ビタミンKエポキシド還元酵素の遺伝子型に基づいた抗凝固薬ワルファリンのオーダーメイド投薬

抄録

Warfarin is the most commonly-used oral anticoagulant for treatment of thromboembolism, but adjustment of the dose that is appropriate to each patient is not so easy because of large inter-individual variation in the dose requirement. We analyzed SNP genotypes of the candidate genes, VKORC1 and CYP2C9 using DNAs of 828 Japanese patients treated with warfarin, and classified the patients into three categories, on the basis of genotypes of the two genes, which we call "warfarin-responsive index". The median warfarin daily dose varied significantly by the classification according to the warfarin-responsive index (2.0 mg/day for the index 0 group, 2.5mg/day for the index 1 group, and 3.5mg/day for the index 2 group; P=4.4×10^<-13>). Thus, a combination of VKORC1 and CYP2C9 genotypes should be applicable to predict appropriate dose of warfarin, leading to safety and cost effectiveness for the personalized warfarin treatments.