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[Impact of pharmacogenetic testing on the risk of bleedings and excessive hypocoagulation episodes in the use of warfarin: the first meta-analysis of Russian prospective studies].

Abstract：

AIM:To perform a meta-analysis of Russian prospective studies comparing the pharmacogenetic versus conventional warfarin dosing procedures. MATERIALS AND METHODS:Publications were sought in the PubMed and eLibrary through September 30, 2013. Seven prospective studies comparing the pharmacogenetic method of warfarin dosing with consideration for CYP2C9, VKORC1, and CYP4F2 gene polymorphisms with the conventional one were selected. The number of minor and major bleedings and hypocoagulation episodes was taken into account. The meta-analysis was performed using MIX Pro 2.0. RESULTS:Six studies compared the number of bleedings in experimental and control groups. Analysis of statistical heterogeneity showed that extraneous factors did not influence the results of meta-analysis. The pharmacogenetic approach decreases the risk of bleeding. The pooled odds ratio (OR) was significant for minor (OR = 0.49; 95% confidence interval (CI), 0.31 to 0.78; p = 0.002), major (OR = 0.07; 95% CI, 0.008 to 0.54; p = 0.01) and both minor and major bleedings (OR = 0.49; 95% CI, 0.31 to 0.78; p = 0.002). Six studies estimated the number of hypocoagulation cases. There was no evidence for statistical heterogeneity (Q-test p = 0.13; I2 = 40%). Four studies showed a group difference in the number of hypocoagulation cases (p < 0.05). The pooled OR was 0.21 (95% CI, 0.15 to 0.3; p < 0.01). The pharmacogenetic dosing groups had fewer hypocoagulation episodes than the control ones. CONCLUSION:The pharmacogenetic approach decreases the risk of bleeding and the episodes of hypocoagulation. The performed meta-analysis covered only two randomized trials. Improving the metalogic quality and statistical power of Russian studies will be able to get more reliable data on the impact of pharmacogenetic testing on clinical outcomes during warfarin therapy.

journal_name

Ter Arkh

journal_title

Terapevticheskii arkhiv

authors

Sychev DA,Ivashchenko DV,Rusin IV

subject

Has Abstract

pub_date

2014-01-01 00:00:00

pages

64-71

issue

eissn

0040-3660

issn

2309-5342

journal_volume

pub_type

杂志文章,meta分析

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[Impact of pharmacogenetic testing on the risk of bleedings and excessive hypocoagulation episodes in the use of warfarin: the first meta-analysis of Russian prospective studies].