Study on the correlation between posaconazole trough concentration and efficacy and its influencing factors in pediatric patients with hematological diseases complicated with invasive fungal infections
- VernacularTitle:血液病合并侵袭性真菌感染患儿泊沙康唑谷浓度与疗效的相关性及影响因素分析
- Author:
Wenli LI
1
;
Tiantian ZHANG
1
;
Yakun ZHANG
1
;
Zhiqing ZHANG
1
Author Information
1. Dept. of Pharmacy，The Second Hospital of Hebei Medical University，Shijiazhuang 050061，China
- Publication Type:Journal Article
- Keywords:
Invasive fungal infection;
Posaconazole;
hematological diseases;
Therapeutic drug monitoring;
Trough concentration;
Influencing factors
- From:
China Pharmacy
2026;37(18):2413-2417
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To investigate the relationship between posaconazole trough concentration （ C min ） and clinical efficacy， and to analyze the factors potentially influencing posaconazole C min in pediatric patients with hematological diseases complicated with invasive fungal infections.METHODS Pediatric patients with hematological diseases complicated with invasive fungal infections who received posaconazole therapy at The Second Hospital of Hebei Medical University from January 2019 to August 2024 were enrolled. Baseline information， fungal infection-related examinations， posaconazole medication details， and pre-treatment laboratory indicators were collected. According to the different therapeutic purposes of posaconazole， stratified evaluation criteria were used to assess therapeutic effectiveness. Posaconazole C min was determined by high performance liquid chromatography. Patients who underwent therapeutic drug monitoring （TDM） were divided into groups according to whether clinical efficacy was achieved， and the difference in posaconazole C min between groups was compared. Receiver operating characteristic （ROC） curve was used to determine the correlation between posaconazole C min and efficacy. Patients were further grouped according to whether posaconazole C min reached the optimal cut-off value predicted by ROC cure， and the factors potentially influencing posaconazole C min were analyzed.RESULTS A total of 130 pediatric patients with hematological diseases complicated with invasive fungal infections who received posaconazole treatment were enrolled， of whom 80 achieved clinical efficacy， with an effective rate of 61.54%. Thirty-nine patients （53 blood samples） underwent TDM， of whom 27 achieved clinical efficacy. The posaconazole C min in the effective group was 2.17 （1.31， 3.51） μg/mL， while that in the ineffective group was 1.19 （0.59， 2.10） μg/mL， with a statistically significant difference between groups （ P ＝0.005）. The optimal cut-off value of posaconazole C min for predicting clinical efficacy by ROC curve was 1.58 μg/mL. Univariate analysis showed that dosage form of posaconazole was a factor influencing C min .CONCLUSIONS Posaconazole demonstrated favorable efficacy in the treatment of pediatric patients with hematological diseases complicated with invasive fungal infections. When C min ≥1.58 μg/mL， posaconazole C min was positively correlated with clinical efficacy； posaconazole dosage form was a factor influencing C min .
