Pharmacogenetics
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2669873/
"Our study has limitations.
First, very little high-quality evidence has been published in this area: we identified only three small randomized trials evaluating pharmacogenetic dosing of warfarin.
Second, important differences in designs, outcome definitions and follow-up intervals used by these three trials reduced the degree to which we could pool their individual findings. We did not perform meta-analysis of secondary outcomes because of significant heterogeneity of the trials.
Third, we did not evaluate genotype-specific outcomes, because these are not relevant when providers are unaware of genotypes in advance.
Lastly, we did not include the three prospective cohort studies using genotype-guided algorithms,59,62,63 because others have reviewed this literature,64,65 and we decided a priori that only randomized trials could reliably demonstrate whether pharmacogenetic dosing improves patient outcomes.
It may be considered early to perform a systematic review on a topic where so few randomized controlled trials are available; however, given the FDA relabeling, we feel it is important to evaluate the current evidence.""In conclusion, our study did not find sufficient evidence to support the use of pharmacogenetics to guide warfarin therapy outside of clinical trials at this time. "
From what I read there also isn't 'sufficient evidence' to NOT support it either.Oy vey!
"Our study has limitations.
First, very little high-quality evidence has been published in this area: we identified only three small randomized trials evaluating pharmacogenetic dosing of warfarin.
Second, important differences in designs, outcome definitions and follow-up intervals used by these three trials reduced the degree to which we could pool their individual findings. We did not perform meta-analysis of secondary outcomes because of significant heterogeneity of the trials.
Third, we did not evaluate genotype-specific outcomes, because these are not relevant when providers are unaware of genotypes in advance.
Lastly, we did not include the three prospective cohort studies using genotype-guided algorithms,59,62,63 because others have reviewed this literature,64,65 and we decided a priori that only randomized trials could reliably demonstrate whether pharmacogenetic dosing improves patient outcomes.
It may be considered early to perform a systematic review on a topic where so few randomized controlled trials are available; however, given the FDA relabeling, we feel it is important to evaluate the current evidence.""In conclusion, our study did not find sufficient evidence to support the use of pharmacogenetics to guide warfarin therapy outside of clinical trials at this time. "
From what I read there also isn't 'sufficient evidence' to NOT support it either.Oy vey!
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