| Objective:To evaluate the efficacy and safety of genotype-guided warfarin on preventing and treating thromboembolic disease with meta-analysis.Methods:PubMed database, Cochrane Library, Wan fang, VIP and CNKI were systemically searched for literature of genotype-guided warfarin on preventing and treating thromboembolic disease. The searching date was up to January 1,2014. The data extraction and methodological grading were performed independently by two authors. RevMan version 5.2 was used for statistical analysis.Results:A total of 11 randomized controlled trials (RCTs) were included in systematic review and 10 RCTs (2905 cases) were quantitatively analyzed. The results of meta-analysis showed that there were no significant difference between genotypic warfarin-dosing group and control dosing group on the aspects of percentage of time in the INR therapeutic range (SMD,0.11; 95% CI:-0.06 to 0.29; P=0.21), patients with stable dose (RR, 1.13; 95% CI:1.00 to 1.28; P=0.05), over coagulation (RR,0.95; 95% CI: 0.83 to 1.08; P=0.44), bleeding (RR,0.89; 95% CI:0.78 to 1.01; P=0.08), thromboembolism (RR,0.61; 95% CI:0.30 to 1.23; P=0.17). The results of subgroup analysis on percentage of time in the INR therapeutic range and patients with stable dose did not show significant difference between the two groups. The sensitivity analysis of outcomes shows that the result was stable and reliable.Conclusion:The evidence of superiority on efficacy and safety of genotypic warfarin-dosing group comparing with control group for preventing and treating thromboembolic disease was still insufficient. |
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