Personalized Anticoagulation: Optimizing Warfarin Management Using Genetics and Simulated Clinical Trials.

ABSTRACT: Clinical trials testing pharmacogenomic-guided warfarin dosing for patients with atrial fibrillation have demonstrated conflicting results. Non-vitamin K antagonist oral anticoagulants are expensive and contraindicated for several conditions. A strategy optimizing anticoagulant selection remains an unmet clinical need. Characteristics from 14 206 patients with atrial fibrillation were integrated into a validated warfarin clinical trial simulation framework using iterative Bayesian network modeling and a pharmacokinetic-pharmacodynamic model. Individual dose-response for patients was simulated for 5 warfarin protocols-a fixed-dose protocol, a clinically guided protocol, and 3 increasingly complex pharmacogenomic-guided protocols. For each protocol, a complexity score was calculated using th

SUBMITTER: Ravvaz K 

PROVIDER: S-EPMC5734112 | biostudies-literature | 2017 Dec

REPOSITORIES: biostudies-literature