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Faculty Detail     Name NITA A LIMDI   Campus Address JT 1235 Zip 6830 Phone 205-934-4385 E-mail nlimdi@uab.edu Other websites http://medicine.uab.edu/neurology/faculty/Limdi/

Faculty Appointment(s) Appointment Type Department Division Rank Primary  Neurology   Neurology Chair Office Associate Professor Secondary  Medicine  Med - Nephrology Associate Professor Secondary  Pharmacology/Toxicology   Pharmacology/Toxicology Chair's Office Associate Professor Center  Center for Aging  Center for Aging Associate Professor Center  General Clinical Research Center  Center for Outcomes & Effectiveness Res & Educ Associate Professor Center  General Clinical Research Center  Comprehensive Neuroscience Center Associate Professor Center  General Clinical Research Center  Ctr for Clinical & Translational Sci Associate Professor

Graduate Biomedical Sciences Affiliations Biochemistry and Structural Biology  Genetics and Genomic Sciences  Pathobiology and Molecular Medicine

Biographical Sketch  Dr. Limdi graduated from Samford University obtaining a Pharm.D degree in 1994. She joined the Department of Hospital Pharmacy as a Pharmacy Specialist in Neurosciences. She continued her training obtaining an MSPH in Clinical Research in 2005 and PhD in Epidemiology in 2007. Dr. Limdi’s primary research focus is on pharmacogenetics/genomics of anticoagulation therapy and pharmacoepidemiology in cardiovascular phenotypes.

Research/Clinical Interest Title Pharmacogenetics of drug response Description Drug response is a complex phenotype depicting an intricate and complex interplay of genetic and environmental factors. Although overall response patterns among participants in clinical studies guides clinical practice, it is often difficult to predict individual patients’ response to medications. The emergence of pharmacogenetics offers hope to improve prediction of medication response with the potential benefit of increasing medication efficacy and safety. My work is focused on understanding genetic and environmental factors that influence drug response determine their relative contribution and understand the interplay between genes and environment. Anticoagulants, specifically warfarin is of particular interest. Warfarin, the most widely used oral anticoagulant, is limited by the capricious nature of patients’ response to any given dose. Warfarin’s narrow therapeutic index makes this variation potentially hazardous perhaps explaining warfarin’s consistent rank among the top 10 drugs associated with serious adverse events. With a network of collaborators in UAB and at other national and international institutions we are defining the genetic and environmental factors that influence warfarin dose and risk of hemorrhagic complications. Our approach is to use complementary approaches: candidate-gene and genome-wide association study in a prospective racially diverse cohort. The long-term goals are to use genetic and environmental predictors to tailor dosage and to predict individual risk of hemorrhage and to use this information to enable informed and personalized clinical decisions.

Selected Publications  Publication PUBMEDID Limdi NA and Veenstra DL. Expectations, validity and reality in pharmacogenomics. Journal of Clinical Epidemiology. 2010 (in press)   19995676  Limdi NA, Goldstein JA, Blaisdell JA, Beasley TM, Rivers CA, Acton RT. Influence of CYP2C9 Genotype on warfarin dose among African American and European Americans. Personalized Medicine. 2007;4(2): 157-169  19802360  Knowlton RC, Razdan S, Limdi NA, Elgavish RA, Killen J, Blount J, Burneo JG, Ver Hoef L; Paige L, Faught E, Kankirawatana P, Riley K, Kuzniecky, R. Effect of magnetic source imaging on intracranial electrode placement for epilepsy surgery. Ann Neurol. 2009; 65(6):716-723.   19557860  Cavallari LH, Limdi NA. Warfarin Pharmacogenomics. Curr Opin Mol Ther. 2009;11(3):243-51.  19479657  DeWolfe JL, Knowlton RK, Beasley MT, Cofield S, Faught E, Limdi NA. Hyperammonemia intravenous valproate loading. Epilepsy Research 2009; 85(1):65-71.  19299111   The International Warfarin Pharmacogenetics Consortium. Estimation of the Warfarin Dose with Clinical and Pharmacogenetic Data. New England Journal of Medicine 2009;360:753-64.   19228618   NA Limdi, Goldstein, TM Beasley, G McGwin, DK Arnett, MF Baird, RT Acton, M Allon. Kidney Function Influences Warfarin Responsiveness and Hemorrhagic Complications. Journal of American Society of Nephrology 2009;20: 912-921  19225037   JA Goldstein, Blaisdell JA, NA Limdi. A potentially deleterious new CYP2C9 polymorphism identified in an African American patient with major hemorrhage on warfarin therapy. Blood Cells Molecules and Disease 2009;42:155–158.   19083245   NA Limdi, TM Beasley, MR Crowley, JA Goldstein, MJ Rieder, DA Flockhart, DK Arnett, N Liu. I Influence of VKORC1 polymorphisms, haplotypes and haplotype groups on warfarin dose among African Americans and European Americans. Pharmacogenomics 2008; 9(10):1445-1458.  18855533  Hedi Schelleman, Nita A. Limdi, Stephen E. Kimmel. Ethnic differences in warfarin maintenance dose requirement. Pharmacogenomics 2008; 9(9):1331-1346.  18781859  First Prev   1 2 3 of  3  Next Last

Keywords Pharmacogenetics, Pharmacogenomics, Pharmacoepidemiology, Warfarin , Antiplatelet drugs, Antithrombotic, comparative effectiveness

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