Students Research in Progress
Sunday, October 13, 2024
12:45 PM–02:15 PM
Abstract
Introduction: Warfarin is a commonly prescribed anticoagulant with a narrow therapeutic range, which requires precise dosing. The traditional dosing methods are not patient specific and are based on population averages, leading to potential for suboptimal outcomes and higher risks of toxicity and adverse events. The Clinical Pharmacogenetics Implementation Consortium (CPIC) recommends pharmacogenetic-based dosing, which offers improvements in therapeutic efficacy and safety. This study evaluates the efficacy and safety of pharmacogenetic-based warfarin dosing in comparison to traditional dosing in an urban indigent population which faces significant healthcare disparities.
Research Question or Hypothesis: Is implementation of pharmacogenetic-based warfarin dosing effective and safe compared to traditional dosing in an urban indigent population facing healthcare disparities?
The primary objective is to support pharmacogenetic-guided dosing in improving the percentage of time within the therapeutic INR range and reduction of adverse events compared to traditional dosing of warfarin in an urban indigent population facing significant healthcare disparities. Secondary objectives include additional efficacy and safety outcomes.
Study Design: Retrospective cohort study
Methods: This retrospective cohort study at Wyckoff Heights University Hospital compares one historic group of patients receiving traditional warfarin dosing and the other receiving pharmacogenetic-guided dosing of warfarin. Data collection includes patient demographics, genetic information, initial and adjusted warfarin doses, time to stable dose, International Normalized Ratio (INR) values, and incidence of adverse events. The primary outcomes include the percentage of time within the therapeutic INR and the incidence of major bleeding. Secondary outcomes involve time to stable dose, time to therapeutic INR, number of dose adjustments, and additional safety outcomes.
Results: Pending
Conclusion: This study aims to demonstrate that pharmacogenetic-based warfarin dosing enhances safety and efficacy of warfarin, particularly in underserved populations. The study seeks to support provision of access to personalized medicine and inform future policies to support broader implementation of pharmacogenetic testing in broader clinical practice settings.
Presenting Author
Ali Al Ali BATouro College of Pharmacy
Authors
Sharon Blum PharmD
Touro College of Pharmacy
Roman Fazylov PharmD
Touro College of Pharmacy
Michelle Jakubovics PharmD
Touro College of Pharmacy