Warfarin Sensitivity Genotyping

CYP2C9 and VKORC1 Interaction⁸

August 2008

What is important is to realize that individuals may have polymorphisms in both genes and have deficiencies in both proteins. In another study in which they looked at the number of days until the INR exceeded a threshold of six they found that in individuals who had no variants detectable in the two genes, no polymorphisms present that very slowly the number of individuals who had an INR greater than six increased over six months.

However in individuals who have polymorphisms in both genes they found that very rapidly the frequency of individuals with INR’s greater than six climbed up to 20% and stabilized there roughly after about 80 days. So individuals who have polymorphisms in both proteins are more susceptible to have higher INRs.

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Jump to section:

• Introduction
• Warfarin
• Warfarin Anticoagulation
• Warfarin
• Warfarin Monitoring
• Therapeutic Graph
• INR Variability in a 74 Year-old Male
• Warfarin and Bleeding Events
• Warfarin Metabolism
• Polymorphisms and Warfarin Sensitivity
• Polymorphisms and Warfarin Sensitivity
• Summary of Polymorphisms and Warfarin Pharmacokinetics⁵
• CYP2C9 Association Study
• PGx-Guided Warfarin Dosing⁷
• Warfarin Pharmacodynamics
• Polymorphisms and Warfarin Sensitivity
• VKORC1 Promoter Polymorphism⁶
• CYP2C9 and VKORC1 Interaction⁸
• Genotype-guided Warfarin Dosing⁹
• Genotype-guided Dosing
• Summary
• Orthopedic Algorithm¹⁰
• Significant Warfarin Drug Interactions
• Differential Effect of Drugs
• Patient Case: Rapidly Increasing INR
• References
• Questions?