Consensus guidelines for optimising antifungal drug delivery and monitoring to avoid toxicity and improve outcomes in patients with haematological malignancy and haemopoietic stem cell transplant recipients, 2021
Antifungal agents can have complex dosing and the potential for drug interaction, both of which can lead to subtherapeutic antifungal drug concentrations and poorer clinical outcomes for patients with haematological malignancy and haemopoietic stem cell transplant recipients. Antifungal agents can a...
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| Vydáno v: | Internal medicine journal Ročník 51; číslo S7; s. 37 - 66 |
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| Hlavní autoři: | , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
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Melbourne
John Wiley & Sons Australia, Ltd
01.11.2021
Wiley Subscription Services, Inc |
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| ISSN: | 1444-0903, 1445-5994, 1445-5994 |
| On-line přístup: | Získat plný text |
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| Abstract | Antifungal agents can have complex dosing and the potential for drug interaction, both of which can lead to subtherapeutic antifungal drug concentrations and poorer clinical outcomes for patients with haematological malignancy and haemopoietic stem cell transplant recipients. Antifungal agents can also be associated with significant toxicities when drug concentrations are too high. Suboptimal dosing can be minimised by clinical assessment, laboratory monitoring, avoidance of interacting drugs, and dose modification. Therapeutic drug monitoring (TDM) plays an increasingly important role in antifungal therapy, particularly for antifungal agents that have an established exposure‐response relationship with either a narrow therapeutic window, large dose‐exposure variability, cytochrome P450 gene polymorphism affecting drug metabolism, the presence of antifungal drug interactions or unexpected toxicity, and/or concerns for non‐compliance or inadequate absorption of oral antifungals. These guidelines provide recommendations on antifungal drug monitoring and TDM‐guided dosing adjustment for selected antifungal agents, and include suggested resources for identifying and analysing antifungal drug interactions. Recommended competencies for optimal interpretation of antifungal TDM and dose recommendations are also provided. |
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| AbstractList | Antifungal agents can have complex dosing and the potential for drug interaction, both of which can lead to subtherapeutic antifungal drug concentrations and poorer clinical outcomes for patients with haematological malignancy and haemopoietic stem cell transplant recipients. Antifungal agents can also be associated with significant toxicities when drug concentrations are too high. Suboptimal dosing can be minimised by clinical assessment, laboratory monitoring, avoidance of interacting drugs, and dose modification. Therapeutic drug monitoring (TDM) plays an increasingly important role in antifungal therapy, particularly for antifungal agents that have an established exposure‐response relationship with either a narrow therapeutic window, large dose‐exposure variability, cytochrome P450 gene polymorphism affecting drug metabolism, the presence of antifungal drug interactions or unexpected toxicity, and/or concerns for non‐compliance or inadequate absorption of oral antifungals. These guidelines provide