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• W2034517320 abstract "VORI, a second generation triazole, was approved by the FDA on 5/28/02. One of the major concerns with VORI is its adverse drug reaction profile and the numerous drug interactions that are likely to occur in pts receiving polypharmacy. We retrospectively evaluated all pts receiving VORI admitted to the HSCT program from 08/02 - 10/20/03. Of 45 evaluable pts, 11% underwent autologous HSCT, 22% allogeneic HSCT, 20% MUD HSCT, 7% UCB, and 40% received chemotherapy for leukemia or lymphoma. Twenty pts (44.5%) received steroids prior to VORI (7 received <1 mg/kg/d; 5 × 1 mg/kg/d; 1 × 1.5 mg/kg/d and 7 × 2 mg/kg/d). VORI was was used empirically in 76% of cases, prophylactically in 9%, and was used to treat documented fungal disease in 15%. According to the EORTC/MSG definitions for IFI, 29% of pts had a proven infection, 56% had a possible IFI, and 6% did not meet established criteria. VORI was used as first-line therapy in 82% pts. Of the documented infections treated, there were 2 Aspergillus non-fumigatus, 2 A.fumigatus, 1 A. flavus, 2 Fusarium spp., 1 Basidiomycete, 1 Curvularia spp., 1 dematiaceous mold, 1 Candida albicans, and 1 polyfungal infection (A. fumigatus and Penicillium spp.). CR’s were seen in 15% cases, PR’s in 46% cases and PD occurred in 38% cases. Combination therapy was used in 20% of pts (5 VORI + caspofungin; 2 VORI + ABLC, 1 VORI + cAmB, 1 VORI + AmBisome, 1 VORI + AmBisome + caspofungin). Mean duration of voriconazole was 27 days (range 2 - 130). Loading doses were administered in 87% pts. VORI was administered PO in 76% pts and 22% IV, 2% PO + IV. Interacting medications were prescribed in 87% pts. The interaction of greatest concern is between calcineurin inhibitors (CyA and FK506) and VORI. Calcineurin inhibitors were prescribed to 20 pts (44%). Of these, 13 (65%) were succesfully dose adjusted to achieve therapeutic serum concentrations, 5 (25%) had dose modifications, but resulted in supratherapeutic concentrations, and 2 pts did not have the required dose modification made (1 resulting in toxicity). Adverse events were seen in 15 pts (3 visual;1 AMS; 11 abnormal LFT’s). Of pts with normal BL LFT’s, 15% had increases in bilirubin, 28% in AST, 15% in ALT, and 28% in alk phosphatase. Among the documented infections treated, VORI resulted in similar response rates to published studies. It is effective, and while there are numerous drug interactions, if managed appropriately, this is a safe agent to use in this high-risk population." @default.
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• W2034517320 date "2004-02-01" @default.
• W2034517320 modified "2023-09-23" @default.
• W2034517320 title "Post marketing surveillance of voriconazole (VORI) use in hematopoietic stem cell transplant (HSCT) recipients at a single academic institution" @default.
• W2034517320 doi "https://doi.org/10.1016/j.bbmt.2003.12.287" @default.
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