Molecular Dx Significance 7/10

CPIC Updates Warfarin Dosing Guideline with CYP4F2 and Ancestry-Specific Recommendations

This 2017 update to the CPIC warfarin guideline expands genotype-guided dosing to include CYP4F2 and rs12777823 alongside CYP2C9 and VKORC1, with ancestry-specific recommendations for adult and paediatric patients. Warfarin pharmacogenomics remains one of the most extensively studied gene-drug interactions, and this guideline provides clinical laboratories with a comprehensive framework for multi-gene reporting to support anticoagulation management.

The original study

Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for Pharmacogenetics-Guided Warfarin Dosing: 2017 Update.

Authors
Johnson JA, Caudle KE, Gong L, Whirl-Carrillo M, Stein CM, Scott SA, et al.
Journal
Clinical pharmacology and therapeutics
Type
Journal Article, Practice Guideline
PMID
28198005
Read the original study →

Original abstract

This document is an update to the 2011 Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline for CYP2C9 and VKORC1 genotypes and warfarin dosing. Evidence from the published literature is presented for CYP2C9, VKORC1, CYP4F2, and rs12777823 genotype-guided warfarin dosing to achieve a target international normalized ratio of 2-3 when clinical genotype results are available. In addition, this updated guideline incorporates recommendations for adult and pediatric patients that are specific to continental ancestry.