Observational studyClinical infectious diseases : an official publication of the Infectious Diseases Society of America2020
Posaconazole Serum Drug Levels Associated With Pseudohyperaldosteronism.
Observational study in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
38 citing papers in PubMed, 2 syntheses or guidelines pooled it, 103 citations in OpenAlex.
- Antifungal Therapy with Azoles Induced the Syndrome of Acquired Apparent Mineralocorticoid Excess: a Literature and Database Analysis.Antimicrobial agents and chemotherapy · 2022Pooled it
- Too Much of a Good Thing: Defining Antimicrobial Therapeutic Targets to Minimize Toxicity.Clinical pharmacology and therapeutics · 2021Pooled it
- Phase 2, open-label, noncomparative clinical trial evaluating safety and efficacy of posaconazole in pediatric patients with proven/probable invasive aspergillosis or possible invasive fungal disease.Antimicrobial agents and chemotherapy · 2026Trial
- Markedly elevated blood concentrations of everolimus during concomitant posaconazole therapy in a liver transplant recipient: a case report.Journal of pharmaceutical health care and sciences · 2026Article
- Successful Control of RefractoryOpen forum infectious diseases · 2026Article
- Endocrine consequences of antifungal therapy: A missed entity.World journal of clinical cases · 2026Review
- Real World Posaconazole Pharmacokinetic Data in Paediatric Stem Cell Transplant Recipients.Children (Basel, Switzerland) · 2025Article
- Effectiveness of combined proton pump inhibitors and posaconazole prophylaxis against invasive fungal infections in patients with hematologic malignancies: a retrospective study.International journal of clinical pharmacy · 2025Article
- Therapeutic Drug Monitoring of Antimicrobial Drugs in Children with Cancer: A New Tool for Personalized Medicine.Paediatric drugs · 2025Review
- Approaches for posaconazole therapeutic drug monitoring and their clinical benefits.European journal of clinical pharmacology · 2024Review
- The effectiveness and safety of posaconazole enteric-coated tablet versus oral suspension in invasive fungal infections.Scientific reports · 2024Article
- Novel antifungals and treatment approaches to tackle resistance and improve outcomes of invasive fungal disease.Clinical microbiology reviews · 2024Review
- The Burden of Invasive Fungal Disease Following Chimeric Antigen Receptor T-Cell Therapy and Strategies for Prevention.Open forum infectious diseases · 2024Review
- Real-world Experience of Posaconazole Therapeutic Drug Monitoring in Oncology Patients: Clinical Implications of Hypoalbuminemia as a Predictor of Subtherapeutic Posaconazole Levels.Open forum infectious diseases · 2024Article
- Disseminated Histoplasmosis in a Patient with Myelofibrosis on Ruxolitinib: A Case Report and Review of the Literature on Ruxolitinib-Associated Invasive Fungal Infections.Journal of fungi (Basel, Switzerland) · 2024Review
- MSG-15: Super-Bioavailability Itraconazole Versus Conventional Itraconazole in the Treatment of Endemic Mycoses-A Multicenter, Open-Label, Randomized Comparative Trial.Open forum infectious diseases · 2024Article
- Assessment of the potential risk of oteseconazole and two other tetrazole antifungals to inhibit adrenal steroidogenesis and peripheral metabolism of corticosteroids.Frontiers in pharmacology · 2024Article
- Fungal Endocarditis: Pathophysiology, Epidemiology, Clinical Presentation, Diagnosis, and Management.Clinical microbiology reviews · 2023Review
- Association of adverse effects with high serum posaconazole concentrations.Medical mycology · 2023Article
- Low Rates of Antifungal Therapeutic Drug Monitoring Among Inpatients Who Received Itraconazole, Posaconazole, or Voriconazole, United States, 2019-2021.Open forum infectious diseases · 2023Article
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Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundPosaconazole tablets are well tolerated and efficacious in the prophylaxis and treatment of aspergillosis, mucormycosis, and other invasive fungal infections. There have been case reports of posaconazole-induced pseudohyperaldosteronism (PIPH); however, its occurrence and association with serum posaconazole drug levels have not previously been investigated.
methodsIn this single-center, retrospective, observational study, we examined the occurrence of PIPH in outpatients newly starting posaconazole and evaluated differences in serum posaconazole concentrations and clinical characteristics between those with and without this syndrome.
resultsSixty-nine patients receiving posaconazole were included, of whom 16 (23.2%) met the definition of PIPH. Patients with PIPH were significantly older (61.1 vs 44.7 years, P = .007) and more frequently had hypertension prior to starting posaconazole (68.8% vs 32.1%, P = .009). Patients with PIPH had a significantly higher median serum posaconazole level than those without PIPH (3.0 vs 1.2 µg/mL, P ≤ .0001). There was a positive correlation between serum posaconazole levels and changes in systolic blood pressure (r = .37, P = .01), a negative correlation between serum posaconazole levels and changes in serum potassium (r = -.39, P = .006), and a positive correlation between serum posaconazole levels and serum 11-deoxycortisol (r = .69, P < .0001).
conclusionsPosaconazole is associated with secondary hypertension and hypokalemia, consistent with pseudohyperaldosteronism, and development is associated with higher serum posaconazole concentrations, older age, and baseline hypertension.
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Registered trials
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.