Study on risk factors for common voriconazole-induced adverse reactions in elderly patients based on a real-world data
Objective To analyze the risk factors for common voriconazole-induced adverse reactions in elderly patients.Methods A retrospective cohort study was conducted to collect the clinical data of the elderly patients who were treated with voriconazole and monitored for blood concentrations in Wenzhou Central Hospital from August 2017 to August 2022.Results A total of 90 patients were included,of whom 31(34.44%)had liver damage,15(16.67%)had electrolyte disturbance,and 9(10.00%)had mental disorders.Univariate analysis showed that high trough concentration was the independent risk factor for liver damage and mental disorders of the patients with voriconazole-induced adverse reactions.The area under receiver operating characteristic(ROC)curve was 0.674 for the patients with liver damage,0.86 for the patients with mental disorders;respectively.The cut-offvalue of the drug concentration was 1.92 mg·L-1 for the patients with liver damage(sensitivity 87.1%,specificity 50.0%),and 4.02 mg·L-1 for the patients with mental disorders(sensitivity 88.9%,specificity 76.7%).Conclusion The minimum concentration of voriconazole is closely associated with the adverse reactions.Individualized medication based on the monitoring of blood concentration can effectively reduce the incidence of voriconazole-induced adverse reactions.
VoriconazoleElderly patientAdverse drug reactionRisk factorBlood concentration
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