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Risk factors contributing to a low darunavir plasma concentration
Alper Daskapan1, Ymkje Stienstra2, Jos G W Kosterink1,3
1University of Groningen, University Medical Center Groningen, Department of Clinical Pharmacy and Pharmacology, Groningen, The Netherlands.
British Journal of Clinical Pharmacology
|October 28, 2017
Summary
Age and estimated glomerular filtration rate predict low darunavir concentrations in HIV patients. Therapeutic drug monitoring can identify individuals at risk for suboptimal drug exposure.
Area of Science:
- Pharmacology
- Infectious Diseases
- Clinical Pharmacy
Background:
- Darunavir is an effective antiretroviral medication for HIV infection.
- Significant pharmacokinetic variability necessitates identifying factors influencing drug concentrations.
- Understanding these factors is crucial for optimizing treatment efficacy.
Purpose of the Study:
- To identify predisposing factors for low darunavir plasma concentrations.
- To analyze patient data for predictors of suboptimal drug exposure.
- To inform clinical practice regarding darunavir dosing and monitoring.
Main Methods:
- Retrospective review of darunavir plasma concentrations in HIV-infected patients.
- Analysis of data from January 2010 to December 2014.
- Logistic regression analysis to identify predictive variables for low drug concentrations.
Main Results:
- Age and estimated glomerular filtration rate were significant predictors of darunavir concentration, alongside food intake.
- The model explained a notable portion of the variability (Nagelkerke R² = 0.284).
- These factors help predict patients likely to have concentrations below the median.
Conclusions:
- Age and renal function are key factors influencing darunavir plasma levels.
- Therapeutic drug monitoring can proactively identify patients at risk of low exposure.
- This approach supports personalized medicine in HIV treatment.
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