PHARMACOGENETIC TESTING AS AN ELEMENT OF PERSONALIZED MEDICINE IN REAL CLINICAL PRACTICE


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Abstract

It has been proven that patients with thrombosis and with a high risk of systemic thromboembolic complications (ТЕС), including patients with non-valvular atrial fibrillation (AF) should receive effective and safe antithrombotic therapy. A personalized approach to prolonged Vitamin K antagonists (VKA) therapy is associated with an improvement in hemostasiological markers of thrombinemia and clinical outcomes in patients with venous thromboembolism (VTE) and non-valvular AF. The aim of the study: to evaluate the efficacy and safety of a personalized approach to VKA therapy using pharmacogenetic testing in patients observed at the Regional Center for Antithrombotic Therapy (RCATT) in Arkhangelsk. Material and methods. Prospective study was carried out on the basis of First City Clinical Hospital named after E.E. Volosevich. The object of the study is patients of the VKA registry who applied to the RCATT (n=107) who underwent pharmacogenetic testing (CYP2C9, CYP4F2, VKORC1 genotype) with calculation of individual doses of warfarin and assessment of quality of life using validated questionnaires. The analysis of the effectiveness and safety of warfarin therapy was carried out. Results. It was found that complications of warfarin therapy developed regardless of the presence of the genotype (CYP2C9, CYP4F2, VKORC1) and the warfarin dosing algorithm under observation in AC. It has been shown that pharmacogenetic testing in patients with VTE and AF is an additional research method, which is indicated for patients with a hemorrhagic history, frequent minor bleeding at target INR values and the presence of concomitant therapy with cytochrome P450 inhibitors. Conclusion. Prolonged VKA therapy does not have a significant negative impact on the quality of life under observation in anticoagulant office.

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About the authors

Alexandra S. Barteneva

Northern State Medical University of the Ministry of Healthcare of Russia

Email: aleksandra106150gmail.com
PhD in Medicine, associate professor of the Department of clinical pharmacology and pharmacotherapy 163000, Arkhangelsk, 51 Troitsky Avenue

Nadezhda A. Vorobyeva

Northern State Medical University of the Ministry of Healthcare of Russia; Northern branch of National Research Center of Hematology of the Ministry of Healthcare of Russia

Email: nadejdav0@gmail.com
Dr. med. habil., professor, head of the Department of clinical pharmacology and pharmacotherapy; director 163000, Arkhangelsk, 51 Troitsky Avenue

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