华法林剂量算法的优化,用于汉族中国患者的CYP2C9*13变体
Dongxu Wang1,2, Hualan Wu1, Qing Zhang1
1Cardiovascular Department, Beijing Hospital, National Centre of Gerontology, Beijing, 100730, China.
European journal of clinical pharmacology
|July 17, 2023
概括
华法林剂量算法需要对汉族患者进行调整,这些患者患有CYP2C9*13基因变异. 包括这种变体可以提高剂量预测的准确性,提高华法林的疗效和安全性.
科学领域:
- 药物遗传学 药物遗传学
- 临床药理学 临床药理学
- 遗传学 是一个遗传学.
背景情况:
- 现有的药物遗传算法不足以解释华法林剂量变化.
- 汉族中国人中存在CYP2C9*13等位基因,但其对华法林剂量的影响尚不清楚.
- 这项研究是首次研究CYP2C9*13对汉族患者华法林剂量的影响.
研究的目的:
- 评估CYP2C9*13变体对汉族患者华法林维持剂量的影响.
- 为了确定调整CYP2C9*13的药物遗传算法是否能提高华法林剂量预测的准确性.
主要方法:
- 在971名汉族中华心房患者中,对CYP2C9*2,*3,*13和VKORC1-1639G>A变异的基因定型.
- 对CYP2C9*13对华法林维持剂量影响的定量分析.
- 应用经过验证的药物遗传算法,对CYP2C9*13.9进行乘法调整.
主要成果:
- 在约0.6%的受试者中发现了CYP2C9*13变异.
- 在CYP2C9*13载体中,华法林维持剂量显著降低.
- 排除CYP2C9*13导致华法林剂量高估1.03-1.16毫克/天;实际剂量比预测低40%左右.
- 为CYP2C9*13调整算法减少了预测错误.
结论:
- 算法预测的华法林剂量需要降低CYP2C9*13载体.
- 将CYP2C9*13变体纳入华法林剂量算法可以提高预测的准确性.
- 这种改进的准确性预计将增加华治疗在汉族患者的疗效和安全性.
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