recommendations on antifungal drug monitoring and TDM‐guided dosing adjustment for selected antifungal agents, and include suggested resources for identifying and analysing antifungal drug interactions. Recommended competencies for optimal interpretation of antifungal TDM and dose recommendations are also provided. Antifungal agents can have complex dosing and the potential for drug interaction, both of which can lead to subtherapeutic antifungal drug concentrations and poorer clinical outcomes for patients with haematological malignancy and haemopoietic stem cell transplant recipients. Antifungal agents can also be associated with significant toxicities when drug concentrations are too high. Suboptimal dosing can be minimised by clinical assessment, laboratory monitoring, avoidance of interacting drugs, and dose modification. Therapeutic drug monitoring (TDM) plays an increasingly important role in antifungal therapy, particularly for antifungal agents that have an established exposure-response relationship with either a narrow therapeutic window, large dose-exposure variability, cytochrome P450 gene polymorphism affecting drug metabolism, the presence of antifungal drug interactions or unexpected toxicity, and/or concerns for non-compliance or inadequate absorption of oral antifungals. These guidelines provide recommendations on antifungal drug monitoring and TDM-guided dosing adjustment for selected antifungal agents, and include suggested resources for identifying and analysing antifungal drug interactions. Recommended competencies for optimal interpretation of antifungal TDM and dose recommendations are also provided.Antifungal agents can have complex dosing and the potential for drug interaction, both of which can lead to subtherapeutic antifungal drug concentrations and poorer clinical outcomes for patients with haematological malignancy and haemopoietic stem cell transplant recipients. Antifungal agents can also be associated with significant toxicities when drug concentrations are too high. Suboptimal dosing can be minimised by clinical assessment, laboratory monitoring, avoidance of interacting drugs, and dose modification. Therapeutic drug monitoring (TDM) plays an increasingly important role in antifungal therapy, particularly for antifungal agents that have an established exposure-response relationship with either a narrow therapeutic window, large dose-exposure variability, cytochrome P450 gene polymorphism affecting drug metabolism, the presence of antifungal drug interactions or unexpected toxicity, and/or concerns for non-compliance or inadequate absorption of oral antifungals. These guidelines provide recommendations on antifungal drug monitoring and TDM-guided dosing adjustment for selected antifungal agents, and include suggested resources for identifying and analysing antifungal drug interactions. Recommended competencies for optimal interpretation of antifungal TDM and dose recommendations are also provided. |
| Author | Zhao, Jessie Chau, Maggie M. Daveson, Kathryn Marriott, Deborah J. E. Alffenaar, Jan‐Willem C. Gwee, Amanda Trubiano, Jason A. Ho, Su Ann Roberts, Jason A. |
