Therapeutic Drug Monitoring and Dose Adjustment of Posaconazole in Adult Patients with Acute Myeloid Leukemia: A Single-Center Experience

Persistent Link:
http://hdl.handle.net/10150/614191
Title:
Therapeutic Drug Monitoring and Dose Adjustment of Posaconazole in Adult Patients with Acute Myeloid Leukemia: A Single-Center Experience
Author:
Hummert, Shelly; Green, Myke R.
Affiliation:
College of Pharmacy, The University of Arizona
Issue Date:
2014
Rights:
Copyright © is held by the author.
Collection Information:
This item is part of the Pharmacy Student Research Projects collection, made available by the College of Pharmacy and the University Libraries at the University of Arizona. For more information about items in this collection, please contact Jennifer Martin, Associate Librarian and Clinical Instructor, Pharmacy Practice and Science, jenmartin@email.arizona.edu.
Publisher:
The University of Arizona.
Abstract:
Specific Aims: Evaluate serum posaconazole concentrations following dose adjustment in response to subtherapeutic serum concentrations. Determine optimal dose adjustment schema and identify toxicity with doses above 600 mg daily (e.g.: 200 mg per os three times daily). Methods: The health records were reviewed for 29 patients ≥ 18 years with acute myeloid leukemia over a four-year period. Participants initially received posaconazole 200 mg per os three times daily as prophylaxis and required at least one dose adjustment secondary to a subtherapeutic posaconazole serum concentration. Patients were stratified by posaconazole dosing following dose adjustment (A=200mg QID, B=300mg TID, C=400 mg TID, D=400 QID). Main Results: There was a statistically significant increase in posaconazole serum concentration in each group compared to baseline serum concentration, aside from group C (group A and B P<0.001, group C P=0.236, and group D P=0.0076). The majority of participants in 3 of the 4 groups reached therapeutic serum concentration (A=0.87, B=0.76, D=0.80) whereas group C had a serum posaconazole concentration on average below therapeutic range (0.51). There was no significant difference between the four groups in regards to renal function (p=0.35) or hepatic function (AST p=0.676, ALT p=0.877, total bilirubin p=0.097). Conclusion: A dose increase led to an increase in posaconazole serum concentration except for the dosing regimen of 400 mg three times daily. However, the study is limited by a small patient population, an unequal number of patients in each group, and potentially by poor absorption of posaconazole suspension. Further research is required to expand on these findings.
Description:
Class of 2014 Abstract
Keywords:
monitoring; posaconazole; patients; acute myeloid leukemia; Therapeutic
Advisor:
Green, Myke R.

Full metadata record

DC FieldValue Language
dc.contributor.advisorGreen, Myke R.en
dc.contributor.authorHummert, Shellyen
dc.contributor.authorGreen, Myke R.en
dc.date.accessioned2016-06-22T20:03:22Z-
dc.date.available2016-06-22T20:03:22Z-
dc.date.issued2014-
dc.identifier.urihttp://hdl.handle.net/10150/614191-
dc.descriptionClass of 2014 Abstracten
dc.description.abstractSpecific Aims: Evaluate serum posaconazole concentrations following dose adjustment in response to subtherapeutic serum concentrations. Determine optimal dose adjustment schema and identify toxicity with doses above 600 mg daily (e.g.: 200 mg per os three times daily). Methods: The health records were reviewed for 29 patients ≥ 18 years with acute myeloid leukemia over a four-year period. Participants initially received posaconazole 200 mg per os three times daily as prophylaxis and required at least one dose adjustment secondary to a subtherapeutic posaconazole serum concentration. Patients were stratified by posaconazole dosing following dose adjustment (A=200mg QID, B=300mg TID, C=400 mg TID, D=400 QID). Main Results: There was a statistically significant increase in posaconazole serum concentration in each group compared to baseline serum concentration, aside from group C (group A and B P<0.001, group C P=0.236, and group D P=0.0076). The majority of participants in 3 of the 4 groups reached therapeutic serum concentration (A=0.87, B=0.76, D=0.80) whereas group C had a serum posaconazole concentration on average below therapeutic range (0.51). There was no significant difference between the four groups in regards to renal function (p=0.35) or hepatic function (AST p=0.676, ALT p=0.877, total bilirubin p=0.097). Conclusion: A dose increase led to an increase in posaconazole serum concentration except for the dosing regimen of 400 mg three times daily. However, the study is limited by a small patient population, an unequal number of patients in each group, and potentially by poor absorption of posaconazole suspension. Further research is required to expand on these findings.en
dc.language.isoen_USen
dc.publisherThe University of Arizona.en
dc.rightsCopyright © is held by the author.en
dc.subjectmonitoringen
dc.subjectposaconazoleen
dc.subjectpatientsen
dc.subjectacute myeloid leukemiaen
dc.subjectTherapeuticen
dc.titleTherapeutic Drug Monitoring and Dose Adjustment of Posaconazole in Adult Patients with Acute Myeloid Leukemia: A Single-Center Experienceen_US
dc.typetexten
dc.typeElectronic Reporten
dc.contributor.departmentCollege of Pharmacy, The University of Arizonaen
dc.description.collectioninformationThis item is part of the Pharmacy Student Research Projects collection, made available by the College of Pharmacy and the University Libraries at the University of Arizona. For more information about items in this collection, please contact Jennifer Martin, Associate Librarian and Clinical Instructor, Pharmacy Practice and Science, jenmartin@email.arizona.edu.en
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