ArticleAntimicrobial agents and chemotherapy2016
Longitudinal Analysis of the Effect of Inflammation on Voriconazole Trough Concentrations.
Article in Antimicrobial agents and chemotherapy, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 1 of them a synthesis that pooled it.
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Who cites it
35 citing papers in PubMed, 1 synthesis or guideline pooled it, 66 citations in OpenAlex.
- The Cytokine Release Syndrome and/or the Proinflammatory Cytokines as Underlying Mechanisms of Downregulation of Drug Metabolism and Drug Transport: A Systematic Review of the Clinical Pharmacokinetics of Victim Drugs of this Drug-Disease Interaction Under Different Clinical Conditions.Clinical pharmacokinetics · 2022Pooled it
- Population pharmacokinetics of voriconazole and CYP2C19 polymorphisms for optimizing dosing regimens in renal transplant recipients.British journal of clinical pharmacology · 2018Trial
- Inflammation investigated as a source of pharmacokinetic variability of atazanavir in AIDS Clinical Trials Group protocol A5224s.Antiviral therapy · 2018Trial
- Inflammation-driven variability in drug metabolism: Insights from voriconazole treatment of HSCT recipients.British journal of clinical pharmacology · 2026Article
- Delayed decrease in voriconazole concentration after resolution of inflammation in a patient with invasive pulmonary aspergillosis: a case report.Journal of pharmaceutical health care and sciences · 2026Article
- Population Pharmacokinetics and Exposure-Response Analysis of Voriconazole in ICU and Non-ICU Hospitalized Adults.Infection and drug resistance · 2026Article
- An Interpretable PK-Informed Hybrid Model for Voriconazole Exposure Prediction: Roles of CYP2C19 Genotype and Inflammation.Drug design, development and therapy · 2026Article
- French-Speaking Network of Pharmacogenetics (RNPGx) Recommendations for Clinical Use of Mavacamten.Clinical pharmacology and therapeutics · 2025Review
- Personalizing voriconazole dosing in Chinese hematological patients: CYP2C19 phenotype and albumin-bilirubin grade as key predictors of trough concentrations.Frontiers in pharmacology · 2025Article
- Association of procalcitonin with voriconazole concentrations: a retrospective cohort study.BMC infectious diseases · 2024Article
- Impact of Inflammatory Burden on Voriconazole Exposure in Oncohematological Pediatric Patients Receiving Antifungal Prophylaxis after Allogeneic HCT.Microorganisms · 2024Article
- Inflammation altered correlation between CYP2C19 genotype and CYP2C19 activity in patients receiving voriconazole.Clinical and translational science · 2024Article
- Influence of C-reactive protein on the pharmacokinetics of voriconazole in relation to theFrontiers in pharmacology · 2024Article
- Impact of Inflammation on Voriconazole Exposure in Critically ill Patients Affected by Probable COVID-19-Associated Pulmonary Aspergillosis.Antibiotics (Basel, Switzerland) · 2023Article
- Enhancing voriconazole therapy in liver dysfunction: exploring administration schemes and predictive factors for trough concentration and efficacy.Frontiers in pharmacology · 2023Article
- Factors influencing plasma concentration of voriconazole and voriconazole- N-oxide in younger adult and elderly patients.Frontiers in pharmacology · 2023Article
- Establishment of a mathematical prediction model for voriconazole stable maintenance dose: a prospective study.Frontiers in cellular and infection microbiology · 2023Observational
- Impact of Inflammation on Midazolam Metabolism in Severe COVID-19 Patients.Clinical pharmacology and therapeutics · 2022Article
- Impact of polymorphisms of pharmacokinetics-related genes and the inflammatory response on the metabolism of voriconazole.Pharmacology research & perspectives · 2022Article
- Inflammation Affects Liver Function and the Metabolism of Voriconazole to Voriconazole-N-Oxide in Adult and Elderly Patients.Frontiers in pharmacology · 2022Article
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Voriconazole (VCZ) exhibits great inter- and intrapatient variability. The latter variation cannot exclusively be explained by concomitant medications, liver disease or dysfunction, and genetic polymorphisms in cytochrome P450 2C19 (CYP2C19). We hypothesized that inflammatory response in patients under VCZ medication might also influence this fluctuation in concentrations. In this study, we explored the association between inflammation, reflected by the C-reactive protein (CRP) concentration, and VCZ trough concentrations over time. A retrospective analysis of data was performed for patients with more than one steady-state VCZ trough concentration and a CRP concentration measured on the same day. A longitudinal analysis was used for series of observations obtained from many study participants over time. The approach involved inclusion of random effects and autocorrelation in linear models to reflect within-person cross-time correlation. A total of 50 patients were eligible for the study, resulting in 139 observations (paired VCZ and CRP concentrations) for the analysis, ranging from 2 to 6 observations per study participant. Inflammation, marked by the CRP concentration, had a significant association with VCZ trough concentrations (P < 0.001). Covariates such as age and interacting comedication ([es]omeprazole), also showed a significant correlation between VCZ and CRP concentrations (P < 0.05). The intrapatient variation of trough concentrations of VCZ was 1.401 (confidence interval [CI], 0.881 to 2.567), and the interpatient variation was 1.756 (CI, 0.934 to 4.440). The autocorrelation between VCZ trough concentrations at two sequential time points was calculated at 0.71 (CI, 0.51 to 0.92). The inflammatory response appears to play a significant role in the largely unpredictable pharmacokinetics of VCZ, especially in patients with high inflammatory response, as reflected by high CRP concentrations.
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