Medco, Mayo Clinic study finds reduced hospitalization rates with genetic testing

March 16, 2010 | Mike Miliard, Managing Editor

ATLANTA – A simple genetic test can reduce hospitalization rates by almost a third for heart patients taking warfarin, the world's most-prescribed blood thinner, according to a study released today by researchers from Medco Health Solutions, Inc. (in association with the Medco Research Institute) and the Mayo Clinic.

Announced at American College of Cardiology's 59th annual scientific session, and due to be published in the Journal of the American College of Cardiology, it is the first nationwide prospective study examining outcomes when incorporating genetic testing into the management of warfarin as part of the usual care of patients.

Warfarin, which is marketed under the brand names Coumadin and Jantoven, is a blood thinner that is exceptionally difficult to properly dose: The two million patients who start the drug each year have widely varying responses to the medicine due to a variety of factors – including genetics. It's estimated that perhaps 20 percent of patients are hospitalized for bleeding within six months of starting the drug.

The comparative effectiveness study, conducted in nationwide "real world" settings, found that testing for a patient's unique genetic predisposition can significantly improve warfarin's safety and effectiveness by providing information about the patient's sensitivity to the drug, revealing that patients whose therapy included genetic testing were 31 percent less likely to be hospitalized for any cause, and 28 percent less likely to be hospitalized for a bleeding episode or thromboembolism when compared to patients using the blood thinner without genetic testing.

"Warfarin represents an excellent example of how to take the modern science of genetic testing and apply it to making an older drug more effective and safer to use," said Robert S. Epstein, MD, lead author of the study and Medco's chief medical officer and president of the Medco Research Institute. "These results show that we can greatly reduce hospitalizations, and their significant costs, by making genetic testing routine early in a patient's therapy with warfarin."

The Food and Drug Administration requires a so-called "black-box warning" on warfarin – the leading cause of drug-related emergency room visits among the elderly – that describes the bleeding risk and recommends regular monitoring to ensure the patient is responding properly to the dose. The FDA recently approved a labeling change that provides dose recommendations based on genetic test results....

I found this article very interesting due to the fact that it offers new options with an existing technology which is simple genetic testing to reduce the amount of people being hospitalized. I thought it was interesting how the study was directed for a blood thinner which we went over how they function in the body and how these new technologies such as genetic testing can help improve existing drugs. The amount of tests and checks available for different medicines have grown exponentially and as we see in this article can help improve existing medicines.

David Figueroa