Korean J Clin Pharm.  2022 Sep;32(3):238-250. 10.24304/kjcp.2022.32.3.238.

Impact of ABCB1 C3435T Polymorphism on Treatment Response of Vitamin K Antagonists: A Systematic Review and Meta-analysis

• Lee SY
• An SH

• KMID: 2533903
• DOI: http://doi.org/10.24304/kjcp.2022.32.3.238

Abstract

Objective
The aim of this study was to examine the impact of ATP-binding cassette subfamily B member 1 (ABCB1) C3435T polymorphism on the treatment response of patients to vitamin K antagonists (VKAs).
Methods
In this systematic review and metaanalysis, the PubMed/Medline, Embase, and Cochrane Library databases were searched for eligible articles for the period up to November 2020. Articles that reported treatment response to VKAs according to the ABCB1 C3435T polymorphism were included in this study.
Results
A total of 13 and 9 articles were included in the systematic review and meta-analysis, respectively. The weekly maintenance dose of warfarin was significantly lower in patients with the ABCB1 3435CT or TT polymorphism type than in those with the ABCB1 3435CC type (weighted mean difference [WMD], −2.53 mg/week; 95% confidence interval [CI], −3.64 to −1.43, p<0.001). However, the weekly maintenance dose of acenocoumarol was not significantly associated with the ABCB1 C3435T polymorphism (WMD, 1.02; 95% CI, −0.61 to 2.65, p=0.22).
Conclusion
The ABCB1 C3435T polymorphism was significantly associated with the weekly maintenance dose of warfarin. Further research is needed to confirm the association between the ABCB1 C3435T polymorphism and the incidence rate of bleeding events.

Keyword

ABCB1; warfarin; acenocoumarol; maintenance dose; bleeding risk