Prediction of the impact of CYP2C9 and VKORC1 genotypes on warfarin-sorafenib interactions in whites and Asians

Pharmacogenomics. 2020 Aug;21(12):853-862. doi: 10.2217/pgs-2020-0036. Epub 2020 Jul 23.

Abstract

Aim: To predict the impact of the different CYP2C9 and VKORC1 genotypes on warfarin-sorafenib interactions in whites and Asians. Materials & methods: The influences of the CYP2C9*1/*3 and VKORC1 -1639 A/A genotypes on increases in anticoagulation responses (international normalized ratio [INR]) in the presence of sorafenib were predicted using the population pharmacokinetic/pharmacodynamic (PK/PD) model in whites and Asians. Results: INRs were predicted to be 2.0-2.1- versus 1.8-1.9-times higher in the presence of sorafenib in the CYP2C9 (*1/*1 vs *1/*3) groups than those for warfarin alone in both whites and Asians. INRs were also predicted to be 2.1-2.2- versus 1.9-2.1-times higher in the VKORC1 (GG or GA vs AA) groups. Conclusion: Warfarin-sorafenib interactions might be similar irrespective of CYP2C9 and VKORC1 genotypes or ethnicity.

Keywords: Asians; CYP2C9; VKORC1; genetic polymorphisms; international normalized ratio; population PD/PK analysis; prediction; sorafenib; warfarin; whites.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anticoagulants / pharmacokinetics
  • Antineoplastic Agents / pharmacokinetics
  • Asian People / genetics*
  • Cytochrome P-450 CYP2C9 / genetics*
  • Drug Interactions / genetics
  • Female
  • Forecasting
  • Genotype
  • Humans
  • International Normalized Ratio / methods
  • Male
  • Middle Aged
  • Sorafenib / pharmacokinetics*
  • Vitamin K Epoxide Reductases / genetics*
  • Warfarin / pharmacokinetics*
  • White People / genetics*

Substances

  • Anticoagulants
  • Antineoplastic Agents
  • Warfarin
  • Sorafenib
  • CYP2C9 protein, human
  • Cytochrome P-450 CYP2C9
  • VKORC1 protein, human
  • Vitamin K Epoxide Reductases