Acenocoumarol Pharmacogenetic Dosing Algorithm versus Usual Care in Patients with Venous Thromboembolism: A Randomised Clinical Trial

Patients with venous thromboembolism (VTE) require immediate treatment anticoagulants such as acenocoumarol. This multicentre randomised clinical trial evaluated the effectiveness of a dosing pharmacogenetic algorithm versus standard-of-care dose adjustment at beginning acenocoumarol treatment. We included 144 patients VTE. On day recruitment, blood sample was obtained for genotyping (CYP2C9*2, CYP2C9*3, VKORC1, CYP4F2, APOE). Dose performed on 3 or 4 after start according to assigned group and follow-up 12 weeks. The principal variable percentage an international normalised ratio (INR) within therapeutic range 7. Thirty-four (47.2%) had INR 7 in genotype-guided compared 14 (21.9%) control (p = 0.0023). There were no significant differences time achieve stable INR, number INRs first 6 weeks end study. Our results suggest use VTE could be useful achieving target days