Evidence map›Paper›PMID 39494768›Full record

ArticleTransplant infectious disease : an official journal of the Transplantation Society

Evaluation of Crushed Posaconazole Delayed Release Tablets in Lung Transplant Recipients.

Rachael Gordon, Bo Yen, Katherine Dewey, Ripal Jariwala, Jasleen Kukreja, Steven Hays, Jonathan P Singer, Rebecca Florez

Abstract read
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In one paragraph

Article in Transplant infectious disease : an official journal of the Transplantation Society. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. 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.

Rachael GordonDepartment of Clinical Pharmacy, University of California, San Francisco, California, USA.ORCID https://orcid.org/0009-0006-3606-1026
Bo YenDepartment of Clinical Pharmacy, University of California, San Francisco, California, USA.ORCID https://orcid.org/0000-0003-4392-3027
Katherine DeweyDepartment of Clinical Pharmacy, University of California, San Francisco, California, USA.ORCID https://orcid.org/0000-0002-3839-6552
Ripal JariwalaDepartment of Clinical Pharmacy, University of California, San Francisco, California, USA.ORCID https://orcid.org/0000-0002-1377-908X
Jasleen KukrejaDepartment of Surgery, University of California, San Francisco, California, USA.ORCID https://orcid.org/0000-0003-2991-6680
Steven HaysDepartment of Medicine, University of California, San Francisco, California, USA.ORCID https://orcid.org/0000-0002-2887-8451
Jonathan P SingerDepartment of Medicine, University of California, San Francisco, California, USA.ORCID https://orcid.org/0000-0003-0224-7472
Rebecca FlorezDepartment of Clinical Pharmacy, University of California, San Francisco, California, USA.ORCID https://orcid.org/0000-0002-4076-0085

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInvasive fungal infections can cause serious complications after lung transplant; therefore, prophylaxis with posaconazole is common. The posaconazole delayed-release (DR) tablet is preferred. Although the package insert states DR tablets cannot be crushed, recent data suggest it is reasonable. We hypothesized that crushed posaconazole DR tablets could reach therapeutic levels in lung transplant recipients.

methodsA retrospective study of lung transplant recipients between January 2018 and July 2023, who received crushed posaconazole DR for at least 5 days was completed. Posaconazole troughs were evaluated, and differences were compared between subjects who were therapeutic to those who were subtherapeutic. A cost analysis was also performed.

resultsThirty subjects received crushed posaconazole DR and 50% were therapeutic. The median trough was 1 mg/L for those who were therapeutic and 0.4 mg/L for those who were not (p < 0.001). The median cumulative dose was 2000 mg, and there were no significant differences in the incidence of diarrhea or tube feeds. More subjects in the therapeutic group were loaded (33% vs. 13%), although this was not statistically significant (p = 0.39). No subjects had breakthrough aspergillus one month after starting crushed therapy.

conclusionCrushed posaconazole DR tablets are a viable and cost savings option, but loading doses and higher maintenance doses may be required to reach therapeutic levels. Those who received loading doses (intravenously or crushed) followed by a daily crushed dose of 400 mg were more likely to be therapeutic. Limitations of our study include that it is single-center, small in sample size, and retrospective.

Indexed as

Antifungal AgentsInvasive Fungal InfectionsLung TransplantationTriazolesAdultAgedDelayed-Action PreparationsFemaleHumansMaleMiddle AgedRetrospective StudiesTabletsTransplant RecipientsAntifungal AgentsDelayed-Action PreparationsposaconazoleTabletsTriazoleslung transplantpharmacokineticsposaconazole

Identifiers

PMID39494768
PMCPMC11827724

What OpenQuestion holds

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Registered trials

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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.