LUONG, Me-Linh, Mona AL-DABBAGH, Andreas H. GROLL, Zdeněk RÁČIL, Yasuhito NANNYA, Dimitra MITSANI a Shahid HUSAIN. Utility of voriconazole therapeutic drug monitoring: a meta-analysis. Journal of Antimicrobial Chemotherapy. Oxford: Oxford University Press, roč. 71, č. 7, s. 1786-1799. ISSN 0305-7453. doi:10.1093/jac/dkw099. 2016.
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Základní údaje
Originální název Utility of voriconazole therapeutic drug monitoring: a meta-analysis
Autoři LUONG, Me-Linh (124 Kanada), Mona AL-DABBAGH (124 Kanada), Andreas H. GROLL (276 Německo), Zdeněk RÁČIL (203 Česká republika, garant, domácí), Yasuhito NANNYA (392 Japonsko), Dimitra MITSANI (840 Spojené státy) a Shahid HUSAIN (124 Kanada).
Vydání Journal of Antimicrobial Chemotherapy, Oxford, Oxford University Press, 2016, 0305-7453.
Další údaje
Originální jazyk angličtina
Typ výsledku Článek v odborném periodiku
Obor 30104 Pharmacology and pharmacy
Stát vydavatele Velká Británie a Severní Irsko
Utajení není předmětem státního či obchodního tajemství
Impakt faktor Impact factor: 5.071
Kód RIV RIV/00216224:14110/16:00089949
Organizační jednotka Lékařská fakulta
Doi http://dx.doi.org/10.1093/jac/dkw099
UT WoS 000383246000005
Klíčová slova anglicky INVASIVE FUNGAL-INFECTIONS; ADVERSE EVENTS; PLASMA-CONCENTRATIONS; BLOOD-CONCENTRATION; CLINICAL-OUTCOMES; EFFICACY; ASPERGILLOSIS; MULTICENTER; GUIDELINES; DISEASES
Štítky EL OK
Příznaky Mezinárodní význam, Recenzováno
Změnil Změnila: Ing. Mgr. Věra Pospíšilíková, učo 9005. Změněno: 25. 10. 2016 10:45.
Anotace
Background: Voriconazole therapeutic drug monitoring (TDM) is increasingly used in clinical practice. However, the utility of voriconazole TDM to guide therapy remains uncertain and controversial. We conducted a metaanalysis of studies assessing the relationship between voriconazole serum concentration and clinical outcomes of success and toxicity. Methods: We searched bibliographic databases for studies on voriconazole serum concentrations and clinical outcomes. We compared success outcomes between patients with therapeutic and subtherapeutic voriconazole serum concentrations, and toxicity outcomes between patients with and without supratherapeutic serum concentrations. Results: Twenty-four studies were analysed. Pooled analysis for efficacy endpoint demonstrated that patients with therapeutic voriconazole serum concentrations (1.0–2.2 mg/L) were more likely to have successful outcomes compared with those with subtherapeutic voriconazole serum concentrations (OR 2.30; 95% CI 1.39–3.81). A therapeutic threshold of 1.0 mg/L was most predictive of successful outcome (OR 1.94; 95% CI 1.04–3.62). Patients with therapeutic concentrations did not have better survival rates. Pooled analysis for toxicity endpoint demonstrated that patients with supratherapeutic voriconazole serum concentrations (4.0–6.0 mg/L) were at increased risk of toxicity (OR 4.17; 95% CI 2.08–8.36). A supratherapeutic threshold of 6.0 mg/L was most predictive of toxicity (OR 4.60; 95% CI 1.49–14.16). Conclusions: Patients with therapeutic voriconazole serum concentrations were twice as likely to achieve successful outcomes. The likelihood of toxicity associated with supratherapeutic voriconazole serum concentrations was 4-fold that of therapeutic concentrations. Our findings suggest that the use of voriconazole TDM to aim for serum concentrations between 1.0 and 6.0 mg/L during therapy may be warranted to optimize clinical success and minimize toxicity.
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