Study on the Risk Factors of Potentially Toxic Concentration of Voriconazole

OBJECTIVE To explore the risk factors associated with potentially toxic concentrations of voriconazole in patients in order to screen the high-risk populations.METHODS Retrospective analysis was performed on patients who used voriconazole and monitored their blood concentrations from January 2017 to December 2019, and the patients were divided into C_min ≤ 5.5 μg·mL^-1 group and C_min>5.5 μg·mL^-1 group according to the blood concentration value. The risk factors for the potentially toxic concentrations of voriconazole were analyzed by univariate and Logistic multivariate analysis. Using ROC curve to analyze the specificity, sensitivity and critical value of numerical risk factors as predictors. RESULTS Seventy eight patients were included, of which 33.33%(26 patients) had a voriconazole trough concentration>5.5 μg·mL^-1. Univariate analysis showed that the potentially toxic concentrations of voriconazole(>5.5 μg·mL^-1) were significantly associated with gender, hypoproteinemia, TBIL and C-reactive protein(CRP). Multivariate analysis showed that high CRP level was independent risk factor for potentially toxic concentrations of voriconazole. ROC curve analysis indicated that patients with CRP>53 mg·L^-1were at high risk of the occurrence of potential toxic concentrations of voriconazole.CONCLUSION For high-risk groups with CRP>53 mg·L^-1, the blood concentration of voriconazole should be closely monitored to avoid adverse events.