Favorable Effects of Voriconazole Trough Concentrations Exceeding 1 μg/mL on Treatment Success and All-Cause Mortality: A Systematic Review and Meta-Analysis

Hanai, Yuki; Hamada, Yukihiro; Kimura, Toshimi; Matsumoto, Kazuaki; Takahashi, Yoshiko; Fujii, Satoshi; Nishizawa, Kenji; Miyazaki, Yoshitsugu; Takesue, Yoshio

doi:10.3390/jof7040306

Cited by 19 publications

(20 citation statements)

References 51 publications

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“…We also included noncomparative observational studies in our analysis based on meta-analyses of previous studies evaluating safety. [40][41][42][43][44] Therefore, our findings may have been some…”

Section: Discussionmentioning

confidence: 85%

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Incidence of elevated creatine phosphokinase between daptomycin alone and concomitant daptomycin and statins: A systematic review and meta‐analysis

Samura

Takada

Hirose

et al. 2022

Brit J Clinical Pharma

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The present systematic review and meta-analysis evaluated the incidence of elevated creatine phosphokinase (CPK) levels between daptomycin alone and concomitant daptomycin and statin use. Methods:We searched the PubMed, Web of Sciences, Cochrane Library and ClinicalTrials.gov databases. We analysed the incidence of elevated CPK between daptomycin alone and concomitant daptomycin and statins among studies defining CPK elevation as levels ≥ the upper limit of normal (ULN) or ≥5Â ULN. We also analysed the incidence of rhabdomyolysis between the groups. We then calculated the odds ratios (ORs) and 95% confidence intervals (CIs) based on the included studies.Results: Comparing CPK elevation defined as CPK levels ≥ULN, a significantly higher incidence of CPK elevation was observed with concomitant daptomycin and statin use than with daptomycin alone (OR = 2.55, 95% CI 1.78-3.64, P < .00001, I 2 = 0%).Likewise, when CPK elevation was defined as CPK levels ≥5Â ULN, a significantly higher incidence of CPK elevation was detected with concomitant daptomycin and statin use than with daptomycin alone (OR = 1.89, 95% CI 1.06-3.35, P = .03, I 2 = 48%). The incidence of rhabdomyolysis was significantly higher following concomitant daptomycin and statin use than with daptomycin alone (OR = 11.60, 95% CI 1.81-74.37, P = .01, I 2 = 0%). Conclusion:The combined use of daptomycin and statins were significant risk factors for the incidence of CPK elevation defined as levels ≥ULN or ≥5Â ULN and rhabdomyolysis.

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Section: Discussionmentioning

confidence: 85%

“…This study solely aimed to evaluate the safety of daptomycin, and there were no randomized controlled trials. We also included noncomparative observational studies in our analysis based on meta‐analyses of previous studies evaluating safety 40–44 . Therefore, our findings may have been some bias and confounding factors.…”

Section: Discussionmentioning

confidence: 99%

Incidence of elevated creatine phosphokinase between daptomycin alone and concomitant daptomycin and statins: A systematic review and meta‐analysis

Samura

Takada

Hirose

et al. 2022

Brit J Clinical Pharma

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“…The most common adverse eﬀects seen in the present study were hepatotoxicity and neurotoxicity during VRCZ treatment,4 which were significantly increased with trough concentrations >4.0 and >5.0 µg/mL 19 20. For each independent risk factor of continuous variables we calculated the AUC to estimate the ability of the model to predict trough concentrations >5.0 µg/mL.…”

Section: Resultsmentioning

confidence: 88%

Factors affecting voriconazole concentration to dose ratio changes according to route of administration

Chen

Zhou

et al. 2022

Eur J Hosp Pharm

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BackgroundVoriconazole (VRCZ) is commonly used as oral and intravenous (IV) formulations. Few studies have comprehensively analysed the variation factors for the weight-corrected VRCZ serum concentration/dose (C/D) ratio based on the administration route. We retrospectively investigated the risk factors that influence the VRCZ C/D ratio in patients treated with oral or IV formulations.MethodsA total of 325 patients were divided into two groups (IV and oral groups). Propensity score matching was performed and linear regression analyses were used to identify the risk factors that affect the VRCZ C/D ratio according to the administration route. Receiver operating characteristic (ROC) curves were also used to assess the predictive potential for VRCZ trough concentration >5 µg/mL.ResultsThe VRCZ C/D ratio in the oral group was significantly lower than that in the IV group (p<0.001). Propensity score matching resulted in 65 in the IV group matched with 65 in the oral group. Multivariate analysis showed that age (p=0.039), aspartate aminotransferase (AST) (p=0.016) and total bilirubin (TBIL) (p=0.041) levels were independent influencing factors of the VRCZ C/D ratio in the oral group. ROC curves showed that the predicted probability of combined age, AST and TBIL had maximal area under the curve (AUC) of 0.901 for VRCZ trough level >5 µg/mL. Meanwhile, the ratio of TBIL (p=0.005) and single dose (p=0.015) were independent factors in the IV group with ROCAUC of 0.781.ConclusionsTo obtain optimal VRCZ efficacy and safety, dose adjustment is required based on multiple factors that may cause the observed difference in the VRCZ C/D ratio and trough levels between oral and IV administration.

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“…In our review, three of four patients who developed toxicity showed a Cmin above 10 mg/L. Recently, some meta-analyses have been reported in order to establish the evidence of PK/PD [ 40 , 41 ]. There is one meta-analysis regarding the Cmin of amikacin for reducing the risk of toxicity in adults [ 42 ].…”

Section: Discussionmentioning

confidence: 95%

Amikacin Therapy in Japanese Pediatric Patients: Narrative Review

Kato

Hamada

2022

IJERPH

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Children show a very wide range of physical development processes. These changes impact pharmacokinetic (PK) variability in pediatric patients. Most PK studies have been conducted on the Caucasian population. Therefore, whether current evidence of how developmental change affects PK and exposure–response relationships applies to Japanese pediatric patients remains unclear. This narrative review focuses on amikacin therapy in Japanese pediatric patients and shows the relationship between amikacin concentrations and efficacy/toxicity. Ten relevant articles were identified. Of these, nine articles were published in the 1980s. All studies reported a maximum concentration (Cmax) and minimum concentration (Cmin) of amikacin. Overall, articles reporting PK/pharmacodynamic (PD) indices and minimum inhibitory concentration (MIC) of isolated bacteria in Japanese pediatric patients is lacking, whereas all patients recovered from an infection state and showed negative cultures. Five of the included studies reported the association between Cmin and toxicity. The Cmin in three of four patients who developed toxicity was above 10 mg/L. This narrative review shows that further PK study of amikacin in Japanese pediatric patients is necessary. In particular, the pursuit of knowledge of Cmax/MIC ratio is vital. On the other hand, this review demonstrates that the optimal Cmin for Japanese pediatric patients is below 10 mg/L as a candidate concentration. However, it is noted that the number of patients who developed toxicity is very small.

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Favorable Effects of Voriconazole Trough Concentrations Exceeding 1 μg/mL on Treatment Success and All-Cause Mortality: A Systematic Review and Meta-Analysis

Cited by 19 publications

References 51 publications

Incidence of elevated creatine phosphokinase between daptomycin alone and concomitant daptomycin and statins: A systematic review and meta‐analysis

Incidence of elevated creatine phosphokinase between daptomycin alone and concomitant daptomycin and statins: A systematic review and meta‐analysis

Factors affecting voriconazole concentration to dose ratio changes according to route of administration

Amikacin Therapy in Japanese Pediatric Patients: Narrative Review

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