Pregled bibliografske jedinice broj: 810930
Clinical application of genotype-guided dosing of oral anticoagulants - Croatian expiriances
Clinical application of genotype-guided dosing of oral anticoagulants - Croatian expiriances // Pharmacogenomics - From Research to Clinic
Ljubljana: Univerza v Ljubljani, 2015. str. 46-53 (pozvano predavanje, međunarodna recenzija, cjeloviti rad (in extenso), ostalo)
CROSBI ID: 810930 Za ispravke kontaktirajte CROSBI podršku putem web obrasca
Naslov
Clinical application of genotype-guided dosing of oral anticoagulants - Croatian expiriances
Autori
Božina, Nada
Vrsta, podvrsta i kategorija rada
Radovi u zbornicima skupova, cjeloviti rad (in extenso), ostalo
Izvornik
Pharmacogenomics - From Research to Clinic
/ - Ljubljana : Univerza v Ljubljani, 2015, 46-53
ISBN
978-961-267-090-0
Skup
Pharmacogenomics - From Research to Clinic
Mjesto i datum
Ljubljana, Slovenija, 08.06.2015. - 10.06.2015
Vrsta sudjelovanja
Pozvano predavanje
Vrsta recenzije
Međunarodna recenzija
Ključne riječi
oral anticoagulants; genotyping; CYP2C9; VKORC1
Sažetak
Anticoagulants are widely prescribed for the treatment and prevention of cardiovascular diseases. Coumarin anticoagulants are characterized by narrow therapeutic index and inter-individual or intra- individual variability in response to the treatment. This variability can be explained by clinical factors such as age, sex, and drug-drug interactions, but also by genetic variants. Relevant polymorphisms related to anticoagulants have included genes that participate in the drugs' pharmacokinetics and target genes. Observational studies have indicated potential benefits of CYP2C9 and VKORC1 guided dosing of coumarin anticoagulants but randomized clinical trials resulted in mixed results. Prospective trials suggest that incorporation of genotype results in faster time to therapeutic range than without ; however, whether these improvements result in improved clinical outcomes is still unclear. Since clinical evidence for pharmacogenetics-guided warfarin dosing is rather limited to intermediary outcomes, researchers need to determine the precise impact of genotype-guided warfarin therapy on patient outcomes. New oral anticoagulant (NOACs) agents are now being used which specifically inhibit either thrombin (dabigatran) or factor Xa (rivaroxaban, apixaban). Unlike coumarin derivatives, NOACs have a wide therapeutic index, a rapid onset of action and were supposed to not require routine laboratory monitoring. Since postmarketing surveillance pointed to the bleeding complications in some patients reliable biological predictors could help to optimize treatment and pharmacogenetics may play a role in NOACs treatment. Bioavailability of dabigatran etexilate, rivaroxaban, and apixaban is dependent on the membrane transporter P- glycoprotein (P-gp), which is also modulated by a variety of drugs and food components.
Izvorni jezik
Engleski
Znanstvena područja
Kliničke medicinske znanosti