| Author_xml | – sequence: 1 givenname: Maggie M. surname: Chau fullname: Chau, Maggie M. organization: The Royal Melbourne Hospital – sequence: 2 givenname: Kathryn surname: Daveson fullname: Daveson, Kathryn organization: The Canberra Hospital – sequence: 3 givenname: Jan‐Willem C. surname: Alffenaar fullname: Alffenaar, Jan‐Willem C. organization: University of Sydney – sequence: 4 givenname: Amanda surname: Gwee fullname: Gwee, Amanda organization: Murdoch Children's Research Institute – sequence: 5 givenname: Su Ann surname: Ho fullname: Ho, Su Ann organization: Peter MacCallum Cancer Centre – sequence: 6 givenname: Deborah J. E. surname: Marriott fullname: Marriott, Deborah J. E. organization: The University of New South Wales – sequence: 7 givenname: Jason A. surname: Trubiano fullname: Trubiano, Jason A. organization: The University of Melbourne – sequence: 8 givenname: Jessie surname: Zhao fullname: Zhao, Jessie organization: The Alfred Hospital – sequence: 9 givenname: Jason A. surname: Roberts fullname: Roberts, Jason A. email: j.roberts2@uq.edu.au organization: Nîmes University Hospital, University of Montpellier |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/34937141$$D View this record in MEDLINE/PubMed |
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| ContentType | Journal Article |
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| Copyright | 2021 Royal Australasian College of Physicians. 2021 Royal Australasian College of Physicians |
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| ISSN | 1444-0903 1445-5994 |
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| Issue | S7 |
| Keywords | toxicity antifungal therapy pharmacogenomics drug interaction therapeutic drug monitoring |
| Language | English |
| License | 2021 Royal Australasian College of Physicians. |
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| Notes | Australasian Antifungal Guidelines Steering Committee: Christina C Chang, Christopher C Blyth, Sharon C‐A Chen, Anna Khanina, C. Orla Morrissey, Jason A. Roberts, Karin A Thursky, Leon Worth, Monica A Slavin. Conflict of interest: The following working group members are consultants or advisory committee members or receive honoraria, fees for service, or travel assistance from; or have research or other associations with the organisations listed: J. A. Roberts – Pfizer, Sandoz, Wolters Kluwer, Merck, Sharpe & Dohme, QPEX, Discuva Ltd., Accelerate Diagnostics, Bayer, Biomerieux, Cipla, The Medicines Company, Cardeas Pharma; A. Gwee – Merck, Sharpe & Dohme; J. A. Trubiano – Merck, Sharpe & Dohme. Funding: J. A. Roberts would like to acknowledge funding from the Australian National Health and Medical Research Council for a Centre of Research Excellence (APP1099452) and a Practitioner Fellowship (APP1117065). ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 |
| OpenAccessLink | https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/imj.15587 |
| PMID | 34937141 |
| PQID | 2612461110 |
| PQPubID | 2045147 |
| PageCount | 30 |
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| PublicationCentury | 2000 |
| PublicationDate | November 2021 2021-11-00 2021-Nov 20211101 |
| PublicationDateYYYYMMDD | 2021-11-01 |
| PublicationDate_xml | – month: 11 year: 2021 text: November 2021 |
| PublicationDecade | 2020 |
| PublicationPlace | Melbourne |
| PublicationPlace_xml | – name: Melbourne – name: Australia – name: Hoboken |
| PublicationTitle | Internal medicine journal |
| PublicationTitleAlternate | Intern Med J |
| PublicationYear | 2021 |
| Publisher | John Wiley & Sons Australia, Ltd Wiley Subscription Services, Inc |
| Publisher_xml | – name: John Wiley & Sons Australia, Ltd – name: Wiley Subscription Services, Inc |
