Pharmacogenomic Profiling Of The Saudi Population And Its Implications For Personalized Dosing Of Anticoagulants

Abstract

Background: Variability in anticoagulant response, particularly to warfarin, is strongly influenced by genetic factors. Population-specific pharmacogenomic data are limited in Saudi Arabia.

Objective: To characterize key pharmacogenomic variants affecting anticoagulant therapy in a Saudi population and assess their implications for personalized dosing and clinical outcomes.

Methods: A total of 500 Saudi patients receiving anticoagulant therapy were genotyped for VKORC1, CYP2C9, and CYP4F2. Associations between genotypes and warfarin dose requirements were analyzed, and clinical outcomes under genotype-guided dosing were evaluated. Healthcare provider perspectives on pharmacogenomic implementation were also assessed.

Results: Significant variability in VKORC1 and CYP2C9 genotypes was observed. Carriers of VKORC1 GA/AA and CYP2C9 variant alleles required significantly lower warfarin doses than wild-type carriers (p < 0.001). A multivariate model explained 68% of dose variability. Genotype-guided dosing resulted in rapid INR stabilization (82% within three weeks) and low rates of bleeding (3%) and thromboembolic events (2%).

Conclusion: Pharmacogenomic profiling revealed clinically meaningful genetic variability in the Saudi population. Genotype-guided anticoagulant dosing improved therapeutic control and supports the integration of pharmacogenomics into personalized anticoagulant management in Saudi Arabia.