The pharmacogenomics journal · 2019
Prospective validation of the International Warfarin Pharmacogenetics Consortium algorithm in high-risk elderly people (VIALE study).
Клиническое исследованиеСтатьяПоддержка исследования: вне правительства СШАВалидационное исследованиеНазвание и аннотация: Перевод в очереди
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Filippelli Amelia, Signoriello Simona, Bancone Ciro, Corbi Graziamaria, Manzo Valentina, Iesu Severino, Politi Cecilia, Gigantino Alberto, De Donato Maria Teresa, Masiello Paolo, Simeon Vittorio, Della Corte Alessandro, Cellurale Michele, Conti Valeria, Frigino Massimo, Ciarambino Tiziana, Marracino Marta, Carpenito Laura, Ferrara Nicola, De Feo Marisa, Gallo Ciro
Аннотация
We assessed the predictive accuracy of the Warfarin Pharmacogenetics Consortium (IWPC) algorithm in a prospective cohort of 376 high-risk elderly patients (≥65 years) who required new treatment with warfarin for either medical (non valvular atrial fibrillation) or surgical conditions (heart valve replacement), had ≥1 comorbid conditions, and regularly used ≥2 other drugs. Follow-up visits were performed according to clinical practice and lasted for a maximum of 1 year. Two hundred and eighty-three (75%) patients achieved a stable maintenance dose. Warfarin maintenance doses were low on average (median 20.3 mg/week, interquartile range, 14.1-27.7 mg/week) and were substantially overestimated by the IWPC algorithm. Overall the percentage of patients whose predicted dose of warfarin was within 20% of the actual stable dose was equal to 37.5%, (95% CI 32.0-43.3%). IWPC algorithm explained only 31% of the actual warfarin dose variability. Modifications of the IWPC algorithm are needed in high-risk elderly people.