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Pharmacogenetics-Based versus Conventional Dosing of Warfarin: A Meta-Analysis of Randomized Controlled Trials

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  • Changcheng Shi
  • Wei Yan
  • Gang Wang
  • Fei Wang
  • Qingyu Li
  • Nengming Lin

Abstract

Background: Recently, using the patient’s genotype to guide warfarin dosing has gained interest; however, whether pharmacogenetics-based dosing (PD) improves clinical outcomes compared to conventional dosing (CD) remains unclear. Thus, we performed a meta-analysis to evaluate these two strategies. Methods: The PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Chinese VIP and Chinese Wan-fang databases were searched. The Cochrane Collaboration’s tool was used to assess the risk of bias in randomized controlled trials (RCTs). The primary outcome was time within the therapeutic range (TTR); the secondary end points were the time to maintenance dose and time to first therapeutic international normalized ratio (INR), an INR greater than 4, adverse events, major bleeding, thromboembolism and death from any cause. Results: A total of 11 trials involving 2,678 patients were included in our meta-analysis. The results showed that PD did not improve the TTR compared to CD, although PD significantly shortened the time to maintenance dose (MD = -8.80; 95% CI: -11.99 to -5.60; P

Suggested Citation

  • Changcheng Shi & Wei Yan & Gang Wang & Fei Wang & Qingyu Li & Nengming Lin, 2015. "Pharmacogenetics-Based versus Conventional Dosing of Warfarin: A Meta-Analysis of Randomized Controlled Trials," PLOS ONE, Public Library of Science, vol. 10(12), pages 1-16, December.
    • Handle: RePEc:plo:pone00:0144511
    DOI: 10.1371/journal.pone.0144511
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