Experience of individualization of oral anticoagulants use and dosage in personalized medicine centre conditions

Abstract

The application of pharmacogenetic testing was analyzed in patients treated at the center of personalized medicine, in order to analyze gene polymorphism frequency - response predictors to indirect anticoagulants therapy, estimation of the warfarin dose selection time, the hospitalization duration. The presence of VKORC1 and CYP2C9 polymorphisms or homozygous polymorphisms combinations is quite common in the Russian population: CYP2C9*2 polymorphism (15.3%) was observed in 8 patients, CYP2C9*3 (9.6%) in 5 patients. VKORC1 gene A allele was detected in 18 patients, accounting for 34.6% of the whole group. In patients with this polymorphism warfarin administration according to the traditional algorithm often leads to excessive anticoagulation and bleeding. Initiation of warfarin therapy according to the scheme taking into account genotyping significantly increases the treatment safety and reduces the adverse events incidence in this group of patients.