Utah hospital participating in largest study of its kind

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    By Courtney Smith

    Researchers at the Intermountain Medical Center have teamed with the National Institute of Health to participate in one of the “nation”s largest study of its kind,” according to an IMC press release.

    “We were chosen as one of 12 sites out of 50 states to participate,” said Dr. Jeffrey Anderson, a cardiologist at IMC. “We are on the leading edge for this study.”

    The new study, Clarify Optimal Anticoagulation through Genetics, will work to target the international normalized ratio based on genetic data to generate a more accurate dosage of Warfarin.

    Warfarin, a drug prescribed to 2-3 million Americans, is a blood thinner used to prevent clots that can lead to heart attacks, strokes or death.

    The IRN is the target range for Warfarin users. A range too high can result in excessive bleeding, whereas a low range can cause recurring blood clots.

    “The main thing we are interested in is getting the bleeding time right,” Anderson said. “Forty percent of the time, the international normalized ration is out of range. This way, we can focus on the individual.”

    Anderson attributes being chosen for the study to previous studies done at IMC, specifically CoumaGen, a study released in 2007 focusing on genotype testing.

    “Because of work previously done, IMC is right at the forefront for this type of study,” he said.

    Currently, Warfarin dosages are prescribed based on an average, taking into consideration age, weight and gender. The doses are then adjusted as the patient responds to the drug.

    “We have to do it by trial and error,” Anderson said. “So if we don”t watch them closely, they can go way out of range. If we knew in advance what their metabolic type was, based on that genetic data, we could advance personalized medicine.”

    COAG is set to start recruitment next month. Anderson speculates that the recruiting process will take about two years and may be the hardest part of the study.

    “I think getting adequate recruitment will be the challenge it always is,” he said. “We have generally cooperative public, patients and physicians, and I think if patients understand the study they will be open to it.”

    The study will involve 1,300 patients and monitor their reaction to Warfarin for six months following enrollment.

    “We hope to get between two and five patients per week, that”s nearly a patient every day,” Anderson said.

    Anderson hopes another result to the study will help individualize medicine for patients.

    “Personalized medicine is not treating everyone the same and adjusting later,” Anderson said. “We want to know the individual dose for each patient.”

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