{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:09:02Z","timestamp":1753877342282,"version":"3.41.2"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2024,11,20]],"date-time":"2024-11-20T00:00:00Z","timestamp":1732060800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100000871","name":"Mayo Clinic","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000871","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,12,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Coccidioidomycosis can cause severe meningitis, requiring lifelong treatment. In this study, we sought to better understand the potential effect of pharmacogenomic testing on treatment outcomes of patients with coccidioidal meningitis. Of 13 patients with coccidioidal meningitis who underwent pharmacogenomic testing, 11 had genetic variants of CYP2C19 and CYP3A5 that affect antifungal efficacy. These results led to real-time treatment changes and future antifungal planning. Routine pharmacogenomic testing helps to avoid antifungal treatments that are futile or lead to adverse effects.<\/jats:p>","DOI":"10.1093\/mmy\/myae113","type":"journal-article","created":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T04:32:02Z","timestamp":1732163522000},"source":"Crossref","is-referenced-by-count":0,"title":["Clinical utility of pharmacogenomic testing for patients with coccidioidal meningitis"],"prefix":"10.1093","volume":"62","author":[{"given":"Rawan","family":"Elkurdi","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Mayo Clinic , Phoenix, Arizona ,","place":["USA"]},{"name":"University of Arizona , Banner \u2013 University Medical Center, Phoenix, Arizona ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie F","family":"Grill","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mayo Clinic , Phoenix, Arizona ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrijana","family":"Kekic","sequence":"additional","affiliation":[{"name":"Pharmacy Services, Mayo Clinic , Phoenix, Arizona ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2267-1473","authenticated-orcid":false,"given":"Janis E","family":"Blair","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Mayo Clinic , Phoenix, Arizona ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,11,20]]},"reference":[{"key":"2024121809562924300_bib1","doi-asserted-by":"crossref","first-page":"305","DOI":"10.7326\/0003-4819-124-3-199602010-00004","article-title":"Is it ever safe to stop azole therapy for Coccidioides immitis meningitis?","volume":"124","author":"Dewsnup","year":"1996","journal-title":"Ann Intern Med"},{"key":"2024121809562924300_bib2","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1093\/clind\/16.2.247","article-title":"The natural history of coccidioidal meningitis: VA-Armed Forces cooperative studies, 1955\u20131958","volume":"16","author":"Vincent","year":"1993","journal-title":"Clin Infect Dis"},{"key":"2024121809562924300_bib3","doi-asserted-by":"crossref","first-page":"247","DOI":"10.3390\/jof5030054","article-title":"Central nervous system infections due to coccidioidomycosis","volume":"5","author":"Jackson","year":"2019","journal-title":"J Fungi"},{"key":"2024121809562924300_bib4","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1007\/s11908-009-0043-1","article-title":"Coccidioidal meningitis: update on epidemiology, clinical features, diagnosis, and management","volume":"11","author":"Blair","year":"2009","journal-title":"Curr Infect Dis Rep"},{"key":"2024121809562924300_bib5","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1086\/497596","article-title":"Coccidioidal meningitis","volume":"42","author":"Johnson","year":"2006","journal-title":"Clin Infect Dis"},{"key":"2024121809562924300_bib6","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1007\/s11910-018-0824-8","article-title":"Coccidioidal meningitis: a review on diagnosis, treatment, and management of complications","volume":"18","author":"Johnson","year":"2018","journal-title":"Curr Neurol Neurosci Rep"},{"key":"2024121809562924300_bib7","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.3390\/jof8111157","article-title":"Fluconazole failure in the treatment of coccidioidal meningitis","volume":"8","author":"Gupta","year":"2022","journal-title":"J Fungi"},{"key":"2024121809562924300_bib8","doi-asserted-by":"crossref","first-page":"e112","DOI":"10.1093\/cid\/ciw360","article-title":"2016 Infectious Diseases Society of America (IDSA) Clinical Practice Guideline for the treatment of coccidioidomycosis","volume":"63","author":"Galgiani","year":"2016","journal-title":"Clin Infect Dis"},{"key":"2024121809562924300_bib9","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/j.pharmthera.2012.12.007","article-title":"Cytochrome P450 enzymes in drug metabolism: regulation of gene expression, enzyme activities, and impact of genetic variation","volume":"138","author":"Zanger","year":"2013","journal-title":"Pharmacol Ther"},{"key":"2024121809562924300_bib10","doi-asserted-by":"crossref","first-page":"ofad500.863","DOI":"10.1093\/ofid\/ofad500.863","article-title":"Therapeutic drug monitoring of triazole antifungals for coccidioidal