Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for Pharmacogenetics-Guided Warfarin Dosing: 2017 Update

J A Johnson; K E Caudle; L Gong; M Whirl-Carrillo; C M Stein; S A Scott; M T Lee; B F Gage; S E Kimmel; M A Perera; J L Anderson; M Pirmohamed; T E Klein; N A Limdi; L H Cavallari; M Wadelius

doi:10.1002/cpt.668

Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for Pharmacogenetics-Guided Warfarin Dosing: 2017 Update

Clin Pharmacol Ther. 2017 Sep;102(3):397-404. doi: 10.1002/cpt.668. Epub 2017 Apr 4.

Authors

J A Johnson¹, K E Caudle², L Gong³, M Whirl-Carrillo³, C M Stein⁴, S A Scott⁵, M T Lee⁶, B F Gage⁷, S E Kimmel^{8

9}, M A Perera¹⁰, J L Anderson¹¹, M Pirmohamed¹², T E Klein³, N A Limdi¹³, L H Cavallari¹, M Wadelius¹⁴

Affiliations

¹ Department of Pharmacotherapy and Translational Research, College of Pharmacy, and Center for Pharmacogenomics, University of Florida, Gainesville, Florida, USA.
² Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
³ Department of Biomedical Data Science, Stanford University, Stanford, California, USA.
⁴ Division of Clinical Pharmacology Vanderbilt Medical School, Nashville, Tennessee, USA.
⁵ Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
⁶ Laboratory for International Alliance on Genomic Research, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan; National Center for Genome Medicine; Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan; Genomic Medicine Institute, Geisinger Health system, Danville, Pennsylvania, USA.
⁷ Department of Internal Medicine, Washington University in St. Louis, St. Louis, Missouri, USA.
⁸ Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.
⁹ Department of Medicine and Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.
¹⁰ Department of Medicine, University of Chicago, Chicago, Illinois, USA.
¹¹ Intermountain Heart Institute, Intermountain Medical Center, and Department of Internal Medicine (Cardiology), University of Utah School of Medicine, Salt Lake City, Utah, USA.
¹² Department of Molecular and Clinical Pharmacology; The Wolfson Centre for Personalised Medicine; Institute of Translational Medicine, University of Liverpool, Liverpool, UK.
¹³ Department of Neurology and Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
¹⁴ Department of Medical Sciences, Clinical Pharmacology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden.

PMID: 28198005
PMCID: PMC5546947
DOI: 10.1002/cpt.668

Abstract

This document is an update to the 2011 Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline for CYP2C9 and VKORC1 genotypes and warfarin dosing. Evidence from the published literature is presented for CYP2C9, VKORC1, CYP4F2, and rs12777823 genotype-guided warfarin dosing to achieve a target international normalized ratio of 2-3 when clinical genotype results are available. In addition, this updated guideline incorporates recommendations for adult and pediatric patients that are specific to continental ancestry.

MeSH terms

Adult
Anticoagulants / administration & dosage*
Child
Cytochrome P-450 CYP2C9 / genetics*
Cytochrome P450 Family 4 / genetics*
Dose-Response Relationship, Drug
Genotype
Humans
Pharmacogenetics
Practice Guidelines as Topic
Vitamin K Epoxide Reductases / genetics*
Warfarin / administration & dosage*

Substances

Anticoagulants
Warfarin
CYP2C9 protein, human
Cytochrome P-450 CYP2C9
Cytochrome P450 Family 4
CYP4F2 protein, human
VKORC1 protein, human
Vitamin K Epoxide Reductases

Abstract

MeSH terms

Substances

Grants and funding