Genetic information personalizes warfarin p...( MADISON Warfarin one of the world's...)

MADISON Warfarin, one of the world's most widely used drugs, is also one of the trickiest to prescribe. Half of those who take it are at risk of serious problems when given the standard starting dose.

Now, in one of the first illustrations of "personalized medicine" based on genetic information, an international research team has created a model to help doctors determine the best dose of the blood-thinning drug for each patient.

Three University of Wisconsin-Madison researchers were involved in the work.

The model, based on data from thousands of patients treated with warfarin, showed that when doctors included information on patients' genetic make-up and other clinical factors in their decision-making, they did a much better job of predicting the appropriate dose.

The study and an accompanying editorial supporting the research appear in Thursday's (Feb. 19, 2009) New England Journal of Medicine.

David Page, professor of biostatistics and medical informatics at the UW School of Medicine and Public Health (SMPH) in Madison, was in charge of overseeing the data analysis on the project, undertaken by the International Warfarin Pharmacogenetics Consortium.

The statistical achievement is one of the first to show the potential of personalized medicine. In this new field, also called pharmacogenetics, physicians look at each patient's genetic make-up to predict how he or she will respond to specific drugs, what doses may be ideal, and if and when treatment should begin.

Gov. Jim Doyle last summer created the Wisconsin Genomics Initiative a collaborative that brings together the SMPH, Marshfield Clinic, the Medical College of Wisconsin and UW-Milwaukee to advance personalized medicine in the Badger State. Page also plays a key role in the initiative.

Warfarin was developed at UW-Madison and patented by WARF in the 1940s. Millions of patients take the anti-coagulant to prevent life
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