<abstract xmlns="http://www.w3.org/1999/xhtml"> Vitamin K antagonists (VKAs) are widely used for the primary and secondary prevention of thromboembolism, their anticoagulant effect being monitored through INR. Achieving and maintaining a stable anticoagulation status is challenging, because of the narrow therapeutic range, and of the extremely variable individual response to therapy. Environmental factors such as age, gender, body mass, diet, herbal supplements, drugs, pre-existing pathology, as well as genetic factors can substantially influence the anticoagulant effect of VKAs. The main genetic factors that contribute to individual variability in response to VKAs are genetic polymorphisms in genes influencing VKAs’ metabolism (CYP2C9) and pharmacodynamic response (VKOR1) and account for about one third in the variation of warfarin and analogues dose requirement. Systematic genotyping of patients requiring warfarin therapy is still a matter of debate. Although novel oral anticoagulants (direct thrombin and factor Xa inhibitors) seem promising, VKAs are still frequently prescribed, therefore physicians should be aware of the various factors influencing VKAs’ effect, and educational programmes for doctors and patients should be conducted in that respect</abstract>

Vitamin K antagonists (VKAs) are widely used for the primary and secondary prevention of thromboembolism, their anticoagulant effect being monitored through INR. Achieving and maintaining a stable anticoagulation status is challenging, because of the narrow therapeutic range, and of the extremely variable individual response to therapy. Environmental factors such as age, gender, body mass, diet, herbal supplements, drugs, pre-existing pathology, as well as genetic factors can substantially influence the anticoagulant effect of VKAs. The main genetic factors that contribute to individual variability in response to VKAs are genetic polymorphisms in genes influencing VKAs’ metabolism (CYP2C9) and pharmacodynamic response (VKOR1) and account for about one third in the variation of warfarin and analogues dose requirement. Systematic genotyping of patients requiring warfarin therapy is still a matter of debate. Although novel oral anticoagulants (direct thrombin and factor Xa inhibitors) seem promising, VKAs are still frequently prescribed, therefore physicians should be aware of the various factors influencing VKAs’ effect, and educational programmes for doctors and patients should be conducted in that respect

Factors influencing vitamin K antagonists therapy / Factori care influențează terapia cu antagoniști ai vitaminei K

University of Medicine and Pharmacy Iuliu Hatieganu Cluj Napoca

Revista Romana de Medicina de Laborator

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Vitamin K antagonists (VKAs) are widely used for the primary and secondary prevention of thromboembolism, their anticoagulant effect being monitored through...

Factors influencing vitamin K antagonists therapy / Factori care influențează terapia cu antagoniști ai vitaminei K

Published Online: Jun 23, 2015

Page range: 159 - 167

Received: Feb 10, 2015

Accepted: May 15, 2015

DOI: https://doi.org/10.1515/rrlm-2015-0015

Keywords
Vitamin K antagonists, warfarin, drug interactions, genotyping CYP2C9, VKORC1

© by Ioana Brudașcă

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Factors influencing vitamin K antagonists therapy / Factori care influențează terapia cu antagoniști ai vitaminei K

Published Online: Jun 23, 2015

Page range: 159 - 167

Received: Feb 10, 2015

Accepted: May 15, 2015

DOI: https://doi.org/10.1515/rrlm-2015-0015

KeywordsVitamin K antagonists, warfarin, drug interactions, genotyping CYP2C9, VKORC1

© by Ioana Brudașcă

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Keywords
Vitamin K antagonists, warfarin, drug interactions, genotyping CYP2C9, VKORC1