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Clinical Review of the Pharmacogenomics of Direct Oral Anticoagulants

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Abstract

Purpose

There is growing interest in the use of pharmacogenomics to optimize the safety and efficacy of anticoagulation therapy. While the pharmacogenomics of warfarin have been well-studied, the pharmacogenomics of direct oral anticoagulants (DOACs) continue to be a fledgling, but growing, field of interest. We present a pertinent clinical review of the present state of research on the pharmacogenomics of DOACs.

Methods and Results

The present article is a review of pertinent clinical and scientific research on the pharmacogenomics of DOACs between January 2008 and December 2017 using MEDLINE and the United States National Institutes of Health Clinical Trials Registry. Many studies have identified single-nucleotide polymorphisms (SNPs) in genes responsible for DOAC metabolism that impacted serum DOAC concentration but had uncertain clinical significance.

Conclusions

As such, there is currently no strong evidence for the use of pharmacogenomic testing in optimizing the safety and efficacy of DOAC therapy. Nonetheless, genes of interest have been identified for each DOAC that may be of potential clinical utility. Further research is currently underway to elucidate the value of pharmacogenomics in this increasingly prescribed therapy.

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Authors and Affiliations

  1. Department of Internal Medicine, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ, 85259, USA

    Andrew S. Tseng & Jacob T. Maddux

  2. College of Pharmacy, University of Arizona, 1295 N Martin Ave, Tucson, AZ, 85721, USA

    Reema D. Patel

  3. Midwestern University, 19555 N 59th Ave, Glendale, AZ, 85308, USA

    Heidi E. Quist

  4. Department of Pharmacy, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ, 85259, USA

    Adrijana Kekic & Christopher B. Grilli

  5. Division of Cardiovascular Diseases, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ, 85259, USA

    Fadi E. Shamoun

Authors
  1. Andrew S. Tseng
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  2. Reema D. Patel
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  3. Heidi E. Quist
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  4. Adrijana Kekic
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  5. Jacob T. Maddux
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  6. Christopher B. Grilli
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  7. Fadi E. Shamoun
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Corresponding author

Correspondence to Fadi E. Shamoun.

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Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Conflict of Interest

The authors declare that they have conflicts of interest.

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Tseng, A.S., Patel, R.D., Quist, H.E. et al. Clinical Review of the Pharmacogenomics of Direct Oral Anticoagulants. Cardiovasc Drugs Ther 32, 121–126 (2018). https://doi.org/10.1007/s10557-018-6774-1

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  • DOI: https://doi.org/10.1007/s10557-018-6774-1

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