Should We Be Applying Warfarin Pharmacogenetics to Clinical Practice? No, Not Now
- Michael H. Rosove, MD; and
- Wayne W. Grody, MD, PhD
Abstract
The U.S. Food and Drug Administration modified warfarin labeling in 2007 to suggest, but not mandate, pharmacogenetic testing. Genetic analysis is now commercially available. However, results predict only one third of all dosing variation, the value of testing in reducing bleeding and thrombosis rates remains unproved, and cost-effectiveness is not established. Careful consideration of clinical factors that influence dosing, conscientious prothrombin time monitoring, and sage dosage adjustment remain paramount in warfarin management. Further study is required before routine warfarin pharmacogenetic testing can be recommended.
Article and Author Information
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Potential Financial Conflicts of Interest: None disclosed.
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Requests for Single Reprints: Michael H. Rosove, MD, 100 UCLA Medical Plaza, Suite 550, Los Angeles, CA 90095; e-mail, mrosove{at}mednet.ucla.edu.
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Current Author Addresses: Dr. Rosove: 100 UCLA Medical Plaza, Suite 550, Los Angeles, CA 90095.
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Dr. Grody: UCLA Center for the Health Sciences, 760 Westwood Plaza, Los Angeles, CA 90095.
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