TITLE:
Effects of Obesity on Posaconazole Kinetics in a Patient with Graft versus Host Disease
AUTHORS:
Justin J. Pettis, Stephanie R. Hyche, Katherine N. Logan, Arash Poursina, P. Brandon Bookstaver
KEYWORDS:
Posaconazole; Obesity; Pharmacokinetics; Therapeutic Drug Monitoring
JOURNAL NAME:
Pharmacology & Pharmacy,
Vol.4 No.2,
April
18,
2013
ABSTRACT:
Posaconazole, a triazole antifungal
agent, displays a highly variable pharmacokinetic profile due in part to the
oral solution, the only currently available dosage form. Posaconazole activity
appears to be dose-dependent and clinical outcomes correlate with steady-state
serum trough concentrations and area under the concentration curve (AUC) over
minimum inhibitory concentration (MIC) ratios. Therapeutic drug monitoring
(TDM) has been recommended to help overcome the unpredictable nature of the
drug. The impact of obesity of posaconazole pharmacokinetics and the use of TDM
in this population has not been well described; however, limited data
demonstrate increased weight correlates with lower serum concentrations and
reduced drug exposure. We describe the use of TDM in an obese man, 12 months status post hematopoietic stem-cell
transplant (HSCT), receiving posaconazole therapy for a presumed invasive
fungal infection (IFI).