Genotype-guided dosing of coumarin derivatives: the European pharmacogenetics of anticoagulant therapy (EU-PACT) trial design.

Abstract:

:The narrow therapeutic range and wide interpatient variability in dose requirement make anticoagulation response to coumarin derivatives unpredictable. As a result, patients require frequent monitoring to avert adverse effects and maintain therapeutic efficacy. Polymorphisms in VKORC1 and CYP2C9 jointly account for about 40% of the interindividual variability in dose requirements. To date, several pharmacogenetic-guided dosing algorithms for coumarin derivatives, predominately for warfarin, have been developed. However, the potential benefit of these dosing algorithms in terms of their safety and clinical utility has not been adequately investigated in randomized settings. The European Pharmacogenetics of Anticoagulant Therapy (EU-PACT) trial will assess, in a single-blinded and randomized controlled trial with a follow-up period of 3 months, the safety and clinical utility of genotype-guided dosing in daily practice for the three main coumarin derivatives used in Europe. The primary outcome measure is the percentage time in the therapeutic range for international normalized ratio. This report describes the design and protocol for the trial.

journal_name

Pharmacogenomics

journal_title

Pharmacogenomics

authors

van Schie RM,Wadelius MI,Kamali F,Daly AK,Manolopoulos VG,de Boer A,Barallon R,Verhoef TI,Kirchheiner J,Haschke-Becher E,Briz M,Rosendaal FR,Redekop WK,Pirmohamed M,Maitland van der Zee AH

doi

10.2217/pgs.09.125

subject

Has Abstract

pub_date

2009-10-01 00:00:00

pages

1687-95

issue

10

eissn

1462-2416

issn

1744-8042

journal_volume

10

pub_type

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