title: Pharmacogenetic dosing of warfarin in the Han-Chinese population: a randomized trial.
abstract: OBJECTIVE
  This study aimed to determine clinical utility of genotype-guided dosing for warfarin in Han-Chinese.
  
  
  METHODS
  A total of 320 patients were randomly assigned International Warfarin Pharmacogenetic Consortium algorithm, Taiwan algorithm and optimal clinical care arms. The primary outcome of the study was the percentage of time in the therapeutic range during the first 90 days of treatment.
  
  
  RESULTS
  The percentage of time in the therapeutic range of the clinical care group in the first 2 weeks was significantly higher than the algorithm groups. This difference was no longer observed after 4 weeks. No difference in excessive anticoagulation (international normalized ratio ≥4.0) and adverse events was observed.
  
  
  CONCLUSIONS
  Genotype-guided dosing did not provide significant benefit. Loading dose with frequent international normalized ratio monitoring could provide sufficient control of anticoagulation.
authors.affiliation: College of Medicine, Chang Gung University, Taoyuan, Taiwan.|Division of Cardiology, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Ming-Shien
authors.initials: MS
authors.lastname: Wen
authors.affiliation: Division of Cardiology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.|Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.
authors.forename: Kuan-Cheng
authors.initials: KC
authors.lastname: Chang
authors.affiliation: College of Medicine, Chang Gung University, Taoyuan, Taiwan.|Stroke Center & Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Tsong-Hai
authors.initials: TH
authors.lastname: Lee
authors.affiliation: Division of Cardiovascular Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.|Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Ying-Fu
authors.initials: YF
authors.lastname: Chen
authors.affiliation: College of Medicine, Chang Gung University, Taoyuan, Taiwan.|Division of Cardiology, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Kuo-Chun
authors.initials: KC
authors.lastname: Hung
authors.affiliation: College of Medicine, Chang Gung University, Taoyuan, Taiwan.|Stroke Center & Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Yeu-Jhy
authors.initials: YJ
authors.lastname: Chang
authors.affiliation: College of Medicine, Chang Gung University, Taoyuan, Taiwan.|Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
authors.forename: Chia-Wei
authors.initials: CW
authors.lastname: Liou
authors.affiliation: Division of Cardiology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.|Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.
authors.forename: Jin-Jer
authors.initials: JJ
authors.lastname: Chen
authors.affiliation: College of Medicine, Chang Gung University, Taoyuan, Taiwan.|Stroke Center & Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Chien-Hung
authors.initials: CH
authors.lastname: Chang
authors.affiliation: College of Medicine, Chang Gung University, Taoyuan, Taiwan.|Division of Cardiology, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Chao-Yung
authors.initials: CY
authors.lastname: Wang
authors.affiliation: Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
authors.forename: Jiann-Shing
authors.initials: JS
authors.lastname: Jeng
authors.affiliation: Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan.
authors.forename: Hui-Ping
authors.initials: HP
authors.lastname: Chuang
authors.affiliation: Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan.
authors.forename: Ying-Ting
authors.initials: YT
authors.lastname: Chen
authors.affiliation: Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan.
authors.forename: Chien-Hsiun
authors.initials: CH
authors.lastname: Chen
authors.affiliation: Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan.
authors.forename: Jer-Yuarn
authors.initials: JY
authors.lastname: Wu
authors.affiliation: Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan.
authors.forename: Yuan-Tsong
authors.initials: YT
authors.lastname: Chen
authors.affiliation: Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan.|Genomic Medicine Institute, Geisinger Health System, Danville, PA 17822, USA.
authors.forename: Ming Ta Michael
authors.initials: MT
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage* / Q000097:blood; D044466:Asian People / Q000235:genetics*; D001777:Blood Coagulation / Q000187:drug effects / Q000235:genetics*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019934:International Normalized Ratio / Q000379:methods; D008297:Male; D008875:Middle Aged; D000071185:Pharmacogenomic Testing / Q000379:methods*; D011159:Population Surveillance; D016037:Single-Blind Method; D013624:Taiwan / Q000453:epidemiology; D014859:Warfarin / Q000008:administration & dosage* / Q000097:blood
chemical_list: D000925:Anticoagulants; D014859:Warfarin
keywords: CYP2C9; VKORC1; dosing algorithms; pharmacogenetics; randomized trial; warfarin