Genotype-guided therapy improves initial XXXX dosing. Results from a prospective randomised study.

@entity1 @entity11271 @entity5062 @entity5058 @entity5060 @entity955
UNASSIGNED: A few trials so far have evaluated the effectiveness of algorithms designed to calculate doses in oral anticoagulant therapy, with negative or contradictory results. We compared a genotype-guided algorithm vs physician management for the initiation of @entity11271 . In a two-arm, prospective, randomised study with @entity1 with @entity955 who started therapy, the first dose was administered to all @entity1 according to the physician's criteria. At 72 hours, the corresponding dose was calculated based on INR in the standard care group (SC, N=92), whereas genetic data ( @entity5058 , @entity5060 and @entity5062 ) were also considered for the genotype-guided dosing (pharmacogenetic) group (PGx, N=87) by using an algorithm previously validated in 2,683 @entity1 . The primary outcomes were: @entity1 with steady dose, the time needed to reach the same and the percentage of therapeutic INRs. After 90 days, 25   % of the SC and 39   % of the PGx @entity1 reached the steady dose (p=0.038). Kaplan-Meier analysis showed that PGx group needed fewer days to reach therapeutic INR (p=0.033). Additionally, PGx had a higher percentage of therapeutic INRs than SC @entity1 (50   % and 45   %, respectively) (p=0.046). After six months the proportion of steadily anticoagulated @entity1 remained significantly higher in PGx (p=0.010). In conclusion, genotype-guided dosing was associated with a higher percentage of @entity1 with steady dose than routine practice when starting oral anticoagulation with @entity11271 .
