This story is about an essential but hard-to-manage drug, warfarin or Coumadin, a blood thinner.

This is a good news-bad news drug, one some doctors call the drug they love to hate. It works. It is a tremendous amount of work keeping it in balance. Bad things can happen to patients when their blood is not thin enough or is too thin—there is a range for normal, not dangerous, needs tweaking but you are okay. Then beyond that the bad things can begin.

This wire service story says that…”the world’s most common blood thinner is also one of its most dangerous drugs.”

The news here is that a study showed that gene testing will enable doctors to check patients’ DNA and determine what they need right from the start. Hallelujah! For patients and families who have lived with the testing, adjusting and more adjusting, this is a real victory.

The prospect of patients being started on the right dose of warfarin right from the start is hard to imagine. After all of these years…

Definitely exciting. This is an advance made possible by gene testing, also exciting.

Associated Press

“Doctors are reporting an exciting win for gene testing and personalized medicine: Checking patients’ DNA before starting them on a popular blood thinner helps get the tricky dose right and keep them out of the hospital.

“The drug is warfarin, sold as Coumadin and in generic form. About 2 million Americans start on it each year to prevent blood clots after surgery or for other medical conditions.

“However, the world’s most common blood thinner is also one of its most dangerous drugs. One person’s ideal dose can be 10 times that of another’s. Even certain foods can throw it off.

“Too much warfarin can lead to bleeding, too little can lead to clots, and either one can kill. Up to 20 percent of patients wind up in the hospital in their first six months on the drug.

“Several companies sell tests for the two genes that control how warfarin is metabolized. But doctors wonder: Is it worth a $250-to-$400 test to guide the dose of a drug that costs less than $6 a month?

“A new study, presented Tuesday at an American College of Cardiology conference, suggests it is.”

Source: Associated Press, March 16, 2010