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62 e_1_2_14_145_1 e_1_2_14_168_1 e_1_2_14_106_1 e_1_2_14_86_1 e_1_2_14_63_1 e_1_2_14_40_1 e_1_2_14_292_1 cr-split#-e_1_2_14_32_1.2 e_1_2_14_228_1 e_1_2_14_277_1 Chapman J (e_1_2_14_296_1) 2012 e_1_2_14_25_1 cr-split#-e_1_2_14_32_1.1 e_1_2_14_48_1 e_1_2_14_205_1 e_1_2_14_254_1 e_1_2_14_171_1 e_1_2_14_194_1 e_1_2_14_231_1 e_1_2_14_303_1 e_1_2_14_133_1 e_1_2_14_179_1 e_1_2_14_114_1 e_1_2_14_137_1 Kunka ME (e_1_2_14_259_1) 2015; 2015 e_1_2_14_92_1 e_1_2_14_261_1 e_1_2_14_284_1 e_1_2_14_54_1 e_1_2_14_39_1 e_1_2_14_77_1 e_1_2_14_16_1 e_1_2_14_200_1 e_1_2_14_223_1 e_1_2_14_246_1 e_1_2_14_140_1 e_1_2_14_186_1 e_1_2_14_163_1 e_1_2_14_125_1 e_1_2_14_103_1 e_1_2_14_148_1 e_1_2_14_2_1 e_1_2_14_20_1 e_1_2_14_81_1 e_1_2_14_208_1 e_1_2_14_272_1 e_1_2_14_295_1 e_1_2_14_43_1 e_1_2_14_66_1 e_1_2_14_28_1 e_1_2_14_89_1 e_1_2_14_211_1 e_1_2_14_234_1 e_1_2_14_257_1 e_1_2_14_269_1 e_1_2_14_151_1 e_1_2_14_197_1 e_1_2_14_174_1 cr-split#-e_1_2_14_122_1.1 e_1_2_14_115_1 cr-split#-e_1_2_14_122_1.2 e_1_2_14_136_1 e_1_2_14_306_1 e_1_2_14_159_1 e_1_2_14_30_1 e_1_2_14_53_1 e_1_2_14_91_1 e_1_2_14_260_1 e_1_2_14_219_1 e_1_2_14_283_1 e_1_2_14_15_1 e_1_2_14_38_1 e_1_2_14_76_1 e_1_2_14_99_1 e_1_2_14_268_1 e_1_2_14_222_1 Walsh A (e_1_2_14_285_1) 1978; 17 e_1_2_14_162_1 e_1_2_14_185_1 e_1_2_14_124_1 e_1_2_14_147_1 e_1_2_14_104_1 e_1_2_14_42_1 e_1_2_14_80_1 e_1_2_14_3_1 e_1_2_14_271_1 e_1_2_14_207_1 e_1_2_14_294_1 e_1_2_14_65_1 e_1_2_14_27_1 e_1_2_14_88_1 Heykants J (e_1_2_14_270_1) 1987 e_1_2_14_279_1 e_1_2_14_210_1 e_1_2_14_256_1 e_1_2_14_233_1 e_1_2_14_150_1 cr-split#-e_1_2_14_31_1.2 e_1_2_14_305_1 cr-split#-e_1_2_14_31_1.1 e_1_2_14_173_1 e_1_2_14_196_1 e_1_2_14_116_1 e_1_2_14_135_1 e_1_2_14_158_1 e_1_2_14_94_1 e_1_2_14_112_1 e_1_2_14_139_1 e_1_2_14_300_1 e_1_2_14_71_1 e_1_2_14_10_1 e_1_2_14_56_1 e_1_2_14_263_1 e_1_2_14_286_1 e_1_2_14_33_1 e_1_2_14_214_1 e_1_2_14_79_1 e_1_2_14_237_1 e_1_2_14_202_1 e_1_2_14_180_1 e_1_2_14_240_1 e_1_2_14_165_1 e_1_2_14_8_1 e_1_2_14_109_1 e_1_2_14_142_1 e_1_2_14_188_1 e_1_2_14_60_1 e_1_2_14_83_1 e_1_2_14_127_1 e_1_2_14_101_1 e_1_2_14_45_1 e_1_2_14_68_1 e_1_2_14_274_1 e_1_2_14_297_1 e_1_2_14_22_1 e_1_2_14_225_1 e_1_2_14_248_1 e_1_2_14_19_1 e_1_2_14_213_1 cr-split#-e_1_2_14_118_1.2 cr-split#-e_1_2_14_245_1.1 cr-split#-e_1_2_14_118_1.1 e_1_2_14_251_1 e_1_2_14_191_1 e_1_2_14_130_1 e_1_2_14_176_1 e_1_2_14_153_1 cr-split#-e_1_2_14_245_1.2 e_1_2_14_199_1 e_1_2_14_113_1 e_1_2_14_138_1 e_1_2_14_70_1 e_1_2_14_262_1 e_1_2_14_55_1 e_1_2_14_17_1 e_1_2_14_78_1 e_1_2_14_236_1 e_1_2_14_224_1 e_1_2_14_29_1 e_1_2_14_201_1 e_1_2_14_141_1 e_1_2_14_164_1 e_1_2_14_187_1 e_1_2_14_9_1 e_1_2_14_126_1 e_1_2_14_149_1 e_1_2_14_102_1 e_1_2_14_82_1 e_1_2_14_67_1 e_1_2_14_273_1 e_1_2_14_21_1 e_1_2_14_44_1 e_1_2_14_209_1 Bucknor MD (e_1_2_14_93_1) 2013; 7 e_1_2_14_247_1 e_1_2_14_190_1 e_1_2_14_18_1 e_1_2_14_235_1 e_1_2_14_212_1 cr-split#-e_1_2_14_156_1.1 cr-split#-e_1_2_14_156_1.2 e_1_2_14_250_1 e_1_2_14_152_1 e_1_2_14_175_1 e_1_2_14_198_1 e_1_2_14_307_1 |
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| SubjectTerms | Antifungal Agents antifungal therapy Cytochrome P450 Dosage Drug delivery Drug dosages Drug interaction Drug Interactions Drug metabolism Drug Monitoring Gene polymorphism Hematologic Neoplasms - drug therapy Hematology Hematopoietic Stem Cell Transplantation Humans Malignancy Patients pharmacogenomics Stem cell transplantation therapeutic drug monitoring Toxicity |
| Title | Consensus guidelines for optimising antifungal drug delivery and monitoring to avoid toxicity and improve outcomes in patients with haematological malignancy and haemopoietic stem cell transplant recipients, 2021 |
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