Evidence map›Paper›PMID 41484425›Full record

Trial reportScientific reports2026

Subgroup analysis of genotype guided vs traditional warfarin dosing in Asian patients from an open label randomized trial.

Hon Jen Wong, Yao Neng Teo, Yao Hao Teo, Nicholas L Syn, Andrea Li-Ann Wong, Hock-Leun Teoh, Raymond C S Seet, Soo-Chin Lee, Boon-Cher Goh, Ching-Hui Sia

Registry-linked trialAbstract readEquivalence TrialMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Scientific reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00700895 (A Randomized Controlled Trial to Assess the Clinical Benefits of a Pharmacogenetics-Guided Dosing Regimen for Calculating Warfarin Maintenance Dose), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00700895 phase3unknown statusnot on this map

A Randomized Controlled Trial to Assess the Clinical Benefits of a Pharmacogenetics-Guided Dosing Regimen for Calculating Warfarin Maintenance Dose

TypeinterventionalSponsorNational University Hospital, SingaporeRan2006 to 2017Enrolled320ConditionsIndications for Warfarin TherapyArmsWarfarin Sodium
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Hon Jen Wong *Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Yao Neng Teo *Department of Medicine, National University Hospital, Singapore, Singapore.
Yao Hao Teo *Department of Cardiology, National University Heart Centre Singapore, NUHS Tower Block Level 9, 1E Kent Ridge Road, Singapore, 119228, Singapore.
Nicholas L SynDepartment of Hematology-Oncology, National University Cancer Institute, Singapore, Singapore.
Andrea Li-Ann WongDepartment of Hematology-Oncology, National University Cancer Institute, Singapore, Singapore.
Hock-Leun TeohDivision of Neurology, Department of Medicine, National University Health System, Singapore, Singapore.
Raymond C S SeetDivision of Neurology, Department of Medicine, National University Health System, Singapore, Singapore.
Soo-Chin LeeDepartment of Hematology-Oncology, National University Cancer Institute, Singapore, Singapore.
Boon-Cher GohDepartment of Hematology-Oncology, National University Cancer Institute, Singapore, Singapore.
Ching-Hui SiaDepartment of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. ching_hui_sia@nuhs.edu.sg.ORCID http://orcid.org/0000-0002-2764-2869

Funding

Biomedical Research Council of the Agency for Science, Technology and Research (A*STAR) A*STARngapore Ministry of Health's National Medical Research Council NMRC/CSA/021/2010 and NMRC/CSA/0048/2013
6 · The paper itself

Abstract

Genotype-guided warfarin dosing has shown improved anticoagulation outcomes in individuals of European and Asian ancestry. However, its usefulness in specific subgroups remains uncertain. This open-label, non-inferiority randomized trial (NCT00700895) was conducted across three academic hospitals in Southeast Asia to assess the utility of genotype-guided warfarin dosing in Asian patients, focusing on specific potentially high-risk subgroups. We enrolled 322 newly initiated warfarin patients. The primary endpoint was the number of dose adjustments within the first 14 days of treatment, with a non-inferiority margin of 0.5. Clinical follow-up lasted 90 days. Among 322 randomized patients, 269 (mean age 58.7 years, 59.9% males) were evaluated for the primary endpoint. The pharmacogenetic algorithm significantly reduced dose titrations during the initial 14 days compared to the traditional dosing algorithm, without compromising safety. This benefit was consistent in those with atrial fibrillation (N = 101, mean difference -1.63, 95% CI -2.16 to -1.10), non-atrial fibrillation indications (N = 165, mean difference -0.88, 95% CI -1.26 to -0.49), stroke-only indications (N = 19, mean difference -1.60, 95% CI -2.83 to -0.37), history of acute myocardial infarction (N = 20), congestive heart failure (N = 34), hypertension (N = 152), diabetes mellitus (N = 95), and across races (Chinese, N = 163; Malay, Indian and Others, N = 104), sexes (female, N = 161 and male, N = 108), and age groups (< 65 years, N = 168 and ≥ 65 years, N = 101). However, no significant reduction was observed in patients with a history of stroke. There were no differences in minor or major bleeding complications, recurrent venous thromboembolism, or out-of-range INR measurements across most subgroups. Healthcare providers may consider using pharmacogenetic algorithms to individualize initial warfarin dosages in specific high risk Asian subpopulations. Trial registration: ClinicalTrials.gov NCT00700895 (19/06/2008).

Indexed as

AnticoagulantsWarfarinAgedAlgorithmsAsian PeopleAtrial FibrillationCytochrome P-450 CYP2C9FemaleGenotypeHumansMaleMiddle AgedPharmacogeneticsStrokeVitamin K Epoxide ReductasesAnticoagulantsCytochrome P-450 CYP2C9Vitamin K Epoxide ReductasesWarfarinAnticoagulantsCYP2C9PharmacogeneticsPharmacogenomicsPolymorphismPrecision MedicineVKORC1Warfarin

Identifiers

PMID41484425
PMCPMC12848041

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.