Posaconazole liquid vs tablet formulation in lung transplant recipients

Area of Science:

• Pharmacology
• Infectious Diseases
• Transplantation Medicine

Background:

• Posaconazole is a broad-spectrum triazole antifungal.
• It is available as oral suspension (POS-Liq) and delayed-release tablets (POS-Tab).
• Lung transplant recipients (LTx-recipients) are at high risk for Aspergillus infections.

Purpose of the Study:

• To compare the clinical effectiveness, toxicity, and pharmacokinetics of POS-Liq versus POS-Tab.
• To evaluate posaconazole trough levels (PTLs) in LTx-recipients.

Main Methods:

• A longitudinal, retrospective study of 24 LTx-recipients.
• Analysis of 191 posaconazole trough levels (PTLs).
• Comparison of different dosing regimens for POS-Liq and POS-Tab.

Main Results:

• POS-Tab achieved triple the target PTLs compared to POS-Liq.
• No hepatotoxicity or QT-prolongation observed with either formulation.
• POS-Tab significantly reduced the tacrolimus concentration-to-dose ratio.

Conclusions:

• POS-Tab is appropriate for prophylaxis and therapy of Aspergillus infections in LTx-recipients.
• POS-Tab demonstrates more reliable PTLs without increased adverse events.
• Close drug monitoring is recommended for both formulations, especially when switching between them.