Table 2:
Performance of race/ethnicity-specific versus traditional genotype-guided warfarin dosing algorithms in diverse populations
| Study algorithm1 | Population | n2 | Genetic Factors3 | Clinical Factors3 | Genetic + Clinical algorithm (R2) | Gage algorithm (R2) | IWPC algorithm (R2) |
|---|---|---|---|---|---|---|---|
| Individuals of African Ancestry | |||||||
| Alzubiedi et al. 201643 | African American | 163 | CYP2C9*2, *3, *5; VKORC1 −1639G>A; CYP4F2*3; rs12777823 | age, weight, CHF, CM | 38% | NR | 26% |
| Hernandez et al. 201446 | African American | 349 | CYP2C9 *2,*3,*5,*8, *11, 18786T; VKORC1 −1639G>A, −8191A; rs12777823 | age, weight, VTE | 27% | NR | 15% |
| Ramirez et al. 201244 | African American | 145 | CYP2C9*2, *3, *6, *8; VKORC1 −1639G>A; CALU rs339097; CYP4F2*3 | age, BSA, sex, race, smoking, CM, VTE | 41% | NR | 29% |
| Latino Populations | |||||||
| Ramos et al. 201249 | Puerto Rican | 163 | CYP2C9*2, *3, *5; VKORC1 −1639G>A | age, PE, CM, dose-adjusted INR | 67% | NR | 36% |
| Botton et al. 201167 | Brazilian4 | 279 | CYP2C9 *2, *3; VKORC1 −1639G>A, rs7294; CYP4F2*3; F2 rs5896 | age, weight, CM | 63% | 42% | 46% |
| Individuals of Asian Ancestry | |||||||
| Lin et al. 201668 (Miao et al. algorithm) | Chinese | 208 | CYP2C9*3; VKORC1 −1639G>A | age, weight | 34% | NR | 27% |
| Cho et al. 201669 | Korean | 101 | CYP2C9*3; VKORC1 −1639G>A | age, weight | 51% | 32% | 37% |
| Zhao et al. 201470 (Zhang et al. algorithm) | Chinese | 122 | CYP2C9*3; VKORC1 −1639G>A | age, weight | 67% | 53% | 31% |
| Lei et al. 201271 (Wu et al. algorithm) | Chinese | 368 | CYP2C9*2, *3; VKORC1 −1639G>A | age, sex, weight | 55% | 58% | 52% |
| Cho et al. 201172 | Korean | 108 | CYP2C9*3; VKORC1 −1639G>A | age, BSA, CM | 46% | 4% | 49% |
BSA, body surface area; CALU, calumenin; CHF, congestive heart failure; CM, concomitant medication; CYP, Cytochrome P450; INR, international normalized ratio; IWPC, International Warfarin Pharmacogenetic Consortium; NR, not reported; PE, pulmonary embolism; VKORC1=Vitamin K epoxide reductase complex subunit 1; VTE, indication for venous thromboembolism.
Algorithms studied were developed in the study cited unless otherwise specified. If multiple algorithms were compared in the reference study, the best performing algorithm is included in the table.
Indicates derivation cohort minus validation cohort
Genetic and clinical factors included in the final novel algorithm. VKORC1 −1639A polymorphisms may be genotyped using tag SNPs such as VKORC1 1173T or 6484T.
Brazilian patients specified as having European ancestry