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已发表论文
一项关于伏立康唑在亚洲肝功能不全患者中的人群药代动力学、安全性及影响谷浓度因素的系统评价
Authors Hu L , Wang C, Huang S, Tang X, Li Y
Received 11 July 2025
Accepted for publication 6 October 2025
Published 14 October 2025 Volume 2025:19 Pages 9265—9278
DOI https://doi.org/10.2147/DDDT.S553073
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Tuo Deng
Lin Hu,1,2 Changyu Wang,3 Shiqiong Huang,1,2 Xi Tang,1,2 Yanfei Li1,2
1Department of Pharmacy, the Affiliated Changsha Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, People’s Republic of China; 2Department of Pharmacy, the First Hospital of Changsha, Changsha, Hunan, People’s Republic of China; 3School of Mathematics and Physics, Wenzhou University, Wenzhou, Fujian, People’s Republic of China
Correspondence: Yanfei Li, Email 919454256@qq.com Lin Hu, Email 1150721071@qq.com
Objective: This study systematically reviews recent research on voriconazole (VRC) use in Asian patients with liver dysfunction to provide a scientific basis for individualized therapy.
Methods: A comprehensive literature search was conducted in EMBASE, PubMed, Web of Science, and the Cochrane Library for clinical studies on VRC use in Asian patients with liver dysfunction, published between January 1, 2000, and March 1, 2025. Studies meeting the inclusion and exclusion criteria were analyzed to summarize VRC safety, factors influencing trough concentrations (Ctrough), pharmacokinetic characteristics, and advancements in dose optimization.
Results: A total of 14 studies were included, comprising 9 studies on the safety of VRC in patients with liver dysfunction, 5 studies investigating factors affecting VRC Ctrough, and 6 studies on population pharmacokinetics (PPK) in this population. The most commonly reported adverse drug reactions (ADRs) related to VRC were hepatotoxicity, neurotoxicity, and visual impairment. ADRs typically occurred within 7 days of VRC administration. VRC Ctrough are influenced by several factors, including liver impairment severity, CYP2C19 polymorphisms, and albumin and bilirubin levels. The PPK models assessed clearance (CL) in patients with different Child-Pugh (CP) classifications, all of which showed a significant reduction in CL among CP-C patients. Regarding the elimination half-life (t₁/2), CP-C patients exhibited a significant prolongation.
Conclusion: Therapeutic drug monitoring (TDM) and PPK studies can aid in optimizing VRC dosing, ensuring safer and more effective individualized therapy.
Keywords: voriconazole, liver dysfunction, population pharmacokinetics, safety, trough concentrations
1Department of Pharmacy, the Affiliated Changsha Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, People’s Republic of China; 2Department of Pharmacy, the First Hospital of Changsha, Changsha, Hunan, People’s Republic of China; 3School of Mathematics and Physics, Wenzhou University, Wenzhou, Fujian, People’s Republic of China
Correspondence: Yanfei Li, Email 919454256@qq.com Lin Hu, Email 1150721071@qq.com
Objective: This study systematically reviews recent research on voriconazole (VRC) use in Asian patients with liver dysfunction to provide a scientific basis for individualized therapy.
Methods: A comprehensive literature search was conducted in EMBASE, PubMed, Web of Science, and the Cochrane Library for clinical studies on VRC use in Asian patients with liver dysfunction, published between January 1, 2000, and March 1, 2025. Studies meeting the inclusion and exclusion criteria were analyzed to summarize VRC safety, factors influencing trough concentrations (Ctrough), pharmacokinetic characteristics, and advancements in dose optimization.
Results: A total of 14 studies were included, comprising 9 studies on the safety of VRC in patients with liver dysfunction, 5 studies investigating factors affecting VRC Ctrough, and 6 studies on population pharmacokinetics (PPK) in this population. The most commonly reported adverse drug reactions (ADRs) related to VRC were hepatotoxicity, neurotoxicity, and visual impairment. ADRs typically occurred within 7 days of VRC administration. VRC Ctrough are influenced by several factors, including liver impairment severity, CYP2C19 polymorphisms, and albumin and bilirubin levels. The PPK models assessed clearance (CL) in patients with different Child-Pugh (CP) classifications, all of which showed a significant reduction in CL among CP-C patients. Regarding the elimination half-life (t₁/2), CP-C patients exhibited a significant prolongation.
Conclusion: Therapeutic drug monitoring (TDM) and PPK studies can aid in optimizing VRC dosing, ensuring safer and more effective individualized therapy.
Keywords: voriconazole, liver dysfunction, population pharmacokinetics, safety, trough concentrations