Verification of five pharmacogenomics-based warfarin administration models.
OBJECTIVE
This study aims to screen and validate five individual warfarin dosing models (four Asian model algorithms, namely, Ohno, Wen, Miao, Huang, and the algorithm of International Warfarin Pharmacogenetic Consortium, namely IWPC algorithm) with the aim of evaluating their accuracy, practicality, and safety.


METHODS
Patients' CYP2C9*3 and VKORC1-1639G >A genes were genotyped, and patient-related information and steady warfarin doses were recorded. The difference between the predicted dose and actual maintenance dose of each model was compared.


RESULTS
The prediction accuracies of the Huang and Wen models were the highest. In terms of clinical practicality, the Huang model rated the highest for the low-dose group, whereas the Ohno and IWPC models rated the highest for the middle-dose group. The models tended to markedly overpredict the doses in the low-dose group, especially the IWPC model. The Miao model tended to severely underpredict the doses in the middle-dose group, whereas no model exhibited severe overprediction.


CONCLUSIONS
Since none of the models ranked high for all the three criteria considered, the impact of various factors should be thoroughly considered before selecting the most appropriate model for the region's population.
Department of Pharmacy, Fuzhou General Hospital of Nanjing Command, PLA, Fuzhou 350025, China.
Meiqin
M
Lin
Department of Pharmacy, Zhongshan Hospital Affiliated to Xiamen University, Xiamen 361100, China.
Liangping
L
Yu
Department of Cardiac Surgery, Union Hospital, Fujian Medical University, Fuzhou 350001, China.
Hanfan
H
Qiu
Department of Cardiac Surgery, Union Hospital, Fujian Medical University, Fuzhou 350001, China.
Qimin
Q
Wang
Department of Pharmacy, Fuzhou General Hospital of Nanjing Command, PLA, Fuzhou 350025, China.
Jing
J
Zhang
Department of Pharmacy, Fuzhou General Hospital of Nanjing Command, PLA, Fuzhou 350025, China.
Hongtao
H
Song
D000925:Anticoagulants / Q000008:administration & dosage*; D065729:Cytochrome P-450 CYP2C9 / Q000378:metabolism; D006801:Humans; D008962:Models, Theoretical; D010597:Pharmacogenetics; D014859:Warfarin / Q000008:administration & dosage*
D000925:Anticoagulants; D014859:Warfarin; D065729:Cytochrome P-450 CYP2C9
Mechanical heart valve replacement; model; pharmacogenomics; verification; warfarin