PMID- 29793038
OWN - NLM
STAT- MEDLINE
DCOM- 20181113
LR  - 20181113
IS  - 1878-3511 (Electronic)
IS  - 1201-9712 (Linking)
VI  - 72
DP  - 2018 Jul
TI  - Therapeutic drug monitoring and safety of voriconazole therapy in patients with 
      Child-Pugh class B and C cirrhosis: A multicenter study.
PG  - 49-54
LID - S1201-9712(18)34417-5 [pii]
LID - 10.1016/j.ijid.2018.05.009 [doi]
AB  - 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+/-3.42mg/l vs. 4.02+/-2.00mg/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 7days 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.
CI  - Copyright (c) 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.
FAU - Wang, Taotao
AU  - Wang T
AD  - Department of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong 
      University, Xi'an 710061, China. Electronic address: 
      wangtaotao1989@mail.xjtu.edu.cn.
FAU - Yan, Miao
AU  - Yan M
AD  - Department of Pharmacy, The Second Xiangya Hospital, Central South University, 
      Changsha 410008, China. Electronic address: yanmiao@csu.edu.cn.
FAU - Tang, Dan
AU  - Tang D
AD  - School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, 
      Nanjing 210009, China. Electronic address: tdan93@126.com.
FAU - Xue, Ling
AU  - Xue L
AD  - Department of Clinical Pharmacology, The First Affiliated Hospital of Soochow 
      University, Suzhou 215006, China. Electronic address: xueling726@126.com.
FAU - Zhang, Tao
AU  - Zhang T
AD  - Department of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong 
      University, Xi'an 710061, China. Electronic address: zhangtao_xjtu@126.com.
FAU - Dong, Yuzhu
AU  - Dong Y
AD  - Department of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong 
      University, Xi'an 710061, China. Electronic address: dongyuzhu1231@126.com.
FAU - Zhu, Li
AU  - Zhu L
AD  - Department of Infectious Disease, The First Affiliated Hospital of Xi'an Jiaotong 
      University, Xi'an 710061, China. Electronic address: 443619066@qq.com.
FAU - Wang, Xinggang
AU  - Wang X
AD  - Department of Pharmacy, Pulmonary Hospital of Lanzhou, Lanzhou 730046, China. 
      Electronic address: gswxg123@163.com.
FAU - Dong, Yalin
AU  - Dong Y
AD  - Department of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong 
      University, Xi'an 710061, China. Electronic address: dongyalin@mail.xjtu.edu.cn.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
DEP - 20180521
PL  - Canada
TA  - Int J Infect Dis
JT  - International journal of infectious diseases : IJID : official publication of the 
      International Society for Infectious Diseases
JID - 9610933
RN  - 0 (Antifungal Agents)
RN  - JFU09I87TR (Voriconazole)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Antifungal Agents/*administration & dosage/pharmacokinetics
MH  - Dose-Response Relationship, Drug
MH  - Drug Monitoring
MH  - Female
MH  - Humans
MH  - Liver Cirrhosis/*drug therapy/physiopathology
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - Voriconazole/*administration & dosage/pharmacokinetics
OTO - NOTNLM
OT  - Adverse events
OT  - Liver cirrhosis
OT  - Therapeutic drug monitoring
OT  - Trough concentration
OT  - Voriconazole
EDAT- 2018/05/25 06:00
MHDA- 2018/11/14 06:00
CRDT- 2018/05/25 06:00
PHST- 2018/02/09 00:00 [received]
PHST- 2018/05/14 00:00 [revised]
PHST- 2018/05/16 00:00 [accepted]
PHST- 2018/05/25 06:00 [pubmed]
PHST- 2018/11/14 06:00 [medline]
PHST- 2018/05/25 06:00 [entrez]
AID - S1201-9712(18)34417-5 [pii]
AID - 10.1016/j.ijid.2018.05.009 [doi]
PST - ppublish
SO  - Int J Infect Dis. 2018 Jul;72:49-54. doi: 10.1016/j.ijid.2018.05.009. Epub 2018 
      May 21.