The DOI matches its Crossref record.
A Randomized Trial of Genotype-Guided Dosing of Warfarin
Open accessAbstract
BACKGROUND: The level of anticoagulation in response to a fixed-dose regimen of warfarin is difficult to predict during the initiation of therapy. We prospectively compared the effect of genotype-guided dosing with that of standard dosing on anticoagulation control in patients starting warfarin therapy. METHODS: We conducted a multicenter, randomized, controlled trial involving patients with atrial fibrillation or venous thromboembolism. Genotyping for CYP2C9*2, CYP2C9*3, and VKORC1 (-1639G→A) was performed with the use of a point-of-care test. For patients assigned to the genotype-guided group, warfarin doses were prescribed according to pharmacogenetic-based algorithms for the first 5 days. Patients in the control (standard dosing) group received a 3-day loading-dose regimen. After the initiation period, the treatment of all patients was managed according to routine clinical practice. The primary outcome measure was the percentage of time in the therapeutic range of 2.0 to 3.0 for the international normalized ratio (INR) during the first 12 weeks after warfarin initiation. RESULTS: A total of 455 patients were recruited, with 227 randomly assigned to the genotype-guided group and 228 assigned to the control group. The mean percentage of time in the therapeutic range was 67.4% in the genotype-guided group as compared with 60.3% in the control group (adjusted difference, 7.0 percentage points; 95% confidence interval, 3.3 to 10.6; P<0.001). There were significantly fewer incidences of excessive anticoagulation (INR ≥4.0) in the genotype-guided group. The median time to reach a therapeutic INR was 21 days in the genotype-guided group as compared with 29 days in the control group (P<0.001). CONCLUSIONS: Pharmacogenetic-based dosing was associated with a higher percentage of time in the therapeutic INR range than was standard dosing during the initiation of warfarin therapy. (Funded by the European Commission Seventh Framework Programme and others; ClinicalTrials.gov number, NCT01119300.).
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cited by
2014 ESC Guidelines on the diagnosis and management of acute pulmonary embolism
Authors/Task Force Members, Konstantinides, S. V., Torbicki, A., Agnelli, G., Danchin, N., Fitzmaurice, D., Galiè, N., Gibbs, J. S. R., Huisman, M. V., Humbert, M., et al. (2014) · European Heart Journal · doi:10.1093/eurheartj/ehu283 · Cited by 3,128
Meschia, J. F., Bushnell, C., Boden-Albala, B., Braun, L. T., Bravata, D. M., Chaturvedi, S., Creager, M. A., Eckel, R. H., Elkind, M. S. V., Fornage, M., et al. (2014) · Stroke · doi:10.1161/str.0000000000000046 · Cited by 2,650
Horlocker, T. T., Vandermeuelen, E., Kopp, S. L., Gogarten, W., Leffert, L. R., & Benzon, H. T. (2018) · Regional Anesthesia and Pain Medicine · doi:10.1097/aap.0000000000000763 · Cited by 932
Aronson, J. K., & Ferner, R. E. (2017) · Current Protocols in Pharmacology · doi:10.1002/cpph.19 · Cited by 417
Wolberg, A. S., Rosendaal, F. R., Weitz, J. I., Jaffer, I. H., Agnelli, G., Baglin, T., & Mackman, N. (2015) · Nature Reviews Disease Primers · doi:10.1038/nrdp.2015.6 · Cited by 369
Metadata
- Authors
- Pirmohamed, M., Burnside, G., Eriksson, N., Jorgensen, A. L., Toh, C. H., Nicholson, T., Kesteven, P., Christersson, C., Wahlström, B., Stafberg, C., Zhang, J. E., Leathart, J. B., Kohnke, H., Maitland-van der Zee, A. H., Williamson, P. R., Daly, A. K., Avery, P., Kamali, F., & Wadelius, M.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2013-12-12
- Volume
- 369
- Issue
- 24
- Pages
- 2294-2303
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2157839219
- Cited by
- 811
- References
- 0
- FWCI
- 115.15
- Type
- journal article
- Language
- en
- Open access
- bronze
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
How to cite
Cite CoChat for the checks on this page, and the paper for its own findings.
- This page
- CoChat. (2026). Citation check: A Randomized Trial of Genotype-Guided Dosing of Warfarin. https://app.cochat.ai/papers/10.1056/nejmoa1311386
- The paper
- Pirmohamed, M., Burnside, G., Eriksson, N., Jorgensen, A. L., Toh, C. H., Nicholson, T., Kesteven, P., Christersson, C., Wahlström, B., Stafberg, C., Zhang, J. E., Leathart, J. B., Kohnke, H., Maitland-van der Zee, A. H., Williamson, P. R., Daly, A. K., Avery, P., Kamali, F., & Wadelius, M. (2013). A Randomized Trial of Genotype-Guided Dosing of Warfarin. New England Journal of Medicine. https://doi.org/10.1056/nejmoa1311386
Data sources
Bibliographic data: Semantic Scholar, OpenAlex, Crossref.
Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
