Differential effects of C-reactive protein levels on voriconazole metabolism at three age groups in allogeneic hematopoietic cell transplant recipients

Abstract

The aim of this study was to evaluate the impact of inflammation on voriconazole (VRCZ) metabolism at three age groups in the allogeneic hematopoietic cell transplant recipients of the Chinese population. The study was performed with collecting more than one VRCZ trough concentration and C-reactive protein (CRP) levels. Longitudinal analysis, correlation and comparative analysis were conducted to evaluate. A total of 104 patients with 386 VRCZ trough concentration and CRP level measured on the same day were collected. For children, CRP levels significantly associated with VRCZ pharmacokinetics in age 11–18 years but not in age 2–10 years. For adults, VRCZ concentrations were increased slightly by 0.006 mg/L when every 1 mg/L increased in CRP levels. Additionally, meropenem and inflammation might work together to cause a higher VRCZ concentration. Therefore, therapeutic drug monitoring of VRCZ should be warranted at age >10 years in allogeneic hematopoietic cell transplant recipients with elevated CRP level.

Keywords:

• Voriconazole
• N-oxide voriconazole
• inflammation
• C-reactive protein
• allogeneic hematopoietic cell transplant recipients

Disclosure statement

The authors declare that they have no conflict of interest.

Additional information

Funding

Beijing Municipal Natural Science Foundation (grant No.7192218) for financial support.

Notes on contributors

Xingxian Luo

Xingxian Luo, Master, Department of Pharmacy, Peking University People's Hospital, Beijing, China (https://www.pkuph.cn/yjk_department.html). Therapeutic Drug Monitoring, Epigenetic regulation of cytochrome P450s, Pharmacogenetics, and Drug-drug interaction.

Taifeng Li

Taifeng Li, Master, Department of Pharmacy, Peking University People's Hospital, Beijing, China (https://www.pkuph.cn/yjk_department.html). Population pharmacokinetics, Biopharmaceutical analysis and Personalized medicine.

Lei Hu

Lei Hu, Doctor, Department of Pharmacy, Peking University People's Hospital, Beijing, China (https://www.pkuph.cn/yjk_department.html). Pharmacogenetics, Population pharmacokinetics, Biopharmaceutical analysis and personalized medicine.

Silu Liu

Silu Liu, Master, Department of Pharmacy, Peking University People's Hospital, Beijing, China (https://www.pkuph.cn/yjk_department.html). Pharmacogenetics, In vitro anti-infection study and Therapeutic Drug Monitoring.

Haiyan Zhao

Haiyan Zhao, Master, Department of Pharmacy, Peking University People's Hospital, Beijing, China (https://www.pkuph.cn/yjk_department.html). Therapeutic Drug Monitoring and Personalized medicine.

Jiaqi Zhang

Jiaqi Zhan, Bachelor, Department of Pharmacy, Peking University People's Hospital, Beijing, China (https://www.pkuph.cn/yjk_department.html). Therapeutic Drug Monitoring and Evidence-based medicine.

Yufei Feng

Yufei Feng, Master. Department of Pharmacy, Peking University People's Hospital, Beijing, China (https://www.pkuph.cn/yjk_department.html). Therapeutic Drug Monitoring, Pharmacoeconomics, and Evidence-based medicine.Lin Huang, Doctor, Department of Pharmacy, Peking University People's Hospital, Beijing, China (https://www.pkuph.cn/yjk_department.html). Therapeutic Drug Monitoring, Drug-drug interaction, Pharmacogenetics and Evidence-based medicine.