Corresponding authors:
Prof. Da-xiong Xiang, Department of Pharmacy, The Second Xiangya
Hospital of Central South University, NO.139, Renmin Road, Changsha,
Hunan 410011, China.
e-mail: xiangdaxiong@csu.edu.cn
Dr. Min Zhang, Department of Infectious Disease, The Second Xiangya
Hospital of Central South University, NO.139, Renmin Road, Changsha,
Hunan, China.
e-mail: zhangmin001@csu.edu.cn
Running head : Voriconazole dosing in patients with liver
dysfunction
Word count : Introduction-Conclusion, 3759
Number of tables : 6
Number of figures : 4
WHAT IS ALREADY KNOWN ABOUT THIS
SUBJECT
- Invasive fungal infections in patients with liver dysfunction are
associated with a high morbidity and significant mortality.
- Liver dysfunction can reduce
the plasma clearance of drugs due to the reduction of hepatic
metabolism or biliary excretion.
- It has been shown that
voriconazole trough
concentration directly correlates with efficacy and toxicity.
WHAT THIS STUDY ADDS
- This prospective study demonstrates that total bilirubin is an
important predictor of voriconazole pharmacokinetic parameters in
patients with liver dysfunction and the clearance of voriconazole was
significantly decreased in patients with liver dysfunction.
- Receiver operating characteristic (ROC) curve analysis confirmed
voriconazole trough concentration of ≤ 5.1 mg/L were associated with
significantly lower the incidence of adverse events.
- Optimised dosing of voriconazole based on total bilirubin may improve
treatment outcomes.