Evidence map›Paper›PMID 39714727›Full record

ArticleEuropean journal of clinical pharmacology2025

Drug-drug interaction of phenytoin sodium and methylprednisolone on voriconazole: a population pharmacokinetic model in children with thalassemia undergoing allogeneic hematopoietic stem cell transplantation.

Yun Wu, Lu-Lu Niu, Ya-Yun Ling, Si-Ru Zhou, Tian-Min Huang, Jian-Ying Qi, Dong-Ni Wu, Rong-da Cai, Ting-Qing Wu, Yang Xiao and 1 more

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Article in European journal of clinical pharmacology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Yun Wu *Department of Pharmacy, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Lu-Lu Niu *Department of Pharmacy, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Ya-Yun LingDepartment of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Si-Ru ZhouDepartment of Pharmacy, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Tian-Min HuangDepartment of Pharmacy, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Jian-Ying QiDepartment of Pharmacy, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Dong-Ni WuDepartment of Pharmacy, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Rong-da CaiDepartment of Pharmacy, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Ting-Qing WuDepartment of Pharmacy, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Yang XiaoDepartment of Pharmacy, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Taotao LiuDepartment of Pharmacy, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China. liutaotao@gxmu.edu.cn.ORCID http://orcid.org/0000-0001-9467-920X

Funding

the Natural Science Foundation of Guangxi, China (No. 2021JJA140122).
6 · The paper itself

Abstract

purposeVoriconazole (VRC) is recommended for the prevention and treatment of invasive fungal infections in children undergoing hematopoietic stem cell transplantation (HSCT). It demonstrates nonlinear pharmacokinetics (PK) and exhibits substantial inter- and intraindividual variability. Phenytoin sodium (PHT) and methylprednisolone (MP) are commonly used in the early stages of HSCT to prevent epilepsy and graft-versus-host disease. Drug-drug interactions between VRC and these medications represent a significant concern in HSCT recipients. This study aims to investigate the effects of coadministration with PHT, MP, and other covariates on VRC metabolism in children with thalassemia (TM) undergoing allogeneic HSCT (Allo-HSCT) using population pharmacokinetics (PPK) and to recommend the optimal dosage regimen for this unique group.

methodsA total of 237 samples from 57 children with TM undergoing Allo-HSCT were collected. Non-linear mixed effects modeling and Monte Carlo simulation (MCS) were applied for PPK analysis and for optimizing VRC dosing, respectively.

resultsThe VRC data were characterized by a two-compartment model with linear elimination and first-order absorption. All parameters were incorporated in allometric scaling form, with PHT and MP significantly influencing VRC clearance. The MCS revealed a negative correlation between the children's body weight (ranging from 10 to 40 kg) and the required dose. When PHT was co-administered, approximately three times the regular dose of VRC was required. In contrast, when MP was administered together, the dose needed to be increased by 12.5-50%.

conclusionThe proposed regimen improved the probability of target attainment for VRC and may serve as a reference for the individualized administration of VRC in clinical practice.

Indexed as

Antifungal AgentsHematopoietic Stem Cell TransplantationMethylprednisoloneModels, BiologicalPhenytoinThalassemiaVoriconazoleAdolescentAnticonvulsantsChildChild, PreschoolDrug InteractionsFemaleHumansInfantMaleAnticonvulsantsAntifungal AgentsMethylprednisolonePhenytoinVoriconazoleAllogeneic hematopoietic stem cell transplantationChildrenDrug–drug interactionPopulation pharmacokineticsThalassemiaVoriconazole

Identifiers

PMID39714727

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.