Observational studyTherapeutic drug monitoring2017
Impact of CYP2C19 Genotype and Liver Function on Voriconazole Pharmacokinetics in Renal Transplant Recipients.
Observational study in Therapeutic drug monitoring, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers.
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Who cites it
33 citing papers in PubMed, 63 citations in OpenAlex.
- Population pharmacokinetics of voriconazole and CYP2C19 polymorphisms for optimizing dosing regimens in renal transplant recipients.British journal of clinical pharmacology · 2018Trial
- Population Pharmacokinetics of Voriconazole in Patients Receiving Extracorporeal Membrane Oxygenation.Pharmaceutical research · 2026Article
- External evaluation of published voriconazole population pharmacokinetic models in adult patients undergoing extracorporeal membrane oxygenation.European journal of clinical pharmacology · 2026Article
- VALID regimen of voriconazole optimizes therapeutic target attainment and minimizes adverse events in patients with liver dysfunction.Frontiers in pharmacology · 2026Article
- CYP2C19-Guided Voriconazole Therapy: A Precision Medicine Approach to Mitigate Adverse Effects in Japanese Patients.Clinical and translational science · 2025Article
- Article
- Personalizing voriconazole dosing in Chinese hematological patients: CYP2C19 phenotype and albumin-bilirubin grade as key predictors of trough concentrations.Frontiers in pharmacology · 2025Article
- A Real-Time Plasma Concentration Prediction Model for Voriconazole in Elderly Patients via Machine Learning Combined with Population Pharmacokinetics.Drug design, development and therapy · 2025Article
- Population pharmacokinetics and dose optimization of voriconazole in patients with COVID-19-associated pulmonary aspergillosis.Frontiers in pharmacology · 2025Article
- Voriconazole therapeutic drug monitoring including analysis of CYP2C19 phenotype in immunocompromised pediatric patients with invasive fungal infections.European journal of clinical pharmacology · 2024Article
- Influence of C-reactive protein on the pharmacokinetics of voriconazole in relation to theFrontiers in pharmacology · 2024Article
- Factors affecting voriconazole concentration to dose ratio changes according to route of administration.European journal of hospital pharmacy : science and practice · 2023Article
- Invasive Aspergillosis after Renal Transplantation.Journal of fungi (Basel, Switzerland) · 2023Review
- The impact of gene polymorphism and hepatic insufficiency on voriconazole dose adjustment in invasive fungal infection individuals.Frontiers in genetics · 2023Review
- Establishment of a mathematical prediction model for voriconazole stable maintenance dose: a prospective study.Frontiers in cellular and infection microbiology · 2023Observational
- Is Halving Maintenance of Voriconazole Safe and Efficient in Patients Suffering from Invasive Fungal Infections with Serious Hepatic Dysfunction?Infection and drug resistance · 2023Article
- External evaluation of population pharmacokinetic models for voriconazole in Chinese adult patients with hematological malignancy.European journal of clinical pharmacology · 2022Article
- Therapeutic drug monitoring andTranslational pediatrics · 2022Article
- Population pharmacokinetics of voriconazole and initial dosage optimization in patients with talaromycosis.Frontiers in pharmacology · 2022Article
- Impact of extracorporeal membrane oxygenation on voriconazole plasma concentrations: A retrospective study.Frontiers in pharmacology · 2022Article
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Authors and funding
14 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundInvasive fungal infection (IFI) is one of the leading causes of early death after renal transplantation. Voriconazole (VRC) is the first-line drug of IFI. Because of the large inter- and intraindividual variability in VRC plasma concentrations and the narrow therapeutic window for treating patients with IFIs, it is crucial to study the factors which could influence pharmacokinetic variability. We performed a population pharmacokinetics (PPK) study of VRC for personalized medicine.
methodsA total of 125 trough concentrations (Cmin) from 56 patients were evaluated, retrospectively. Nonlinear mixed effect model was used to describe a PPK model that was internally validated by bootstrap method. Potential covariates included demographic characteristics, physiological and pathological data, concomitant medications, and CYP2C19 genotype.
resultsA 1-compartment model with first-order absorption and elimination was fit to characterize the VRC pharmacokinetics in renal transplant recipients (RTRs). Aspartate aminotransferase (AST) had a significant influence on clearance (CL) while CYP2C19 genotype had a major impact on the volume of distribution (V). The parameters of CL and V were 4.76 L/h and 22.47 L, respectively. The final model was V (L) = 22.47 × [1 + 2.21 × (EM = 1)] × [1 + 4.67 × (IM = 1)] × [1 + 3.30 × (PM = 1)] × exp (0.96); CL (L/h) = 4.76 × (AST/33)^(-0.23) × exp (0.14). VRC Cmin in intermediate metabolizers was significantly higher than in extensive metabolizers.
conclusionsLiver function and CYP2C19 polymorphism are major determinants of VRC pharmacokinetic variability in RTRs. Genotypes and clinical biomarkers can determine the initial scheme. Subsequently, therapeutic drug monitoring can optimize clinical efficacy and minimize toxicity. Hence, this is a feasible way to facilitate personalized medicine in RTRs. In addition, it is the first report about PPK of VRC in RTRs.
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