Development and Validation of a Novel Warfarin Dosing Algorithm for Korean Patients With VKORC1 1173C
10.3343/alm.2020.40.3.216
- Author:
Eun Hye CHO
1
;
Kyunghoon LEE
;
Mina YANG
;
Rihwa CHOI
;
Sun Young BAEK
;
Insuk SOHN
;
June Soo KIM
;
Young Keun ON
;
Oh Young BANG
;
Hyun Jung CHO
;
Soo Youn LEE
Author Information
1. Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. suddenbz@skku.edu
- Publication Type:Original Article
- From:Annals of Laboratory Medicine
2020;40(3):216-223
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND:Differences in the performance of suggested warfarin dosing algorithms among different ethnicities and genotypes have been reported; this necessitates the development of an algorithm with enhanced performance for specific population groups. Previous warfarin dosing algorithms underestimated warfarin doses in VKORC1 1173C carriers. We aimed to develop and validate a new warfarin dosing algorithm for Korean patients with VKORC1 1173C.
METHODS:A total of 109 patients carrying VKORC1 1173CT (N=105) or 1173CC (N=4) were included in this study. Multiple regression analysis was performed to deduce a new dosing algorithm. Following literature searches for genotype-guided warfarin dosing algorithms, 21 algorithms were selected and evaluated using the correlation coefficient (Ï) of actual dose and estimated dose, mean error, and root mean square error.
RESULTS:The developed algorithm is as follows: maintenance dose (mg/week)=exp [3.223−0.009×(age)+0.577×(body surface area [BSA])+0.178×(sex)−0.481×(CYP2C9 genotype)+0.227×(VKORC1 genotype)]. Integrated variables explained 44% of the variance in the maintenance dose. The predicted and actual doses showed moderate correlation (Ï=0.641) with the best performance with a mean error of −1.30 mg/week. The proportion of underestimated groups was 17%, which was lower than with the other algorithms.
CONCLUSIONS:This is the first study to develop and validate a warfarin dosing algorithm based on data from VKORC1 1173C carriers; it showed superior predictive performance compared with previously published algorithms.
