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A study published in JAMA on September 26 revealed that testing patients' genetic information before using warfarin reduced patient adverse events by 27%. Therefore, scientists hope that in the future, genetic testing will be widely promoted to guide the use of warfarin.
In 1955, US President Eisenhower had a heart attack. He took warfarin for anticoagulant therapy, which made Warfarin famous. The history of oral anticoagulant drugs entered the "warfarin era."
Warfarin is a coumarin oral anticoagulant that is a first-line treatment for blood embolism (such as deep vein thrombosis, atrial fibrillation, pulmonary thrombosis, etc.). About 1%.
As a widely used anticoagulant, although warfarin has been used clinically for more than 50 years, its dose is still difficult to grasp - excessive use can cause bleeding in the body, too little can not prevent thrombosis. Therefore, warfarin can cause more adverse reactions than other oral drugs, and is one of the most frequently reported drugs in the FDA adverse drug reaction monitoring system.
"Blood caused by warfarin has caused tens of thousands of patients to enter the emergency room or ICU. Doctors continue to prescribe this because it is efficient, reversible, and cheap. Our goal is to make warfarin safer." Professor Brian F. Gage of the study said.
It is reported that the scientists randomly divided the clinical trial patients into two groups, one group received warfarin according to standard factors such as age, height and weight; the other group received warfarin treatment based on these clinical factors plus genetic variants. . Of the 789 patients in the first group, 116 had at least one adverse event (14.7%); of the other 808 patients, only 87 experienced adverse events (10.8%).
The study revealed that patients treated with genetic testing had a 27% reduction in adverse events compared with patients receiving traditional warfarin therapy!
The researchers also said that in fact there are still some genes that affect the use of warfarin, and hope that the next step will be able to quantify the impact of these mutations on warfarin.
Professor Gage hopes to promote genetic testing on a large scale to guide the use of warfarin in the future. He said that although genetic testing is more expensive than clinical references, the former is declining. In this study, the genetic testing cost per person is less than 200. The dollar is less than the cost of a patient's anticoagulant for a month."
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