Evidence map›Paper›PMID 39819426›Full record

ArticleBMC infectious diseases2025

Safety and recommendation of voriconazole for invasive pulmonary aspergillosis in severe liver disease patients: a retrospective cohort study.

Xin Zhang, Caopei Zheng, Ling Zhang, Yuqing Sun, Ying Liang, Xue Chen, Lijun Pang, Yulin Zhang

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In one paragraph

Article in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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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

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Xin Zhang *Department of Respiratory and Critical Care Medicine, Beijing Youan Hospital, Capital Medical University, 8 Xitoutiao, Youanmenwai, Fengtai District, Beijing, 100069, China.
Caopei Zheng *Department of Respiratory and Critical Care Medicine, Beijing Youan Hospital, Capital Medical University, 8 Xitoutiao, Youanmenwai, Fengtai District, Beijing, 100069, China.
Ling ZhangDepartment of Respiratory and Critical Care Medicine, Beijing Youan Hospital, Capital Medical University, 8 Xitoutiao, Youanmenwai, Fengtai District, Beijing, 100069, China.
Yuqing SunDepartment of Respiratory and Critical Care Medicine, Beijing Youan Hospital, Capital Medical University, 8 Xitoutiao, Youanmenwai, Fengtai District, Beijing, 100069, China.
Ying LiangBeijing Key Laboratory for HIV/AIDS Research, Clinical and Research Centre for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China.
Xue ChenDepartment of Respiratory and Critical Care Medicine, Beijing Youan Hospital, Capital Medical University, 8 Xitoutiao, Youanmenwai, