TY - JOUR
T1 - Therapeutic drug monitoring of voriconazole in Japanese patients
T2 - analysis based on clinical practice data
AU - Matsumoto, Kazuaki
AU - Abematsu, Kazuko
AU - Shigemi, Akari
AU - Kanazawa, Naoko
AU - Watanabe, Erika
AU - Yokoyama, Yuta
AU - Ikawa, Kazuro
AU - Morikawa, Norifumi
AU - Takeda, Yasuo
N1 - Publisher Copyright:
© 2016 Edizioni Scientifiche per l'Informazione su Farmaci e Terapia.
PY - 2016/5/3
Y1 - 2016/5/3
N2 - The aim of this study was to investigate whether routine therapeutic drug monitoring (TDM) of voriconazole (VRCZ) reduced discontinuation due to hepatotoxicity. Hepatotoxicity was observed in 15 (51.7%) out of 29 patients. The percentages of patients who developed hepatotoxicity within 4 days and 1 week were 26.7 and 46.7%, respectively. The drug trough concentrations in patients with and without hepatotoxicity were 5.55 ± 2.73 and 2.36 ± 1.67 μg/ml (P < 0.01, the two-sided Student's t-test), respectively. Trough concentrations reached the target of 1–5 μg/ml in patients with gradual dose reductions based on TDM, and, consequently, liver enzyme levels returned to the original levels before the VRCZ treatment. All patients eventually continued effective VRCZ therapy despite its hepatotoxicity. Thus, dose adjustments by TDM to achieve the target trough concentrations is useful in order to avoid hepatotoxicity and enable continued effective VRCZ therapy for Japanese patients with invasive fungal infections.
AB - The aim of this study was to investigate whether routine therapeutic drug monitoring (TDM) of voriconazole (VRCZ) reduced discontinuation due to hepatotoxicity. Hepatotoxicity was observed in 15 (51.7%) out of 29 patients. The percentages of patients who developed hepatotoxicity within 4 days and 1 week were 26.7 and 46.7%, respectively. The drug trough concentrations in patients with and without hepatotoxicity were 5.55 ± 2.73 and 2.36 ± 1.67 μg/ml (P < 0.01, the two-sided Student's t-test), respectively. Trough concentrations reached the target of 1–5 μg/ml in patients with gradual dose reductions based on TDM, and, consequently, liver enzyme levels returned to the original levels before the VRCZ treatment. All patients eventually continued effective VRCZ therapy despite its hepatotoxicity. Thus, dose adjustments by TDM to achieve the target trough concentrations is useful in order to avoid hepatotoxicity and enable continued effective VRCZ therapy for Japanese patients with invasive fungal infections.
KW - Hepatotoxicity
KW - Japanese
KW - Therapeutic drug monitoring
KW - Voriconazole
UR - http://www.scopus.com/inward/record.url?scp=84978733909&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84978733909&partnerID=8YFLogxK
U2 - 10.1179/1973947815Y.0000000057
DO - 10.1179/1973947815Y.0000000057
M3 - Article
C2 - 26187373
AN - SCOPUS:84978733909
SN - 1120-009X
VL - 28
SP - 198
EP - 202
JO - Journal of Chemotherapy
JF - Journal of Chemotherapy
IS - 3
ER -