meningitis","volume":"10","author":"Fang","year":"2023","journal-title":"Open Forum Infect Dis"},{"key":"2024121809562924300_bib11","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1016\/S0140-6736(19)31276-0","article-title":"Pharmacogenomics","volume":"394","author":"Roden","year":"2019","journal-title":"Lancet"},{"key":"2024121809562924300_bib12","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1002\/cpt.1012","article-title":"Optimization of voriconazole therapy for the treatment of invasive fungal infections in adults","volume":"104","author":"Mangal","year":"2018","journal-title":"Clin Pharmacol Ther"},{"issue":"3","key":"2024121809562924300_bib13","doi-asserted-by":"crossref","first-page":"e02232","DOI":"10.1128\/AAC.02232-18","article-title":"Isavuconazole in the treatment of coccidioidal meningitis","volume":"63","author":"Heidari","year":"2019","journal-title":"Antimicrob Agents Chemother"},{"key":"2024121809562924300_bib14","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1097\/MJT.0b013e3181ff7e10","article-title":"Importance of pharmacokinetic considerations for selecting therapy in the treatment of invasive fungal infections","volume":"19","author":"Lewis","year":"2012","journal-title":"Am J Ther"},{"key":"2024121809562924300_bib15","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1128\/AAC.00705-08","article-title":"Antifungal therapeutic drug monitoring: established and emerging indications","volume":"53","author":"Andes","year":"2009","journal-title":"Antimicrob Agents Chemother"},{"key":"2024121809562924300_bib16","doi-asserted-by":"crossref","first-page":"1627","DOI":"10.1592\/phco.27.12.1627","article-title":"Pharmacokinetics of oral posaconazole in allogeneic hematopoietic stem cell transplant recipients with graft-versus-host disease","volume":"27","author":"Krishna","year":"2007","journal-title":"Pharmacotherapy"},{"key":"2024121809562924300_bib17","doi-asserted-by":"crossref","first-page":"2546","DOI":"10.1128\/AAC.46.8.2546-2553.2002","article-title":"Pharmacokinetics and safety of voriconazole following intravenous- to oral-dose escalation regimens","volume":"46","author":"Purkins","year":"2002","journal-title":"Antimicrob Agents Chemother"},{"key":"2024121809562924300_bib18","first-page":"191","article-title":"Pharmacogenomics: the right drug to the right person","volume":"1","author":"T","year":"2009","journal-title":"J Clin Med Res"},{"key":"2024121809562924300_bib19","doi-asserted-by":"crossref","first-page":"245","DOI":"10.2174\/138161210790112700","article-title":"Ethical and social issues in pharmacogenomics testing","volume":"16","author":"Vijverberg","year":"2010","journal-title":"Curr Pharm Des"},{"key":"2024121809562924300_bib20","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1007\/s00228-010-0857-7","article-title":"Pharmacogenetic testing and therapeutic drug monitoring are complementary tools for optimal individualization of drug therapy","volume":"66","author":"Gervasini","year":"2010","journal-title":"Eur J Clin Pharmacol"},{"key":"2024121809562924300_bib21","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1038\/clpt.2013.229","article-title":"Clinically actionable genotypes among 10,000 patients with preemptive pharmacogenomic testing","volume":"95","author":"Van\u00a0Driest","year":"2014","journal-title":"Clin Pharmacol Ther"},{"key":"2024121809562924300_bib22","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1002\/cpt.350","article-title":"Genetic variation among 82 pharmacogenes: the PGRNseq data from the eMERGE network","volume":"100","author":"Bush","year":"2016","journal-title":"Clin Pharmacol Ther"},{"key":"2024121809562924300_bib23","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1016\/j.ijantimicag.2015.12.003","article-title":"Impact of CYP2C19 genetic polymorphisms on voriconazole dosing and exposure in adult patients with invasive fungal infections","volume":"47","author":"Lamoureux","year":"2016","journal-title":"Int J Antimicrob Agents"},{"key":"2024121809562924300_bib24","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1097\/FPC.0000000000000277","article-title":"Impact of the CYP2C19 genotype on voriconazole exposure in adults with invasive fungal infections","volume":"27","author":"Hamadeh","year":"2017","journal-title":"Pharmacogenet Genomics"},{"key":"2024121809562924300_bib25","doi-asserted-by":"crossref","first-page":"906","DOI":"10.1111\/j.1365-2125.2009.03534.x","article-title":"Pharmacokinetics, metabolism and bioavailability of the triazole antifungal agent voriconazole in relation to CYP2C19 genotype","volume":"68","author":"Scholz","year":"2009","journal-title":"Br J Clin Pharmacol"},{"key":"2024121809562924300_bib26","doi-asserted-by":"crossref","first-page":"1587","DOI":"10.1111\/bcp.13595","article-title":"Population pharmacokinetics of voriconazole and CYP2C19 polymorphisms for optimizing dosing regimens in renal transplant recipients","volume":"84","author":"Lin","year":"2018","journal-title":"Br J Clin Pharmacol"},{"key":"2024121809562924300_bib27","doi-asserted-by":"crossref","first-page":"2020","DOI":"10.1016\/j.bcp.2007.03.012","article-title":"Roles of