Evidence map›Paper›PMID 31145490›Full record

Observational studyMycoses2019

Posaconazole therapeutic drug monitoring in clinical practice and longitudinal analysis of the effect of routine laboratory measurements on posaconazole concentrations.

Anne-Grete Märtson, Anette Veringa, Edwin R van den Heuvel, Martijn Bakker, Daan J Touw, Tjip S van der Werf, Lambert F R Span, Jan-Willem C Alffenaar

Open access · bronzeAbstract readObservational Study
In one paragraph

Observational study in Mycoses, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 1 pooled it
2.0field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.

  1. Pooled it
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  6. Review
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  13. Observational
  14. Evaluation of Crushed Posaconazole Delayed Release Tablets in Lung Transplant Recipients.Transplant infectious disease : an official journal of the Transplantation Society
    Article
  15. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 2 countries.

Anne-Grete MärtsonDepartment of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Anette VeringaDepartment of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Edwin R van den HeuvelDepartment of Mathematics and Computer Science, Eindhoven University of Technology, Eindhoven, The Netherlands.
Martijn BakkerDepartment of Hematology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Daan J TouwDepartment of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Tjip S van der WerfDepartment of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Lambert F R SpanDepartment of Hematology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Jan-Willem C AlffenaarDepartment of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.ORCID https://orcid.org/0000-0001-6703-0288
University Medical Center Groningen · NLEindhoven University of Technology · NLThe University of Sydney · AU

Funding

Marie Skłodowska-Curie Actions 713660 - PRONKJEWAIL - H2020-MSCA-COFUND-2015Merck Sharp and Dohme 53559
6 · The paper itself

Abstract

Posaconazole is indicated for prophylaxis and treatment of invasive aspergillosis. Therapeutic drug monitoring (TDM) of posaconazole is used to optimise drug exposure. The aim of this study was to analyse and describe the TDM practices and exposure of posaconazole tablets. Patients who received posaconazole for treatment or prophylaxis of fungal infections were included in the study. The following therapeutic window was defined: if concentration was low (<0.7 mg/L for prophylaxis or < 1.5 mg/L for treatment) or high (>3.75 mg/L), the hospital pharmacist provided the physician with dosage advice, which implementation to patient care was analysed. A longitudinal analysis was performed to analyse if different confounding variables had an effect on posaconazole concentrations. Forty-seven patients were enrolled resulting in 217 posaconazole trough concentrations. A median of 3 (IQR 1-7) samples was measured per patient. The median concentration was 1.7 mg/L (IQR 0.8-2.7) for prophylaxis and 1.76 mg/L (IQR 1.3-2.3) for treatment. Overall, 78 posaconazole concentrations were out of the therapeutic window. For 45 (54%) of these concentrations, a dosage change was recommended. In the longitudinal analysis, the laboratory markers and patient baseline variables did not have an effect on posaconazole concentrations. Adequate posaconazole exposure was shown in 64% (affected 28 patients) of the measured concentrations. TDM practice of posaconazole can be improved by increasing the implementation rate of dose recommendation by a multidisciplinary antifungal stewardship team.

Indexed as

Drug MonitoringAdministration, OralAgedAntifungal AgentsAntimicrobial StewardshipClinical Laboratory TechniquesDose-Response Relationship, DrugFemaleHumansInvasive Fungal InfectionsLongitudinal StudiesMaleMiddle AgedProspective StudiesTabletsTriazolesAntifungal AgentsposaconazoleTabletsTriazolesclinical pharmacyhaematological malignanciesinvasive fungal infectionslongitudinal analysispharmacistpharmacokineticsposaconazoletherapeutic drug monitoring

Identifiers

PMID31145490
PMCPMC6852019
OpenAlexW2947396082

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.