Identification of Risk Factors for Daptomycin-Associated Creatine Phosphokinase Elevation and Development of a Risk Prediction Model for Incidence Probability

Masaru Samura, Naoki Hirose, Takenori Kurata, Keisuke Takada, Fumio Nagumo, Sakura Koshioka, Junichi Ishii, Masaki Uchida, Junki Inoue, Yuki Enoki, Kazuaki Taguchi, Ryuji Higashita, Norifumi Kunika, Koji Tanikawa, Kazuaki Matsumoto

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

Background: In this study, we investigated the risk factors for daptomycin-associated creatine phosphokinase (CPK) elevation and established a risk score for CPK elevation. Methods: Patients who received daptomycin at our hospital were classified into the non-elevated or elevated CPK group based on their peak CPK levels during daptomycin therapy. Univariable and multivariable analyses were performed, and a risk score and prediction model for the incidence probability of CPK elevation were calculated based on logistic regression analysis. Results: The non-elevated and elevated CPK groups included 181 and 17 patients, respectively. Logistic regression analysis revealed that concomitant statin use (odds ratio [OR], 4.45 [95% confidence interval {CI}, 1.40-14.47]; risk score 4), concomitant antihistamine use (OR, 5.66 [95% CI, 1.58-20.75]; risk score 4), and trough concentration (Cmin) between 20 and <30 μg/mL (OR, 14.48 [95% CI, 2.90-87.13]; risk score 5) and ≥30.0 μg/mL (OR, 24.64 [95% CI, 3.21-204.53]; risk score 5) were risk factors for daptomycin-associated CPK elevation. The predicted incidence probabilities of CPK elevation were <10% (low risk), 10%-<25% (moderate risk), and ≥25% (high risk) with total risk scores of ≤4, 5-6, and ≥8, respectively. The risk prediction model exhibited a good fit (area under the receiver operating characteristic curve, 0.85 [95% CI,. 74-.95]). Conclusions: These results suggested that concomitant use of statins with antihistamines and Cmin ≥20 μg/mL were risk factors for daptomycin-associated CPK elevation. Our prediction model might aid in reducing the incidence of daptomycin-associated CPK elevation.

Original languageEnglish
Article numberofab568
JournalOpen Forum Infectious Diseases
Volume8
Issue number12
DOIs
Publication statusPublished - 2021 Dec 1

Keywords

  • Creatine phosphokinase
  • Daptomycin
  • Incidence prediction model
  • Risk factor
  • Risk score
  • Trough concentration

ASJC Scopus subject areas

  • Oncology
  • Clinical Neurology

Fingerprint

Dive into the research topics of 'Identification of Risk Factors for Daptomycin-Associated Creatine Phosphokinase Elevation and Development of a Risk Prediction Model for Incidence Probability'. Together they form a unique fingerprint.

Cite this