Genetic Test Provided to Help Dose Blood Thinner

In a new hospital program, patients suffering from dangerous blood clots will receive genetic testing to aid healthcare professionals in decisions for prescribing proper doses of the blood-thinner warfarin.

Warfarin, prescribed to treat deep vein thrombosis and pulmonary embolism and to prevent stroke as a result of atrial fibrillation or heart valve replacement, carries a "black-box" warning from the US Food and Drug Administration (FDA) for bleeding risk. Being difficult to dose, it is usually begun at similar amounts for all patients. The University of Illinois (UI) Hospital & Health Sciences System (Chicago, IL) is one of the first to use genetic information to help patients receive an appropriate dose of the drug, which consistently ranks among the leading causes of serious drug-related adverse events.

The genetic test will identify common variants in CYP2C9, an enzyme that breaks down warfarin, and in VKORC1, a clotting enzyme that is the target of warfarin, said Larisa Cavallari, associate professor of pharmacy practice at UI at Chicago (UIC; Chicago, IL, USA) and one of the codirectors of the program. The ultimate goal, Cavallari added, is to provide patients with personalized medicine customized to account for their unique genetic ancestry. "The majority of pharmacogenetic research and use of pharmacogenetics in clinical practice in the United States has been in populations of European descent. We're confident that genotype-guided pharmacotherapy in urban, underserved populations will improve the effectiveness and safety of medications," said Edith Nutescu, UIC clinical professor of pharmacy practice and another of the program codirectors.

The pharmacogenetics project is a collaboration between the UIC colleges of Pharmacy and of Medicine, including the latter's cardiology, medicine, hematology, and clinical pathology departments.

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University of Illinois Hospital & Health Sciences System
University of Illinois at Chicago