期刊
TRENDS IN PHARMACOLOGICAL SCIENCES
卷 36, 期 3, 页码 153-163出版社
ELSEVIER SCIENCE LONDON
DOI: 10.1016/j.tips.2015.01.003
关键词
oral anticoagulant; warfarin; vitamin K antagonist; pharmacogenomics; algorithm
资金
- European Commission
- NHS Chair of Pharmacogenetics programme
- Medical Research Council (MRC) Centre for Drug Safety Science
- Swedish Research Council [523-2008-5568]
- Swedish Heart and Lung Foundation
- Clinical Research Support (ALF) at Uppsala University
- Medical Research Council [MR/L006758/1] Funding Source: researchfish
- National Institute for Health Research [NF-SI-0512-10064] Funding Source: researchfish
- MRC [MR/L006758/1] Funding Source: UKRI
There have recently been significant advances in the field of oral anticoagulation, but these have also led to many controversies. Warfarin is still the commonest drug used for clotting disorders but its use is complicated owing to wide inter-individual variability in dose requirement and its narrow therapeutic index. Warfarin dose requirement can be influenced by both genetic and environmental factors. Two recent randomized controlled trials (RCTs) came to different conclusion regarding the utility of genotype-guided dosing; we critically explore the reasons for the differences. The new generation of oral anticoagulants have been demonstrated to be as efficacious as warfarin, but further work is needed to evaluate their safety in real clinical settings.
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