Comparative performance of pharmacogenetics-based warfarin dosing algorithms derived from Caucasian, Asian, and mixed races in Thai population

© 2017 John Wiley & Sons Ltd Aim: This study was conducted to compare predictive accuracy of the available pharmacogenetics (PGx)-guided warfarin dosing algorithms derived from Caucasian, Asian, and mixed population to identify a suitable algorithm for Thai population. Methods: Ten warfarin do...

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Main Authors: Supatat Chumnumwat, Kong Yi, Aroonrut Lucksiri, Wichit Nosoongnoen, Busba Chindavijak, Suvatna Chulavatnatol, Ajjima Sarapakdi, Surakit Nathisuwan
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Published: 2018
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http://cmuir.cmu.ac.th/jspui/handle/6653943832/58952
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spelling th-cmuir.6653943832-589522018-09-05T04:38:10Z Comparative performance of pharmacogenetics-based warfarin dosing algorithms derived from Caucasian, Asian, and mixed races in Thai population Supatat Chumnumwat Kong Yi Aroonrut Lucksiri Wichit Nosoongnoen Busba Chindavijak Suvatna Chulavatnatol Ajjima Sarapakdi Surakit Nathisuwan Medicine Pharmacology, Toxicology and Pharmaceutics © 2017 John Wiley & Sons Ltd Aim: This study was conducted to compare predictive accuracy of the available pharmacogenetics (PGx)-guided warfarin dosing algorithms derived from Caucasian, Asian, and mixed population to identify a suitable algorithm for Thai population. Methods: Ten warfarin dosing algorithms derived from different population including Caucasian, East Asian, South-East Asian, and mixed races were selected and tested with clinical and genetic data of Thai patients. Comparative performances of these algorithms were tested using mean dose error (MDE) between actual warfarin maintenance dose (AWMD) and predicted dose generated by each dosing algorithm, and percentage of ideal dose prediction (IDP). Sensitivity analysis for predictive accuracy was also conducted by stratifying patients into low (AWMD ≤21 mg/wk), intermediate (AWMD >21 to <49 mg/wk), and high maintenance dose (AWMD ≥49 mg/wk) groups. Results: Data of 165 patients were included for the analyses. Mean actual warfarin dose of the study population was 25.03 ± 10.53 mg/wk. Large variability of MDE, ranging from −12.11 to 11.24 mg/wk, among algorithms was observed. International Warfarin Pharmacogenetics Consortium, Gage et al, and Ohno et al algorithms had comparable performances to Sangviroon et al algorithm, as observed by MDE of <1 mg/wk with percentage of IDP ≥40%. Further sensitivity analyses among patients requiring low and intermediate maintenance doses confirmed such findings with IDP percentage ranging from 37.8% to 59.2%. Among high-dose group, only Ohno et al and Sarapakdi et al algorithms had acceptable performance. Conclusions: Warfarin PGx-guided dosing algorithms derived from large, mixed population performed comparably to Sangviroon et al algorithm. Certain algorithms should be avoided due to significant dose prediction error. 2018-09-05T04:35:30Z 2018-09-05T04:35:30Z 2018-04-01 Journal 17555922 17555914 2-s2.0-85043387384 10.1111/1755-5922.12315 https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85043387384&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/58952
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
topic Medicine
Pharmacology, Toxicology and Pharmaceutics
spellingShingle Medicine
Pharmacology, Toxicology and Pharmaceutics
Supatat Chumnumwat
Kong Yi
Aroonrut Lucksiri
Wichit Nosoongnoen
Busba Chindavijak
Suvatna Chulavatnatol
Ajjima Sarapakdi
Surakit Nathisuwan
Comparative performance of pharmacogenetics-based warfarin dosing algorithms derived from Caucasian, Asian, and mixed races in Thai population
description © 2017 John Wiley & Sons Ltd Aim: This study was conducted to compare predictive accuracy of the available pharmacogenetics (PGx)-guided warfarin dosing algorithms derived from Caucasian, Asian, and mixed population to identify a suitable algorithm for Thai population. Methods: Ten warfarin dosing algorithms derived from different population including Caucasian, East Asian, South-East Asian, and mixed races were selected and tested with clinical and genetic data of Thai patients. Comparative performances of these algorithms were tested using mean dose error (MDE) between actual warfarin maintenance dose (AWMD) and predicted dose generated by each dosing algorithm, and percentage of ideal dose prediction (IDP). Sensitivity analysis for predictive accuracy was also conducted by stratifying patients into low (AWMD ≤21 mg/wk), intermediate (AWMD >21 to <49 mg/wk), and high maintenance dose (AWMD ≥49 mg/wk) groups. Results: Data of 165 patients were included for the analyses. Mean actual warfarin dose of the study population was 25.03 ± 10.53 mg/wk. Large variability of MDE, ranging from −12.11 to 11.24 mg/wk, among algorithms was observed. International Warfarin Pharmacogenetics Consortium, Gage et al, and Ohno et al algorithms had comparable performances to Sangviroon et al algorithm, as observed by MDE of <1 mg/wk with percentage of IDP ≥40%. Further sensitivity analyses among patients requiring low and intermediate maintenance doses confirmed such findings with IDP percentage ranging from 37.8% to 59.2%. Among high-dose group, only Ohno et al and Sarapakdi et al algorithms had acceptable performance. Conclusions: Warfarin PGx-guided dosing algorithms derived from large, mixed population performed comparably to Sangviroon et al algorithm. Certain algorithms should be avoided due to significant dose prediction error.
format Journal
author Supatat Chumnumwat
Kong Yi
Aroonrut Lucksiri
Wichit Nosoongnoen
Busba Chindavijak
Suvatna Chulavatnatol
Ajjima Sarapakdi
Surakit Nathisuwan
author_facet Supatat Chumnumwat
Kong Yi
Aroonrut Lucksiri
Wichit Nosoongnoen
Busba Chindavijak
Suvatna Chulavatnatol
Ajjima Sarapakdi
Surakit Nathisuwan
author_sort Supatat Chumnumwat
title Comparative performance of pharmacogenetics-based warfarin dosing algorithms derived from Caucasian, Asian, and mixed races in Thai population
title_short Comparative performance of pharmacogenetics-based warfarin dosing algorithms derived from Caucasian, Asian, and mixed races in Thai population
title_full Comparative performance of pharmacogenetics-based warfarin dosing algorithms derived from Caucasian, Asian, and mixed races in Thai population
title_fullStr Comparative performance of pharmacogenetics-based warfarin dosing algorithms derived from Caucasian, Asian, and mixed races in Thai population
title_full_unstemmed Comparative performance of pharmacogenetics-based warfarin dosing algorithms derived from Caucasian, Asian, and mixed races in Thai population
title_sort comparative performance of pharmacogenetics-based warfarin dosing algorithms derived from caucasian, asian, and mixed races in thai population
publishDate 2018
url https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85043387384&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/58952
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