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Genotype-guided dosing of coumarin derivatives: the European pharmacogenetics of anticoagulant therapy (EU-PACT) trial design
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical pharmacogenomics and osteoporosis.ORCID iD: 0000-0002-6368-2622
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2009 (English)In: Pharmacogenomics (London), ISSN 1462-2416, E-ISSN 1744-8042, Vol. 10, no 10, 1687-1695 p.Article in journal (Refereed) Published
Abstract [en]

The narrow therapeutic range and wide interpatient variability in dose requirement make anticoagulation response to coumarin derivatives unpredictable. As a result, patients require frequent monitoring to avert adverse effects and maintain therapeutic efficacy. Polymorphisms in VKORC1 and CYP2C9 jointly account for about 40% of the interindividual variability in dose requirements. To date, several pharmacogenetic-guided dosing algorithms for coumarin derivatives, predominately for warfarin, have been developed. However, the potential benefit of these dosing algorithms in terms of their safety and clinical utility has not been adequately investigated in randomized settings. The European Pharmacogenetics of Anticoagulant Therapy (EU-PACT) trial will assess, in a single-blinded and randomized controlled trial with a follow-up period of 3 months, the safety and clinical utility of genotype-guided dosing in daily practice for the three main coumarin derivatives used in Europe. The primary outcome measure is the percentage time in the therapeutic range for international normalized ratio. This report describes the design and protocol for the trial.

Place, publisher, year, edition, pages
2009. Vol. 10, no 10, 1687-1695 p.
Keyword [en]
acenocoumarol, CYP2C9, dosing algorithm, EU-PACT pharmacogenetics, phenprocoumon, randomized controlled trial, VKORC1, warfarin
National Category
Medical and Health Sciences
Research subject
Clinical Pharmacology
URN: urn:nbn:se:uu:diva-120547DOI: 10.2217/pgs.09.125ISI: 000271359200013PubMedID: 19842940OAI: oai:DiVA.org:uu-120547DiVA: diva2:303535
Available from: 2010-03-12 Created: 2010-03-12 Last updated: 2016-02-19

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