用各种波萨可纳配方实现治疗目标的评估
Tamara Krekel1, Jennifer Miller1, Alan Catalano1
1Department of Pharmacy, Barnes-Jewish Hospital, Saint Louis, Missouri, USA.
概括
建议对波萨科纳进行治疗药物监测 (TDM),即使是延迟释放或静脉注射配方,因为许多患者无法达到目标水平. 可能需要更高的初始剂量,特别是对于那些具有潜疗波萨可纳低谷风险因素的人来说.
科学领域:
- 药理学 药理学是指药理学的学科.
- 临床药房 临床药房
- 传染性疾病 传染性疾病
背景情况:
- 治疗药物监测 (TDM) 对于口服波萨科纳即时释放悬浮剂至关重要,因为吸收的变化.
- 之前的建议表明,对于延迟释放 (DR) 或静脉注射 (IV) 波萨可纳配方,TDM可能不需要.
- 这项研究旨在评估DR和IVposaconazole的目标值.
研究的目的:
- 为了评估实现目标稳定状态 (SS) 低度的目标稳定状态 (SS) 低度,波萨可纳DR片和IV溶液.
- 为了确定与达到治疗性波萨可纳水平相关的患者因素.
- 为了告知波萨可纳的剂量和监测指南.
主要方法:
- 对接受波萨科纳 (300毫克每24小时) 的成年患者进行了回顾性单中心研究.
- 包括那些在独家DR片或IV配方上至少有一次SS低位测量的患者.
- 评估了达到SS最低值≥1300,≥1000和≥700ng/mL的患者的百分比;包括风险因素分析.
主要成果:
- 在142名患者中,52.1%,71.8%和86%的患者分别达到SS最低值≥1300,≥1000和≥700ng/mL.
- 在体重小于90公斤,BMI小于30公斤/米2或没有酸性抑制治疗的患者中,观察到达到≥1300 ng/mL的更高水平.
- 在子组之间没有发现中位数SS低谷或≥1000或≥700 ng/mL的实现率的显著差异.
结论:
- 很大一部分患者 (47.9%) 没有达到1300 ng/mL的目标SS低谷,而28.8%的患者未能达到1000 ng/mL.
- 推TDM用于所有波萨可纳治疗配方,包括DR和IV.
- 建议考虑使用较高的初始波萨可纳剂量 (≥300毫克每24小时),特别是对于患有次治疗水平的危险因素的患者.
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