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Pharmacogenetics and beyond: variability of voriconazole plasma levels in a patient with primary immunodeficiency
Julie Autmizguine1, Maja Krajinovic, Julie Rousseau
1Infectious Diseases Division, CHU Sainte-Justine - University of Montreal, Montreal, QC, Canada.
Abstract:
We report the case of a patient highly susceptible to invasive aspergillosis who received treatment with voriconazole (VRC). As part of therapeutic drug monitoring, VRC plasma trough concentrations were measured, showing undetectable levels (<0.16 µg/ml). Genotyping showed a heterozygous profile CYP2C19*1/*17, known to be associated with an ultrarapid-metabolism phenotype, contributing to the very low systemic exposure observed. Therefore, in this situation, the use of VRC treatment could be associated with therapeutic failure.
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