{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T03:17:32Z","timestamp":1774927052162,"version":"3.50.1"},"reference-count":13,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,10,26]],"date-time":"2022-10-26T00:00:00Z","timestamp":1666742400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Posaconazole is used for prophylaxis and treatment of invasive fungal infections in lung transplant recipients (LTR). Previous studies have not described the relationship between elevated posaconazole trough concentrations and adverse drug reactions in this population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This IRB\u2010approved, retrospective cohort study at NewYork\u2010Presbyterian Hospital included LTR who had posaconazole trough concentrations measured. The primary aim of this study was to evaluate elevated posaconazole trough concentrations and changes in liver function tests as well as QTc interval. A secondary aim of this study was to identify patient factors associated with elevated posaconazole trough levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 109 LTR were included. The average age was 58.1\u00a0years (IQR, 48\u201365), the majority were male (56%). A total of 932 trough levels were assessed with a median number of 8 (IQR, 5\u201315) levels per patient. The median posaconazole trough concentration was 1.7\u00a0mg\/L (IQR, 1.1\u20132.5). Hepatotoxicity, as defined by common terminology criteria for adverse events (CTCAE), was observed in 73.4% of subjects, with the majority classified as grade 1 (67.5%). However, there was no correlation between elevated posaconazole levels and aspartate aminotransferase (<jats:italic>r<\/jats:italic>\u00a0=\u00a0.03), alanine aminotransferase (<jats:italic>r<\/jats:italic>\u00a0=\u00a0.04), alkaline phosphatase (<jats:italic>r<\/jats:italic>\u00a0=\u00a0.04), and total bilirubin (<jats:italic>r<\/jats:italic>\u00a0=\u00a0.02). There was also no correlation between posaconazole trough concentrations and QTc interval (<jats:italic>r<\/jats:italic>\u00a0=\u00a0.03).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This analysis demonstrates that no correlation exists between whole blood posaconazole levels and hepatotoxicity or QTc prolongation. Based on these results, posaconazole dose reductions may not be warranted for posaconazole levels that are significantly above the therapeutic target to avert risk for hepatotoxicity or QTc prolongation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.14826","type":"journal-article","created":{"date-parts":[[2022,10,7]],"date-time":"2022-10-07T15:18:49Z","timestamp":1665155929000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Elevated posaconazole trough concentrations are not associated with increased risk for posaconazole toxicity in lung transplant recipients"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4237-7960","authenticated-orcid":false,"given":"David C.","family":"Sabatino","sequence":"first","affiliation":[{"name":"Department of Pharmacy NewYork\u2010Presbyterian Hospital  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2520-6657","authenticated-orcid":false,"given":"Nicholas W.","family":"Lange","sequence":"additional","affiliation":[{"name":"Department of Pharmacy NewYork\u2010Presbyterian Hospital  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5450-3995","authenticated-orcid":false,"given":"David M.","family":"Salerno","sequence":"additional","affiliation":[{"name":"Department of Pharmacy NewYork\u2010Presbyterian Hospital  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jenna","family":"Scheffert","sequence":"additional","affiliation":[{"name":"Department of Pharmacy NewYork\u2010Presbyterian Hospital  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,10,26]]},"reference":[{"issue":"2","key":"e_1_2_7_2_1","first-page":"188","article-title":"Posaconazole (Noxafil): a new triazole antifungal agent","volume":"20","author":"Greer ND","year":"2007","journal-title":"Proc (Bayl Univ Med Cent)"},{"key":"e_1_2_7_3_1","unstructured":"Posaconazole (Noxafil). [package insert].Merck & Co. Inc. Whitehouse Station (NJ):2014."},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.50.2.658-666.2006"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12281-016-0255-4"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa061098"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa061094"},{"key":"e_1_2_7_8_1","unstructured":"Common Terminology Criteria for Adverse Events (CTCAE) Version 5.US Department of Health and Human Services National Institutes of Health National Cancer Institute. Accessed: May 18 2022.https:\/\/ctep.cancer.gov\/protocoldevelopment\/electronic_applications\/docs\/ctcae_v5_quick_reference_5X7.pdf"},{"issue":"11","key":"e_1_2_7_9_1","first-page":"1169","article-title":"Top\u2010ranking drugs out of 3312 drug\u2010induced liver injury cases evaluated by the Roussel Uclaf Causality Assessment Method","volume":"14","author":"Teschke R","year":"2018","journal-title":"Expert Opin Drug Metab Toxicol"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2012.04042.x"},{"issue":"45","key":"e_1_2_7_11_1","first-page":"739","article-title":"Neurological adverse events to voriconazole: evidence for therapeutic drug monitoring","volume":"136","author":"Imhof A","year":"2006","journal-title":"Swiss Med Wkly"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkx122"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciz741"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.1707"}],"container-title":["Clinical Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ctr.14826","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ctr.14826","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ctr.14826","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,19]],"date-time":"2023-08-19T07:14:46Z","timestamp":1692429286000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ctr.14826"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,26]]},"references-count":13,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,1]]}},"alternative-id":["10.1111\/ctr.14826"],"URL":"https:\/\/doi.org\/10.1111\/ctr.14826","archive":["Portico"],"relation":{},"ISSN":["0902-0063","1399-0012"],"issn-type":[{"value":"0902-0063","type":"print"},{"value":"1399-0012","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,26]]},"assertion":[{"value":"2022-05-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-09-19","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-10-26","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e14826"}}