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Therapeutic drug monitoring and safety of voriconazole therapy in patients with Child–Pugh class B and C cirrhosis: A multicenter study.
- Source :
-
International Journal of Infectious Diseases . Jul2018, Vol. 72, p49-54. 6p. - Publication Year :
- 2018
-
Abstract
- Objectives The purpose of this study was to investigate the pharmacokinetic profile and safety of voriconazole treatment in patients with Child–Pugh class B and C cirrhosis. Methods Liver cirrhosis patients who had received the recommended voriconazole maintenance dose (group A) or halved maintenance dose (group B), orally or intravenously, were included. Voriconazole-related adverse events (AEs) were defined according to the Common Terminology Criteria for Adverse Events. Results A total of 110 trough plasma concentrations of voriconazole ( C min ) were measured in 78 patients. There was a significant difference in voriconazole C min between group A and group B ( C min , 6.95 ± 3.42 mg/l vs. 4.02 ± 2.00 mg/l; p < 0.001). No significant difference in voriconazole C min between Child–Pugh class B and C cirrhosis patients was observed in either of the two groups. The international normalized ratio and co-medication with a CYP2C19 inhibitor had a significant effect on voriconazole C min in group B. The incidence of AEs in group A was 26.5% and in group B was 15.9%, and 87.5% of AEs developed within 7 days after starting voriconazole treatment. Conclusions These results suggest that the recommended dose and halved maintenance dose may be inappropriate in patients with Child–Pugh class B and C cirrhosis due to the high C min , and that voriconazole C min should be monitored earlier to avoid AEs. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 12019712
- Volume :
- 72
- Database :
- Academic Search Index
- Journal :
- International Journal of Infectious Diseases
- Publication Type :
- Academic Journal
- Accession number :
- 130314747
- Full Text :
- https://doi.org/10.1016/j.ijid.2018.05.009