Differential effects of C-reactive protein levels on voriconazole metabolism at three age groups in allogeneic hematopoietic cell transplant recipients

The aim of this study was to evaluate the impact of inflammation on voriconazole (VRCZ) metabolism at three age groups in the allogeneic hematopoietic cell transplant recipients of the Chinese population. The study was performed with collecting more than one VRCZ trough concentration and C-reactive...

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Bibliographic Details
Published in:Journal of chemotherapy (Florence) 2021-02, Vol.33 (2), p.95-105
Main Authors: Luo, Xingxian, Li, Taifeng, Hu, Lei, Liu, Silu, Zhao, Haiyan, Zhang, Jiaqi, Feng, Yufei, Huang, Lin
Format: Article
Language:English
Subjects:
allogeneic hematopoietic cell transplant recipients
C-reactive protein
inflammation
N-oxide voriconazole
Voriconazole
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Summary:The aim of this study was to evaluate the impact of inflammation on voriconazole (VRCZ) metabolism at three age groups in the allogeneic hematopoietic cell transplant recipients of the Chinese population. The study was performed with collecting more than one VRCZ trough concentration and C-reactive protein (CRP) levels. Longitudinal analysis, correlation and comparative analysis were conducted to evaluate. A total of 104 patients with 386 VRCZ trough concentration and CRP level measured on the same day were collected. For children, CRP levels significantly associated with VRCZ pharmacokinetics in age 11-18 years but not in age 2-10 years. For adults, VRCZ concentrations were increased slightly by 0.006 mg/L when every 1 mg/L increased in CRP levels. Additionally, meropenem and inflammation might work together to cause a higher VRCZ concentration. Therefore, therapeutic drug monitoring of VRCZ should be warranted at age >10 years in allogeneic hematopoietic cell transplant recipients with elevated CRP level.
ISSN:1120-009X
1973-9478
DOI:10.1080/1120009X.2020.1765604