Variant _CYP2C9_ alleles require lower induction and maintenance doses than those with wild-type alleles, and are at increased risk for bleeding during initiation of treatment, explains the team from Hadassah University Hospital in Jerusalem, Israel.Patients are given a low loading dose on beginning treatment with frequent international normalized ratio (INR) checks, but this approach "does not eliminate the risk of bleeding and unnecessarily prolongs the loading period for the majority of patients," Y Caraco and co-workers observe.Further, the team assessed treatment responses in 96 patients whose first 8 days of treatment was decided using a standard warfarin algorithm based on INR and previous response to wafarin therapy.Responses werepared with those of 95 patients whose warfarin therapy was calculated using an algorithm taking into consideration their individual _CYP2C9_ genotype.In the journal _Clinical Pharmacology and Therapeutics_, on average, patients whose dose was calculated using the genotype algorithm achieved a therapeutic INR and stable anticoagulation a significant 2.18.Faster than those who were given standard treatment.Explain that these patients achieved anticoagulation faster than the other patients because, based on the genotype algorithm, they received a 28% higher daily dose of warfarin.Algortihm had other benefits, they add, noting that patients treated by genotype spent significantly more time within the therapeutic range (80.63.Had fewer minor bleeding events (3.Than controls.Read more Azithromycin alters macrophage phenotype
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