title: Impact of theCYP4F2gene polymorphisms on the warfarin maintenance dose: A systematic review and meta-analysis.
abstract: Warfarin is an oral anticoagulant with significant interpatient variability in dosage. A large number of studies have confirmed that the individual warfarin dose is mainly affected by the cytochrome P450 complex subunit 2C9 and vitamin K epoxide reductase complex subunit 1. However, the association between cytochrome P450 4F2 (CYP4F2) gene polymorphisms and warfarin dosage in the Asian population remains controversial. To investigate the impact of theCYP4F2polymorphism rs2108622 (p.V433M) on warfarin dose requirement, a systematic review and meta-analysis were conducted. According to the strict inclusion and exclusion criteria set, a comprehensive literature search was performed, and the studies published before August 5, 2015 were searched for in PubMed, EMBASE and the China National Knowledge Infrastructure databases. The references were checked by two independent reviewers. The association between the warfarin maintenance dose andCYP4F2polymorphism was analyzed. Twenty-two studies were included in the meta-analysis. Compared with theCYP4F2genotype CC, carriers of the CT and TT genotypes required a 9 [95% confidence interval (CI): 6.0-13.0] and 20% (95% CI, 13.0-27.0) higher warfarin dose, respectively. In the combined analysis, T carriers (CT+TT) required an 11% (95% CI, 8.0-14.0) higher warfarin dose compared to the CC genotype. In addition, there was a 10% (95% CI, 5.0-15.0) higher warfarin dose in TT carriers compared to the CT genotype (all P<0.05). The results of the meta-analysis suggest that the effects of theCYP4F2polymorphism on individual warfarin dose have a statistically significant difference, and the effect degree is variable in the subgroups. Further studies are expected to explore whether the pharmacogenetics model including theCYP4F2polymorphism can strengthen the prediction of warfarin dose.
authors.affiliation: Center of Clinical Pharmacology, The Third Xiangya Hospital of Central South University, Changsha, Hunan 410013, P.R. China; School of Pharmaceutical Science, Central South University, Changsha, Hunan 410013, P.R. China.
authors.forename: Xue
authors.initials: X
authors.lastname: Sun
authors.affiliation: Center of Clinical Pharmacology, The Third Xiangya Hospital of Central South University, Changsha, Hunan 410013, P.R. China; School of Pharmaceutical Science, Central South University, Changsha, Hunan 410013, P.R. China.
authors.forename: Wan-Ying
authors.initials: WY
authors.lastname: Yu
authors.affiliation: Center of Clinical Pharmacology, The Third Xiangya Hospital of Central South University, Changsha, Hunan 410013, P.R. China.
authors.forename: Wan-LE
authors.initials: WL
authors.lastname: Ma
authors.affiliation: Center for Medical Experiments, The Third Xiangya Hospital of Central South University, Changsha, Hunan 410013, P.R. China.
authors.forename: Li-Hua
authors.initials: LH
authors.lastname: Huang
authors.affiliation: Center of Clinical Pharmacology, The Third Xiangya Hospital of Central South University, Changsha, Hunan 410013, P.R. China.
authors.forename: Guo-Ping
authors.initials: GP
authors.lastname: Yang
keywords: CYP4F2; dose; polymorphism; thrombosis; warfarin