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Home Clinical Clinical News Genetic testing ‘not effective’

Genetic testing ‘not effective’


Genetic testing in order to determine anticoagulant dosing is essentially not effective, a Masterclass in Clinical Pharmacology heard recently at the RCPI.


Professor David Kerins, consultant physician at Mercy University Hospital, Cork, and Associate Professor of Therapeutics at University College Cork, discussed emerging evidence for new and old anticoagulants at the Masterclass. Genetic testing of individual patients’ variations of two genes (CYP2C9 and VKORCI) has been shown to help determine the ideal dosage of warfarin, as these genes indicate a patient’s susceptibility to the anticoagulant.


Prof Kerins stated that genetic testing was not an effective tool for physicians just yet, due to limitations in its use. “Although it has been shown in clinical trials to help with dosing, the greatest difference is seen in the first two weeks of treatment, yet the turnaround time for the test is about two weeks,” he explained. “In my view it is not effective, we either need a more rapid test or a much cheaper test,” commented Prof Kerins, adding that a cost benefit analysis for genetic testing of high risk patients would be “very helpful”.


Genetic testing has proven to be of value in retrospective studies of patients on warfarin, however, the role of testing on an initiation cohort of warfarin naive patients needs to be proven, he said. “It is this lack of prospective testing that I see see as a deficit of the currently available tests for CYP2C9 and VCORC1 testing,” Prof Kerins told IMN.



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