Posaconazole concentrations after allogeneic hematopoietic stem cell transplantation. Issue 5 (25th July 2013)

• Record Type: Journal Article
• Authors: Heinz, W.J.; Einsele, H.; Helle‐Beyersdorf, A.; Zirkel, J.; Grau, A.; Schirmer, D.; Lenker, U.; Klinker, H.
• Is Part Of: Transplant infectious disease. Volume 15:Issue 5(2013)
• Page Start: 449
• Page End: 456
• Publication Date: 2013-07-25
• Subjects: Transplantation of organs, tissues, etc -- Complications -- Periodicals; Communicable diseases -- Periodicals; Infection -- Periodicals; 617.01
• DOI: 10.1111/tid.12108
• Languages: English
• ISSNs: 1398-2273

Abstract

<abstract abstract-type="main" id="tid12108-abs-0001"> <title>Abstract</title> <sec id="tid12108-sec-0001" sec-type="section"> <title>Introduction</title> <p>Posaconazole is recommended for prophylaxis of fungal infections and for salvage therapy of invasive aspergillosis after stem cell transplantation. An impact of drug concentration on efficacy has been suggested.</p> </sec> <sec id="tid12108-sec-0002" sec-type="section"> <title>Methods</title> <p>In this study, we investigated serum levels of posaconazole in 262 samples from 64 allogeneic stem cell recipients.</p> </sec> <sec id="tid12108-sec-0003" sec-type="section"> <title>Results</title> <p>A high degree of interindividual variation was observed. Concentrations were significantly higher for male patients compared with female patients (median 570 and 426 ng/mL, respectively), but no differences for age or dosing groups (400 mg twice daily [BID] or 200 mg three times a day) could be detected. The predictive value of the first determined posaconazole concentration in steady state and of a concentration >500 and 700 ng/mL at any time was evaluated, compared with patients with a first level <300 ng/mL (mean 10.3%, median 0%).</p> </sec> <sec id="tid12108-sec-0004" sec-type="section"> <title>Conclusion</title> <p>In patients receiving 400 mg BID, the mean rate of serum levels >500 ng/mL in subsequent determinations was higher, if the first serum concentration during steady state was >300 ng/mL (mean 61.1%, median 60%, <italic>P</italic> = 0.002) or >500 ng/mL (67.7%, median 75%, <italic>P</italic> = 0.002). Based on this retrospective analysis, a posaconazole serum concentration >500 ng/mL at any time point might also help to predict sufficient drug concentrations.</p> </sec> </abstract>