Patient Genetics and Warfarin (Coumadin) Dosing

Filed in archive Genomics, Proteomics and Bioinformatics on April 12, 2010

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Previous studies have indicated that individual genetic variation affects how warfarin is tolerated and broken down by the body, and scientists have developed several formulas that take genetic information into account when calculating warfarin dosage. Now, a five-year, $3.7 million clinical trial is underway to investigate a formula that includes three gene variations that have been shown to influence a person's warfarin sensitivity or metabolism.

"Without any anticoagulant, orthopedic patients have a nearly 50 percent chance of having a blood clot after hip or knee replacement," says Brian Gage, MD, associate professor of medicine at Washington University and lead investigator of the trial. "These are the people at highest risk for blood clots, and because they've just had surgery they are also at high risk for bleeding. This balance is why this question of warfarin dosing is critical. Finding the right dose is like walking a tightrope."

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