CPIC Guideline Update: CYP2C9/VKORC1/CYP4F2 and Warfarin

The 2017 update of CPIC guideline for pharmacogenetics-guided warfarin dosing has been accepted for publication in Clinical Pharmacology and Therapeutics. CPIC extensively reviewed the literature up to Dec 2016. Both the dosing recommendations and supplemental information were updated. The accepted article can currently be viewed on the PharmGKB and CPIC websites.

The 2017 update includes the following updates and additions:

• Updated dosing recommendations based on genotypes from CYP2C9, VKORC1, CYP4F2 and rs12777823 (Fig 2)
• Added recommendation for pediatric patients (Fig 3)
• Updated evidence linking CYP2C9/VKORC1/CYP4F2 genotype to warfarin phenotype (Supplemental Table S1, S2, S3)
• Added evidence comparing pharmacogenetics warfarin dosing algorithms to standard of care dosing or clinical algorithms (Supplemental Table S4)
• Added information regarding warfarin dosing algorithms used in prospective clinical trials (Supplemental Table S5)
• Added evidence linking CYP2C9/VKORC1/CYP4F2 genotype to warfarin phenotype in pediatric patients (Supplemental Table S7)

For further details, see CPIC with further content at PharmGKB.