 0.56 mg/d/decade). Required doses were higher for individuals with CYP2C9 variants containing the allele *1 compared to those individuals with variants composed of other alleles (P 1⁄4 .006). Similarly, individuals with VKORC1-1639GG and VKORC1-1639GA genotypes also required higher doses compared to the AA genotype (P < .001). Evaluation of potential gene-gene interactions between CYP2C9 and VKORC1 polymorphisms showed significant differences in dosing for CYP2C9 genotypes within the VKORC1-1639G/A subgroup (P 1⁄4 .013). A stepwise multivariate linear regression analysis showed that 38.2% of the warfarin dose response variance was accounted for by a model involving age (20.9%), VKORC1-1639G/A (11.3%), and CYP2C9*1, *2, and *3 variants (7.1%). These results corroborate previous findings on warfarin pharmacogenetics and define a contrastable gene-bioenvironment interaction model suited to be used in Hispanic populations.

• Autores: Palacio Muñoz, Lina Marcela; Falla Avila, Diana Yanina; Tobón, Ignacio; Mejía Restrepo, Fernando Antonio; Lewis, John E.; Martínez, Ariel F.; Arcos Burgos, Oscar Mauricio; Camargo Guerrero, Mauricio
• Tipo de recurso: Article of investigation
• Fecha de publicación: 2010
• Institución: Universidad de Antioquia
• Repositorio: Repositorio UdeA
• Idioma: eng
• OAI Identifier: oai:bibliotecadigital.udea.edu.co:10495/41789
• Acceso en línea: https://hdl.handle.net/10495/41789
• Palabra clave: Anticoagulantes - administración y dosificación; Anticoagulants - administration and dosage; Anticoagulantes - farmacocinética; Anticoagulants - pharmacokinetics; Hidrocarburo de Aril Hidroxilasas; Aryl Hydrocarbon Hydroxylases; Colombia - epidemiología; Colombia - epidemiology; Citocromo P-450 CYP2C9; Cytochrome P-450 CYP2C9; Relación Dosis-Respuesta a Droga; Dose-Response Relationship, Drug; Etnicidad - estadística y datos numéricos; Ethnicity - statistics and numerical data; Frecuencia de los Genes; Gene Frequency; Variación Genética; Genetic Variation; Genotipo; Genotype; Oxigenasas de Función Mixta; Mixed Function Oxygenases; Trombosis; Thrombosis; Vitamina K Epóxido Reductasas; Vitamin K Epoxide Reductases; Warfarina; Warfarin; https://id.nlm.nih.gov/mesh/D000925; https://id.nlm.nih.gov/mesh/D001189; https://id.nlm.nih.gov/mesh/D003105; https://id.nlm.nih.gov/mesh/D065729; https://id.nlm.nih.gov/mesh/D004305; https://id.nlm.nih.gov/mesh/D005006; https://id.nlm.nih.gov/mesh/D005787; https://id.nlm.nih.gov/mesh/D014644; https://id.nlm.nih.gov/mesh/D005838; https://id.nlm.nih.gov/mesh/D006899; https://id.nlm.nih.gov/mesh/D013927; https://id.nlm.nih.gov/mesh/D064417; https://id.nlm.nih.gov/mesh/D014859
• Rights: openAccess
• License: http://creativecommons.org/licenses/by-nc/2.5/co/