Relationship between Voriconazole Concentration and Invasive Aspergillosis Treatment Outcome: Efficacy and Safety
- Author:
Tantasawat M
- Collective Name:Puttilerpong C , Panomvana Na Ayudhya , Chantarit P
- Publication Type:Journal Article
- Keywords:
voriconazole, invasive aspergillosis, clinical outcome, hepatotoxicity
- From:
The International Medical Journal Malaysia
2019;18(3):21-29
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: This study aimed to determine the association between the voriconazole (VRZ)
concentration and clinical outcomes, including both the efficacy and safety in invasive aspergillosis (IA)
treatment. Methods: The medical records of adult Thai patients with IA and treated with VRZ at the
Ramathibodi Hospital, Thailand, between January 2013 and March 2016 were retrospectively reviewed, and
their medical, social, demographic, laboratory data, VRZ dosage regimens and concentrations, and clinical
outcome were recorded. The association between the VRZ concentration and clinical outcome was then
determined. Results: A total of 81 patients were included in this study. Forty (49.4%) patients were male,
with median age of 56.1 years. Sixty of them had hematologic malignancies. Forty-seven patients were
diagnosed with probable IA. Median blood sampling time for VRZ level measurement was 11.5 h after the last
dose administration on day 9. The median duration of treatment and outcome evaluation was 103 days
and 73 days, respectively. Overall success and mortality rate were 76.5% and 14.8%, respectively. In the
treatment success group, we found the success rate of around 90% with VRZ trough concentration (Ctr) of 3-4
mg/L. Eleven patients developed liver injuries (LI) and the rate of LI increased significantly with VRZ Ctr of
more than 5 mg/L. Conclusion: We recommend VRZ trough concentration of 3-4 mg/L, as at this range the
patients responded better to the treatment than at > 5.0 mg/L since it was associated with augmented
hepatotoxicity.
- Full text:180304.pdf