CYP3A4 and CYP2C19 in methyl hydroxylated and N-oxidized metabolite formation from voriconazole, a new anti-fungal agent, in human liver microsomes","volume":"73","author":"Murayama","year":"2007","journal-title":"Biochem Pharmacol"},{"key":"2024121809562924300_bib28","doi-asserted-by":"crossref","first-page":"2305","DOI":"10.1128\/AAC.04838-14","article-title":"Variability of voriconazole plasma concentrations after allogeneic hematopoietic stem cell transplantation: impact of cytochrome p450 polymorphisms and comedications on initial and subsequent trough levels","volume":"59","author":"Gautier-Veyret","year":"2015","journal-title":"Antimicrob Agents Chemother"},{"key":"2024121809562924300_bib29","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1002\/cpt.809","article-title":"Impact of CYP3A4 genotype on voriconazole exposure","volume":"103","author":"Duflot","year":"2018","journal-title":"Clin Pharmacol Ther"},{"key":"2024121809562924300_bib30","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1016\/j.ijantimicag.2019.06.026","article-title":"Prediction models for voriconazole pharmacokinetics based on pharmacogenetics: an exploratory study in a Spanish population","volume":"54","author":"Dapia","year":"2019","journal-title":"Int J Antimicrob Agents"},{"key":"2024121809562924300_bib31","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1002\/cpt.662","article-title":"Pharmacogenetics of voriconazole: CYP2C19 but also CYP3A4 need to be genotyped","volume":"102","author":"Gautier-Veyret","year":"2017","journal-title":"Clin Pharmacol Ther"},{"key":"2024121809562924300_bib32","doi-asserted-by":"crossref","first-page":"1080","DOI":"10.1093\/cid\/cis599","article-title":"The effect of therapeutic drug monitoring on safety and efficacy of voriconazole in invasive fungal infections: a randomized controlled trial","volume":"55","author":"Park","year":"2012","journal-title":"Clin Infect Dis"},{"key":"2024121809562924300_bib33","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1093\/cid\/cis446","article-title":"Editorial commentary: antifungal therapeutic drug monitoring progress: getting it right the first time","volume":"55","author":"Andes","year":"2012","journal-title":"Clin Infect Dis"},{"key":"2024121809562924300_bib34","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1111\/j.1469-0691.2009.02990.x","article-title":"Voriconazole concentrations and outcome of invasive fungal infections","volume":"16","author":"Miyakis","year":"2010","journal-title":"Clin Microbiol Infect"},{"key":"2024121809562924300_bib35","doi-asserted-by":"crossref","first-page":"1463","DOI":"10.1093\/cid\/ciy859","article-title":"Voriconazole resistance and mortality in invasive aspergillosis: a multicenter retrospective cohort study","volume":"68","author":"Lestrade","year":"2019","journal-title":"Clin Infect Dis"},{"key":"2024121809562924300_bib36","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1002\/cpt.583","article-title":"Clinical Pharmacogenetics Implementation Consortium (CPIC) Guidelines for CYP2C19 and Voriconazole therapy","volume":"102","author":"Moriyama","year":"2017","journal-title":"Clin Pharmacol Ther"},{"key":"2024121809562924300_bib37","doi-asserted-by":"crossref","first-page":"6001","DOI":"10.1128\/AAC.00700-12","article-title":"Utilization of omeprazole to augment subtherapeutic voriconazole concentrations for treatment of Aspergillus infections","volume":"56","author":"Boyd","year":"2012","journal-title":"Antimicrob Agents Chemother"},{"key":"2024121809562924300_bib38","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1016\/j.mayocpiqo.2020.05.006","article-title":"The many faces of itraconazole cardiac toxicity","volume":"4","author":"Teaford","year":"2020","journal-title":"Mayo Clin Proc Innov Qual Outcomes"},{"key":"2024121809562924300_bib39","doi-asserted-by":"crossref","first-page":"2341","DOI":"10.1093\/jac\/dkz188","article-title":"Serial monitoring of isavuconazole blood levels during prolonged antifungal therapy","volume":"74","author":"Furfaro","year":"2019","journal-title":"J Antimicrob Chemother"}],"container-title":["Medical Mycology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/mmy\/advance-article-pdf\/doi\/10.1093\/mmy\/myae113\/60774346\/myae113.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/mmy\/article-pdf\/62\/12\/myae113\/61223251\/myae113.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/mmy\/article-pdf\/62\/12\/myae113\/61223251\/myae113.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,18]],"date-time":"2024-12-18T09:56:43Z","timestamp":1734515803000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/mmy\/article\/doi\/10.1093\/mmy\/myae113\/7905877"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,20]]},"references-count":39,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2024,12,5]]}},"URL":"https:\/\/doi.org\/10.1093\/mmy\/myae113","relation":{},"ISSN":["1369-3786","1460-2709"],"issn-type":[{"type":"print","value":"1369-3786"},{"type":"electronic","value":"1460-2709"}],"subject":[],"published-other":{"date-parts":[[2024,12]]},"published":{"date-parts":[[2024,11,20]]},"article-number":"myae113"}}