Department of Pharmacy, UC San Diego Health, San Diego, CA, USA.
Division of Pulmonary and Critical Care Medicine, UC San Diego Health, San Diego, CA, USA.
Clin Transplant. 2018 Aug;32(8):e13300. doi: 10.1111/ctr.13300. Epub 2018 Jun 15.
In November 2013, posaconazole delayed release (DR) tablets were approved by the FDA with the labeled dose of 300 mg daily for fungal prophylaxis. There are no studies demonstrating the appropriate dose in lung transplant recipients (LTR). We performed a 2-center retrospective cohort study of LTR taking posaconazole DR tablets for prophylaxis between January 2014 and January 2017. Mean serum trough concentrations and percentage of measurements ≥0.7 mcg/mL were compared by daily dose. Forty-nine subjects with 156 steady state serum posaconazole concentrations were included. There was a significant difference in percentage of first measured concentration ≥0.7 mcg/mL by initial daily dose (P = .04). The mean serum posaconazole concentration by dose was 0.9 (±0.42) mcg/mL for 100 mg daily, 1.66 (±0.91) mcg/mL for 200 mg daily, 2.39 (±1.49) mcg/mL for 300 mg daily, and 1.75 (±0.21) mcg/mL for 400 mg daily (P < .001). Mean concentrations were at goal in 63.3%, 96.9%, 94.9%, and 100% of subjects taking 100 mg, 200 mg, 300 mg, and 400 mg daily respectively (P = .04). Our results suggest that doses less than 300 mg daily of posaconazole DR tablets may be adequate to achieve target serum concentrations in LTR. Larger studies are needed to confirm these findings.
2013 年 11 月，FDA 批准泊沙康唑延迟释放（DR）片剂，每日剂量为 300mg，用于真菌预防。尚无研究证明肺移植受者（LTR）的合适剂量。我们对 2014 年 1 月至 2017 年 1 月期间使用泊沙康唑 DR 片剂进行预防的 LTR 进行了一项 2 中心回顾性队列研究。按每日剂量比较平均血清谷浓度和≥0.7μg/mL 的测量值百分比。纳入了 49 例服用泊沙康唑 DR 片剂进行预防的患者，共 156 例稳定的血清泊沙康唑浓度。初始每日剂量的首次测量浓度≥0.7μg/mL 的百分比有显著差异（P=0.04）。按剂量计算的血清泊沙康唑浓度分别为 100mg 组的 0.9（±0.42）μg/mL，200mg 组的 1.66（±0.91）μg/mL，300mg 组的 2.39（±1.49）μg/mL，和 400mg 组的 1.75（±0.21）μg/mL（P<0.001）。分别接受 100mg、200mg、300mg 和 400mg 每日剂量的患者中，有 63.3%、96.9%、94.9%和 100%的患者达到目标浓度（P=0.04）。我们的结果表明，LTR 每日接受少于 300mg 的泊沙康唑 DR 片剂剂量可能足以达到目标血清浓度。需要更大的研究来证实这些发现。
