Extremely low therapeutic doses of acenocoumarol in a patient with

Vitamin-K antagonists (VKAs) have remained the mainstay of oral anticoagulant therapy for the treatment and prevention of thromboembolism. The management of treatment with VKAs is challenging due to their narrow therapeutic index and the wide interindividual variation in response to therapy. Variant...

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Bibliographic Details
Published in:Pharmacogenomics 2019-04, Vol.20 (5), p.311-317
Main Authors: Chaidaroglou, Antigoni, Kanellopoulou, Theoni, Panopoulos, George, Stavridis, George, Degiannis, Dimitrios
Format: Article
Language:English
Subjects:
acenocoumarol
anticoagulation
pharmacogenomics
vitamin-K antagonists
warfarin
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Summary:Vitamin-K antagonists (VKAs) have remained the mainstay of oral anticoagulant therapy for the treatment and prevention of thromboembolism. The management of treatment with VKAs is challenging due to their narrow therapeutic index and the wide interindividual variation in response to therapy. Variants of the and the gene account for 30-50% of the variability in dosing requirements, and it has been proposed that genotyping of these loci could facilitate management of VKA therapy and minimize risk of overanticoagulation, even in very low doses. We present the first reported case of a patient with the compounded genotype and under treatment with acenocoumarol, and review of other reported cases with analogous genotypic profiles but under treatment with warfarin.
ISSN:1462-2416
1744-8042
DOI:10.2217/pgs-2018-0189