Meng Mingwei, Wei Ruhua, Lu Yating, Cao Wen, Mo Kai, Huang Zheng, Qin Yane, Lan Xiaobu
Department of Pharmacy, The Fifth Affiliated Hospital of Guangxi Medical University & The First People's Hospital of Nanning, Nanning, China.
Department of Pharmacy, Guangxi International Zhuang Medicine Hospital, Nanning, China.
Front Pharmacol. 2025 Jul 28;16:1620179. doi: 10.3389/fphar.2025.1620179. eCollection 2025.
This study aimed to characterize the exposure-response relationship of caspofungin through analysis of trough serum concentration (Cmin) associated with clinical efficacy, while identifying clinically determinants of Cmin.
A single-center retrospective cohort study collected therapeutic drug monitoring data from 83 hospitalized patients receiving caspofungin therapy between January 2022 and January 2025. Spearman correlation analysis and the receiver operating characteristic (ROC) curve were employed to evaluate associations between trough serum concentrations and clinical endpoints, with concomitant assessment of binary logistic regression analysis of determinants affecting interindividual exposure variability.
A total of 83 eligible cases were included, with 51 cases in the effective treatment group and 32 cases in the ineffective group. The median caspofungin Cmin in the effective group was 5.62 [4.54, 7.0] μg/mL, while that in the ineffective group was 2.43 [1.61, 3.03] μg/mL. Spearman correlation analysis revealed a positive correlation between caspofungin Cmin and clinical efficacy, with r = 0.8 and < 0.01. The ROC curve for caspofungin Cmin was 0.974, with a maximum Youden index of 0.816, corresponding to a cutoff value of 3.58 μg/mL, a sensitivity of 94.1%, and a specificity of 87.5%. Binary logistic regression analysis showed that patient body weight [OR = 0.839 (0.765∼0.921), < 0.001] was an influencing factor of caspofungin Cmin.
Caspofungin trough serum concentration is correlated with its efficacy. Maintaining a trough concentration of caspofungin greater than 3.58 μg/mL within the dosing interval may achieve better clinical efficacy. Additionally, patient body weight should be considered when optimizing the dosing regimen due to its impact on drug concentration.
本研究旨在通过分析与临床疗效相关的谷浓度（Cmin）来表征卡泊芬净的暴露-反应关系，同时确定Cmin的临床决定因素。
一项单中心回顾性队列研究收集了2022年1月至2025年1月期间83例接受卡泊芬净治疗的住院患者的治疗药物监测数据。采用Spearman相关性分析和受试者工作特征（ROC）曲线评估谷浓度与临床终点之间的关联，同时对影响个体间暴露变异性的决定因素进行二元逻辑回归分析。
共纳入83例符合条件的病例，有效治疗组51例，无效组32例。有效组卡泊芬净Cmin中位数为5.62[4.54，7.0]μg/mL，无效组为2.43[1.61，3.03]μg/mL。Spearman相关性分析显示卡泊芬净Cmin与临床疗效呈正相关，r = 0.8，P<0.01。卡泊芬净Cmin的ROC曲线为0.974，最大约登指数为0.816，对应截断值为3.58μg/mL，灵敏度为94.1%，特异性为87.5%。二元逻辑回归分析显示患者体重[OR = 0.839（0.765～0.921），P<0.001]是卡泊芬净Cmin的影响因素。
卡泊芬净谷浓度与其疗效相关。在给药间隔内维持卡泊芬净谷浓度大于3.58μg/mL可能获得更好的临床疗效。此外，优化给药方案时应考虑患者体重，因为其对药物浓度有影响。
