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The Use of Genetics in Guiding Therapy



Warfarin PGx

Slide 14

June 2012

There are two major genes involved in warfarin PGx. CYP2C9 is one of the enzymes responsible for the metabolism of warfarin. Two common star alleles in the CYP2C9 gene, known as *2 and *3, lead to decreased enzymatic activity and warfarin sensitivity. The second gene is VKORC1, which encodes for the vitamin K epoxide reductase complex, subunit 1. A common promoter variant at -1639G>A, can lead to warfarin sensitivity or mild warfarin resistance, depending on which combination of alleles are present. The table show here is from the warfarin, or Coumadin, package insert. This table is a genotype-guided dosing table and is based on the combination of CYP2C9 *2 and *3 alleles and VKORC1 promoter polymorphism alleles that may be present in an individual.

Warfarin PGx

 


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