The effect of inflammation on voriconazole plasma trough concentrations
in Chinese children and adolescent patients
Abstract
AIMS The aim of this study was to explore whether inflammation,
reflected by the C-reactive protein (CRP) concentrations affected the
VRC plasma concentration in hospitalized Chinese children and adolescent
patients. METHODS Medical records of inpatients were reviewed
retrospectively. A linear regression analysis was performed to assess
the relationship between CRP values and VRC plasma trough concentration.
RESULTS Fifth-nine patients aged 1-18 years were included. A total of 90
VRC trough concentrations were included in the linear regression. The
plasma trough concentration of VRC increased with the CRP concentration
(n=90, r=0.377, P<0.001). VRC trough concentrations in
patients with the group of moderate inflammation (3.09
(0.12~8.58); n=30) were significantly (P=0.011) higher
than the group of mild inflammation (1.53 (0.01~9.35);
n=60). There were no significant difference (P=0.865) in VRC trough
concentration between patients with the group of mild inflammation (≤40
mg/L, n=30) and moderate inflammation (41-200 mg/L, n=6) in patients
aged<12 years. VRC trough concentrations were significantly
higher (P=0.032) in patients with the group of moderate inflammation
(41-200 mg/L, n=24) compared to the group of mild inflammation (≤40
mg/L, n=30) in patients aged ≥12 years. When CRP concentration increased
1 mg/L, the VRC trough concentration increased by 0.010 mg/L and 0.009
mg/L in the unadjusted (95% confidence interval (CI), 0.005 to 0.016
mg/L) and adjusted (95% CI, 0.001 to 0.016 mg/L) linear regression
analyses, respectively. CONCLUSIONS Inflammation response appears to
provide an explanation for some of the variability in VRC exposure.