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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MDPI AG
2021-06-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/13/2949 |
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| author | Hoi Yan Tong Alberto M. Borobia Manuel Quintana-Díaz Sara Fabra Manuel González-Viñolis Carmen Fernández-Capitán María A. Rodriguez-Dávila Alicia Lorenzo Ana María López-Parra Nuria Ruiz-Giménez Francisco Abad-Santos Carmen Suarez Olga Madridano Jorge Francisco Gómez-Cerezo Pilar Llamas Carlos Baeza-Richer Eduardo Arroyo-Pardo Antonio J. Carcas The PGX-ACE Spanish Investigators Group |
| author_facet | Hoi Yan Tong Alberto M. Borobia Manuel Quintana-Díaz Sara Fabra Manuel González-Viñolis Carmen Fernández-Capitán María A. Rodriguez-Dávila Alicia Lorenzo Ana María López-Parra Nuria Ruiz-Giménez Francisco Abad-Santos Carmen Suarez Olga Madridano Jorge Francisco Gómez-Cerezo Pilar Llamas Carlos Baeza-Richer Eduardo Arroyo-Pardo Antonio J. Carcas The PGX-ACE Spanish Investigators Group |
| author_sort | Hoi Yan Tong |
| collection | DOAJ |
| description | 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 (<i>CYP2C9*2</i>, <i>CYP2C9*3</i>, <i>VKORC1</i>, <i>CYP4F2</i>, <i>APOE</i>). 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 (<i>p</i> = 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. |
| first_indexed | 2024-03-10T09:54:33Z |
| format | Article |
| id | doaj.art-318978bb05d24b09a0943bdb2bdfa627 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T09:54:33Z |
| publishDate | 2021-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-318978bb05d24b09a0943bdb2bdfa6272023-11-22T02:25:21ZengMDPI AGJournal of Clinical Medicine2077-03832021-06-011013294910.3390/jcm10132949Acenocoumarol Pharmacogenetic Dosing Algorithm versus Usual Care in Patients with Venous Thromboembolism: A Randomised Clinical TrialHoi Yan Tong0Alberto M. Borobia1Manuel Quintana-Díaz2Sara Fabra3Manuel González-Viñolis4Carmen Fernández-Capitán5María A. Rodriguez-Dávila6Alicia Lorenzo7Ana María López-Parra8Nuria Ruiz-Giménez9Francisco Abad-Santos10Carmen Suarez11Olga Madridano12Jorge Francisco Gómez-Cerezo13Pilar Llamas14Carlos Baeza-Richer15Eduardo Arroyo-Pardo16Antonio J. Carcas17The PGX-ACE Spanish Investigators GroupClinical Pharmacology Department, La Paz University Hospital, IdiPAZ, 28046 Madrid, SpainClinical Pharmacology Department, La Paz University Hospital, IdiPAZ, 28046 Madrid, SpainGeneral Emergency Department, La Paz University Hospital, IdiPAZ, 28046 Madrid, SpainGeneral Emergency Department, La Paz University Hospital, IdiPAZ, 28046 Madrid, SpainGeneral Emergency Department, La Paz University Hospital, IdiPAZ, 28046 Madrid, SpainInternal Medicine Department, La Paz University Hospital, IdiPAZ, 28046 Madrid, SpainInternal Medicine Department, La Paz University Hospital, IdiPAZ, 28046 Madrid, SpainInternal Medicine Department, La Paz University Hospital, IdiPAZ, 28046 Madrid, SpainLaboratory of Population and Forensic Genetics, Department of Legal Medicine, Psyquiatry and Patology, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, SpainDepartment of Internal Medicine, University Hospital La Princesa, 28006 Madrid, SpainClinical Pharmacology Department, University Hospital La Princesa, Teófilo Hernando Institute, Autonomous University of Madrid (UAM), Health Research Institute La Princesa (IIS-IP), 28006 Madrid, SpainDepartment of Internal Medicine, University Hospital La Princesa, 28006 Madrid, SpainDepartment of Internal Medicine, University Hospital Infanta Sofía, 28702 Madrid, SpainDepartment of Internal Medicine, University Hospital Infanta Sofía, 28702 Madrid, SpainDepartment of Internal Medicine, University Hospital Jiménez Díaz Foundation, 28040 Madrid, SpainLaboratory of Population and Forensic Genetics, Department of Legal Medicine, Psyquiatry and Patology, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, SpainLaboratory of Population and Forensic Genetics, Department of Legal Medicine, Psyquiatry and Patology, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, SpainClinical Pharmacology Department, La Paz University Hospital, IdiPAZ, 28046 Madrid, SpainPatients 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 (<i>CYP2C9*2</i>, <i>CYP2C9*3</i>, <i>VKORC1</i>, <i>CYP4F2</i>, <i>APOE</i>). 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 (<i>p</i> = 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.https://www.mdpi.com/2077-0383/10/13/2949pharmacogeneticsacenocoumarolvenous thromboembolismclinical trial |
| spellingShingle | Hoi Yan Tong Alberto M. Borobia Manuel Quintana-Díaz Sara Fabra Manuel González-Viñolis Carmen Fernández-Capitán María A. Rodriguez-Dávila Alicia Lorenzo Ana María López-Parra Nuria Ruiz-Giménez Francisco Abad-Santos Carmen Suarez Olga Madridano Jorge Francisco Gómez-Cerezo Pilar Llamas Carlos Baeza-Richer Eduardo Arroyo-Pardo Antonio J. Carcas The PGX-ACE Spanish Investigators Group Acenocoumarol Pharmacogenetic Dosing Algorithm versus Usual Care in Patients with Venous Thromboembolism: A Randomised Clinical Trial Journal of Clinical Medicine pharmacogenetics acenocoumarol venous thromboembolism clinical trial |
| title | Acenocoumarol Pharmacogenetic Dosing Algorithm versus Usual Care in Patients with Venous Thromboembolism: A Randomised Clinical Trial |
| title_full | Acenocoumarol Pharmacogenetic Dosing Algorithm versus Usual Care in Patients with Venous Thromboembolism: A Randomised Clinical Trial |
| title_fullStr | Acenocoumarol Pharmacogenetic Dosing Algorithm versus Usual Care in Patients with Venous Thromboembolism: A Randomised Clinical Trial |
| title_full_unstemmed | Acenocoumarol Pharmacogenetic Dosing Algorithm versus Usual Care in Patients with Venous Thromboembolism: A Randomised Clinical Trial |
| title_short | Acenocoumarol Pharmacogenetic Dosing Algorithm versus Usual Care in Patients with Venous Thromboembolism: A Randomised Clinical Trial |
| title_sort | acenocoumarol pharmacogenetic dosing algorithm versus usual care in patients with venous thromboembolism a randomised clinical trial |
| topic | pharmacogenetics acenocoumarol venous thromboembolism clinical trial |
| url | https://www.mdpi.com/2077-0383/10/13/2949 |
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