Factors Influencing and Adverse Reactions of Voriconazole Clearance in Patients with Hematological Diseases.
10.19746/j.cnki.issn.1009-2137.2023.02.036
- Author:
He-Gui HUANG
1
;
Hai-Lin WANG
2
;
Yi-Kai LIN
1
;
Yan-Dong YI
1
;
Min LIU
1
;
Jun-Li DONG
1
;
Jian-Min LIU
1
;
Fan CHEN
1
;
Ti-Ying DENG
1
;
Song HU
3
Author Information
1. Department of Pharmacy, Wuhan No.1 Hospital, Wuhan 430022, Hubei Province, China.
2. Hubei University of Science and Technology, Xianning 437100, Hubei Province, China.
3. Department of Pharmacy, Wuhan No.1 Hospital, Wuhan 430022, Hubei Province, China. E-mail: huyaoshi@sina.com.
- Publication Type:Journal Article
- Keywords:
C-reactive protein;
albumin;
hematological diseases;
renal function;
voriconazole
- MeSH:
Humans;
Male;
Female;
Voriconazole/therapeutic use*;
Antifungal Agents/therapeutic use*;
C-Reactive Protein;
Creatinine;
Glucocorticoids;
Retrospective Studies;
Drug Monitoring;
Hematologic Diseases
- From:
Journal of Experimental Hematology
2023;31(2):562-567
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To monitor the changes of voriconazole minimum concentration(Cmin) in patients with hematological diseases, and evaluate the factors influencing and adverse reactions of voriconazole clearance in patients with hematological diseases, so as to provide a theoretical basis for reasonable clinical use of voriconazole.
METHODS:136 patients with hematological diseases who used voriconazole in Wuhan NO.1 Hospital from May 2018 to December 2019 were selected. The correlation between C-reactive protein, albumin, creatinine and voriconazole Cmin were analyzed, and the changes of voriconazole Cmin after glucocorticoid treatment was also detected. In addition, stratified analysis was used to explore the adverse events of voriconazole.
RESULTS:Among 136 patients, 77 were male (56.62%) and 59 were female (43.38%). There were positive correlations between voriconazole Cmin and C-reactive protein and creatinine levels (r=0.277, r=0.208), while voriconazole Cmin was negatively correlated with albumin level (r=-2.673). Voriconazole Cmin in patients treated with glucocorticoid was decreased significantly (P<0.05). In addition, sratified analysis of voriconazole Cmin showed that compared with voriconazole Cmin 1.0-5.0 mg/L group, the incidence of adverse reactions of visual impairment in voriconazole Cmin> 5.0 mg/L group was increased (χ2=4.318, P=0.038).
CONCLUSION:The levels of C-reactive protein, albumin and creatinine are closely related to the voriconazole Cmin, which indicate that inflammation and hyponutrition may prevent the clearance of voriconazole in patients with hematological diseases. It is necessary to monitor the voriconazole Cmin of patients with hematological diseases, and adjust the dosage in time to reduce adverse reactions.
