Scholarlink

<p>This study aims to evaluate the clinical efficacy and safety of Bayesian pharmacogenomic-guided dosing. In this study, sixty patients enrolled from January 2022 to December 2023 were assigned to either a Bayesian pharmacogenomic-guided dosing group (<i>n</i> = 30) or a conventional dosing group (<i>n</i> = 30). The Bayesian pharmacogenomic-guided dosing group received warfarin maintenance doses optimized by clinical pharmacists using a pharmacokinetic-pharmacodynamic model that incorporated demographic, clinical, and genetic variables. Patients in the conventional dosing group received warfarin dose adjustments based on clinical judgment and international normalized ratio (INR). During a 3-month follow-up, both groups were monitored for the following parameters: daily warfarin dose (mg/day), INR, time to first therapeutic INR, time to stable anticoagulation, percentage of time in target range, and safety outcomes. The Bayesian pharmacogenomic-guided dosing group outperformed the conventional group across all efficacy endpoints. The Bayesian pharmacogenomic-guided dosing group achieved a significantly shorter time to first therapeutic INR than the conventional group (7.71 ± 3.95&#xa0;days vs. 19.18 ± 9.08&#xa0;days, <i>P</i> &lt; 0.01). The rates of achieving stable anticoagulation were significantly higher in the Bayesian pharmacogenomic-guided dosing group than in the conventional group (within 2&#xa0;weeks: 50.0% vs. 10.0%, <i>P</i> &lt; 0.01; within 3&#xa0;weeks: 90.0% vs. 33.3%, <i>P</i> &lt; 0.01). Compared to the conventional group, the percentage of time in target range was significantly higher in the Bayesian pharmacogenomic-guided dosing group over 30&#xa0;days (86.8% vs. 16.77%, <i>P</i> &lt; 0.001). Safety analysis showed that the incidence of adverse events was significantly lower in the Bayesian pharmacogenomic-guided dosing group (3.33% vs. 40.0%, <i>P</i> &lt; 0.01). No major bleeding events occurred in either group. Relative to empirical management, Bayesian pharmacogenomic-guided dosing not only enhanced anticoagulation precision but also accelerated the achievement of therapeutic targets. These findings support the implementation of model-informed precision dosing strategies in clinical practice.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Real-world clinical validation study: individualized warfarin dosing strategy integrating genetic polymorphisms and Bayesian

  • 期刊论文

  • 发表日期：

    2026年5月16日

查看全文
  • Pu Bai,
  • Cunfa Shi,
  • Peitao Xie,
  • Lishan Lu

摘要

This study aims to evaluate the clinical efficacy and safety of Bayesian pharmacogenomic-guided dosing. In this study, sixty patients enrolled from January 2022 to December 2023 were assigned to either a Bayesian pharmacogenomic-guided dosing group (n = 30) or a conventional dosing group (n = 30). The Bayesian pharmacogenomic-guided dosing group received warfarin maintenance doses optimized by clinical pharmacists using a pharmacokinetic-pharmacodynamic model that incorporated demographic, clinical, and genetic variables. Patients in the conventional dosing group received warfarin dose adjustments based on clinical judgment and international normalized ratio (INR). During a 3-month follow-up, both groups were monitored for the following parameters: daily warfarin dose (mg/day), INR, time to first therapeutic INR, time to stable anticoagulation, percentage of time in target range, and safety outcomes. The Bayesian pharmacogenomic-guided dosing group outperformed the conventional group across all efficacy endpoints. The Bayesian pharmacogenomic-guided dosing group achieved a significantly shorter time to first therapeutic INR than the conventional group (7.71 ± 3.95 days vs. 19.18 ± 9.08 days, P < 0.01). The rates of achieving stable anticoagulation were significantly higher in the Bayesian pharmacogenomic-guided dosing group than in the conventional group (within 2 weeks: 50.0% vs. 10.0%, P < 0.01; within 3 weeks: 90.0% vs. 33.3%, P < 0.01). Compared to the conventional group, the percentage of time in target range was significantly higher in the Bayesian pharmacogenomic-guided dosing group over 30 days (86.8% vs. 16.77%, P < 0.001). Safety analysis showed that the incidence of adverse events was significantly lower in the Bayesian pharmacogenomic-guided dosing group (3.33% vs. 40.0%, P < 0.01). No major bleeding events occurred in either group. Relative to empirical management, Bayesian pharmacogenomic-guided dosing not only enhanced anticoagulation precision but also accelerated the achievement of therapeutic targets. These findings support the implementation of model-informed precision dosing strategies in clinical practice.