Impact of CYP2C19 gene polymorphisms on warfarin dose requirement: a systematic review and meta-analysis

Pharmacogenomics. 2022 Nov;23(16):903-911. doi: 10.2217/pgs-2022-0106. Epub 2022 Oct 12.

Abstract

Background: Various genetic factors influence warfarin maintenance dose. Methods: A literature search was performed on PubMed, Embase and the Cochrane Library, and a meta-analysis to analyze the impact of CYP2C19 polymorphisms on warfarin maintenance dose was conducted. Results: From nine studies encompassing 1393 patients, three CYP2C19 SNPs were identified: rs4244285, rs4986893 and rs3814637. Warfarin maintenance dose was significantly reduced by 10% in individuals with the rs4986893 A allele compared with the GG carriers and was 34%, 16% and 18% lower in patients with rs3814637 TT and CT genotypes and T allele, respectively, than that in CC carriers. No significant dose difference was observed among the rs4244285 genotypes. Conclusion: CYP2C19 rs4986893 and rs3814637 are associated with significantly reduced warfarin dose requirements.

Keywords: CYP2C19; meta-analysis; single nucleotide polymorphisms; warfarin.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alleles
  • Cytochrome P-450 CYP2C19 / genetics
  • Cytochrome P-450 CYP2C9 / genetics
  • Genotype
  • Humans
  • Polymorphism, Single Nucleotide* / genetics
  • Warfarin* / therapeutic use

Substances

  • Warfarin
  • Cytochrome P-450 CYP2C19
  • Cytochrome P-450 CYP2C9
  • CYP2C19 protein, human