Journal of Clinical Pharmacy and Therapeutics

Research Article

Factors Influencing Blood Concentration of Voriconazole and Therapeutic Drug Monitoring in Patients with Child–Pugh Class C Cirrhosis

Table 2

Factors influencing voriconazole trough plasma concentrations (C_min).


Factors	Total	C_min ≤ 5.5 μg/mL group (n = 51)	C_min > 5.5 μg/mL group (n = 15)	value

Age (years), n (%)				0.431
≤65	55 (83)	41 (80)	14 (93)
>65	11 (17)	10 (20)	1 (7)
Sex, n (%)				1.000
Male	52 (79)	40 (78)	12 (80)
Female	14 (21)	11 (22)	3 (20)
BMI (kg/m²), n (%)				0.512
<18.5	10 (15)	7 (14)	3 (20)
18.5–30	51 (77)	39 (76)	12 (80)
>30	5 (8)	5 (10)	0 (0)
Dosing schedule, n (%)				0.112
100 mg twice daily	48 (73)	40 (78)	8 (53)
200 mg twice daily	18 (27)	11 (22)	7 (47)
Route of administration, n (%)				0.705
Intravenous	38 (58)	30 (59)	8 (53)
Oral or gastric canal	28 (42)	21 (41)	7 (47)
CYP2C19, genotype, n (%)				0.748
EM	28 (42)	22 (43)	6 (40)
IM	25 (38)	20 (39)	5 (33)
PM	13 (20)	9 (18)	4 (27)
Hemodialysis, n (%)				0.181
Yes	15 (23)	14 (28)	1 (7)
No	51 (77)	37 (73)	14 (93)
Plasma exchange, n (%)				0.641
Yes	9 (14)	8 (16)	1 (7)
No	57 (86)	43 (84)	14 (93)
Laboratory tests, median (IQR)
ALT (U/L)	45.5 (23.3–106.5)	46.0 (25.0–89.0)	35.0 (19.0–161.0)	0.945
AST (U/L)	65.5 (37.8–183.0)	63.0 (37.5–186.0)	115.0 (41.0–204.0)	0.551
ALB (g/L)	28.0 (25.0–30.0)	28.0 (25.0–30.0)	28.0 (24.0–32.0)	0.869
INR	1.7 (1.4–2.1)	1.7 (1.4–2.2)	1.7 (1.5–2.1)	0.824
PTa (%)	38.5 (29.7–52.8)	37.4 (29.7–53.6)	39.5 (29.6–47.9)	0.813
TBIL (μmol/L)	228.3 (130.5–400.0)	216.6 (130.7–386.5)	278.1 (109.1–444.8)	0.525
DBIL (μmol/L)	163.4 (87.3–299.6)	157.0 (90.4–284.8)	223.1 (40.0–315.7)	0.535
SCr (μmol/L)	104.5 (80.8–155.0)	113.0 (85.0–163.0)	82.0 (65.0–105.0)	0.038
MELD score, median (IQR)	23.5 (18.1–29.2)	23.5 (18.5–30.0)	23.5 (17.8–27.2)	0.530
Concomitant medications
Prednisolone/methylprednisolone, n (%)				0.863
Yes	12 (18)	2 (13)	10 (20)
No	54 (82)	13 (87)	41 (80)
Proton pump inhibitors, n (%)				0.539
Yes	58 (88)	46 (90)	12 (80)
No	8 (12)	5 (10)	3 (20)

ALB, albumin; ALT, alanine aminotransferase; AST, aspartate aminotransferase; BMI, body mass index; DBIL, direct bilirubin; IMs, intermediate metabolizers of the CYP2C19 enzyme; INR, international normalized ration; MELD, score model for end-stage liver disease score; NMs, normal metabolizers of the CYP2C19 enzyme; PMs, poor metabolizers of the CYP2C19 enzyme; PTa, prothrombin activity; SCr, serum creatinine; TBIL, total bilirubin. Factors were entered into the logistic regression analysis ( < 0.2).