Genetic Determinants of Warfarin Anticoagulation Effect
The response to warfarin varies greatly among individuals. Some of this variability can be ascribed to genetic polymorphisms in the gene encoding for CYP2C9, the enzyme mediating the metabolism of S warfarin. In addition genetic polymorphism in other genes (i.e. VKORC1, factor VII) have been shown to account for some of the variability in the response to warfarin irrespective of CYP2C9.The present study has several segments:
- Evaluation of the relationship between genetic polymorphisms in the genes encoding for CYP2C9, VKORC1 and factor VII and warfarin maintenance dose at steady state. This study is a confirmation of previous data in our own population.
- Evaluation of relationship between genetic polymorphisms in the genes encoding for CYP2C9, VKORC1 and factor VII and warfarin loading dose during the induction period.
- Testing the hypothesis that warfarin loading based on the individual's combined CYP2C9, VKORC1 and factor VII genotype may be more efficient and associated with reduced adverse drug effects.
|Study Design:||Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single Blind
Primary Purpose: Treatment
|Official Title:||Warfarin Induction Regimen Based Upon CYP2C9, VKORC1 Factor VII Genotyping, PMR and INR Monitoring, as Compared to the Conventional Regimen: a Prospective Controlled Study|
- Pharmacokinetic end points:
- Warfarin clearance and formation clearance of 7-hydroxy-warfarin at steady state
- Maintenance dose of warfarin at steady state.
- Time to reach INR > 2.
- Time to reach pharmacodynamic steady state.
- Time spent at therapeutic INR <3 and >2.
- Time spent at INR >3.
- Time spent at INR <2.
- The incidence of minor and major bleeding episodes.
|Study Start Date:||August 2002|
Please refer to this study by its ClinicalTrials.gov identifier: NCT00162435
|Contact: Yoseph Caraco, MD||00 972 2 firstname.lastname@example.org|
|Hadassah Medical Organization||Recruiting|
|Contact: Arik Tzukert, DMD 00 972 2 6776095 email@example.com|
|Contact: Hadas Lemberg, PhD 00 972 2 6777572 firstname.lastname@example.org|
|Principal Investigator: Yoseph Caraco, MD|
|Principal Investigator:||Yoseph Caraco, MD||Hadassah Medical Organization|