ボリコナゾールによる肝障害に関するレトロスペクティブ調査

概要

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Hepatotoxicity associated with voriconazole (VRCZ) is a clinically significant adverse effect,and regular liver function tests are needed to detect it during the early stages.Although information regarding the clinical features,outcomes and risk factors of VRCZ hepatotoxicity is considered to be important in ensuring the proper management of antifungal therapy,such information has not been sufficiently reported.In this retrospective study,we evaluated VRCZ-related hepatotoxicity outcomes.Hepatotoxicity due to VRCZ occurred in 24 of 59 patients (40.7%),and was frequently observed within 3 weeks after the initiation of its administration (16 of 24 patients ; 66.7%).In 10 of the 59 patients (16.9%),the drug had to be discontinued due to abnormal liver function.On performing multivariate analysis using logistic regression to identify risk factors influencing hepatotoxicity due to VRCZ,we found that overdosing,i.e.administering doses exceeding recommended weight-based doses,tended to increase the occurrence of hepatotoxicity (Odds ratio=5.271,95% confidence intervals 0.925-30.045,P=0.061).In conclusion,our findings suggest that there is a need for weight-based standard dosage adjustment of VRCZ to avoid the risk of hepatotoxicity.In addition,we recommend frequent monitoring of liver enzymes to prevent serious hepatotoxicity within 3 weeks of initiating administration of VRCZ.
日本医療薬学会の論文