ABSTRACT
AIM: To evaluate the accuracy and predictive performance of Bayesian dosing for warfarin in Chinese patients. MATERIALS & METHODS: Six multiple linear regression algorithms (Wei, Lou, Miao, Huang, Gage and IWPC) and a Bayesian method implemented in Warfarin Dose Calculator were compared with each other. RESULTS: Six multiple linear regression warfarin dosing algorithms had similar predictive ability, except Miao and Lou. The mean prediction error of Bayesian priori and posteriori method were 0.01 mg/day (95% CI: -0.18 to 0.19) and 0.17 mg/day (95% CI: -0.05 to 0.29), respectively, and Bayesian posteriori method demonstrated better performance in all dose ranges. CONCLUSION: The Bayesian method showed a good potential for warfarin maintenance dose prediction in Chinese patients requiring less than 6 mg/day.
Subject(s)
Anticoagulants/administration & dosage , Dose-Response Relationship, Drug , Pharmacogenetics , Warfarin/administration & dosage , Adult , Aged , Aged, 80 and over , Algorithms , Anticoagulants/adverse effects , Atrial Fibrillation/drug therapy , Bayes Theorem , Cytochrome P-450 CYP2C9/genetics , Ethnicity , Female , Genotype , Humans , International Normalized Ratio , Linear Models , Male , Middle Aged , Pulmonary Embolism/drug therapy , Venous Thrombosis/drug therapy , Warfarin/adverse effectsABSTRACT
BACKGROUND: The relationship of CYP2C19 genotype and clinical efficacy in stroke or transient ischemic attack (TIA) patients treated with clopidogrel monotherapy or clopidogrel plus aspirin remains unknown. We thus aim to conduct a meta-analysis to appraise evidence on the association of CYP2C19 genotype and clinical efficacy for stroke or TIA. METHODS: An electronic search will be performed for clinical trials that reported the interested efficacy data (stroke, myocardial infarction, or vascular death) and safety data (any bleeding) in clopigogrel-treated patients with stroke or TIA. Odds ratios (ORs) with their confidence intervals (CIs) will be calculated using a meta-analysis. RESULTS: This study will provide the evidence of the relationship between CYP2C19 genotype and clinical efficacy and safety in stroke/TIA patients taking clopidogrel by pooling the results of individual studies. CONCLUSIONS: The results will bring about vigorous evidence in this issue and guide both clinical decision-making and future research.
