NCT00830570

The Clinical and Economic Impact of Pharmacogenomic Testing of Warfarin Therapy in Typical Community Practice Settings

in Typical Community Practice Settings

• Status: Completed
• Phase: —
• Study type: Observational
• Enrollment: 1,635 (actual)
• Sponsor: Medco Health Solutions, Inc. · Industry
• Sex: All
• Age: 40 Years – 75 Years
• Healthy volunteers: Not accepted

Summary

The purpose of this quasi-experiment study, which could also be classified as a prospective observational intervention study, is to assess the impact of cytochrome P450 2C9 (CYP 2C9) and vitamin K epoxide reductase complex, subunit 1 (VKORC1) testing within a primary patient care setting.

Detailed description

Anticoagulation therapy with warfarin is the most common mode of treatment and prophylaxis for venous and arterial thromboembolic conditions. Warfarin is metabolized in the liver by the cytochrome P450 system, the cytochrome P450 2C9 (CYP 2C9) isoenzyme specifically, and polymorphisms in the CYP 2C9 gene have been associated with changes in metabolic function of the translated isoenzyme . These polymorphisms result in reduced metabolism of warfarin as compared to subjects having the wild type gene, consequently leading to systemic accumulation of warfarin; it is theorized that this leads to higher risk of adverse events. Other allelic variations have also been linked to changes in vitamin K conservation through their effects on vitamin K epoxide reductase complex, subunit 1 (VKORC1) . The combined impact of CYP 2C9 and VKORC1 polymorphisms on warfarin's pharmacology have recently been reported. It is hypothesized that evaluation of genomic allelic type guided warfarin dosing will reduce thromboembolic and bleeding risks associated with warfarin therapy, and that adoption of a genetic testing strategy in a primary patient care setting would improve warfarin effectiveness and patient safety, and reduce costs to health care payers.

Conditions

• Embolism and Thrombosis
• Embolism
• Vascular Diseases
• Warfarin
• Venous Thromboembolism
• Thrombosis
• Thromboembolism

Interventions

Type	Name	Description
OTHER	CYP 2C9 and VKORC1 Testing for Warfarin	Test patients for their warfarin sensitivity and provide this information to their physician authorizing the test.

Timeline

• Start date: 2007-07-01
• Primary completion: 2010-01-01
• Completion: 2010-01-01
• First posted: 2009-01-28
• Last updated: 2010-11-16

Locations

1 site across 1 country: United States