Pharmacogenetic-guided algorithms to estimate personalized dose or individual responses to anti-thrombotic drugs

摘要: Abstract Purpose Genotyping seems to be regarded as less useful than expected for predicting the inter-individual variation in drug response. We aim improve predictive accuracy of genotyping by developing models that also incorporate certain non-genetic factors. Study selection and results The anti-coagulant warfarin is widely used prevent venous thromboembolic events. Although frequent monitoring prothrombin time international normalized ratio (PT-INR) allows an appropriate maintenance dose obtained most individuals, there are some individuals whom it difficult achieve target PT-INR even when increased. anti-platelet clopidogrel typically with aspirin cardiovascular events following percutaneous coronary intervention. However, existence resistance a major concern Asian populations owing high prevalence deficient allele CYP2C19 gene, which encodes enzyme produces active metabolite. Individual response these anti-thrombotic drugs cannot accurately predicted based on genetic factors alone. have constructed two algorithms, one predicts estimates individual responses outpatients without device-based platelet function test. applied Akaike's Information Criterion evaluate validity algorithms. Conclusions In addition data, factors, such clinical laboratory should considered predict more each individual.