title: Ethnic differences in warfarin maintenance dose requirement and its relationship with genetics.
abstract: Warfarin is a highly efficacious drug, but management of warfarin is difficult, in part because of the large interindividual maintenance dose differences. Warfarin dose requirements differ by race and it has been suggested that some of these differences are owing to genetic diversity. For example, persons of African descent have lower allele frequencies of the CYP2C9*2 and *3 and VKORC1 1173T allele, which have been associated with lower warfarin dose requirements in Caucasians. Since there is currently debate whether genetic information should be used in clinical practice to determine the starting dose for a warfarin initiator, it is of great importance to determine whether everyone will benefit from this knowledge.
authors.affiliation: Center for Clinical Epidemiology and Biostatistics, and Department of Biostatistics & Epidemiology, University of Pennsylvania School of Medicine, 826 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104-6021, USA. hschelle@mail.med.upenn.edu
authors.forename: Hedi
authors.initials: H
authors.lastname: Schelleman
authors.forename: Nita A
authors.initials: NA
authors.lastname: Limdi
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Kimmel
mesh_terms: D005006:Ethnicity / Q000235:genetics*; D005787:Gene Frequency / Q000187:drug effects / Q000235:genetics; D014644:Genetic Variation / Q000187:drug effects / Q000235:genetics*; D005838:Genotype; D006801:Humans; D011110:Polymorphism, Genetic / Q000187:drug effects / Q000235:genetics; D014859:Warfarin / Q000008:administration & dosage*
chemical_list: D014859:Warfarin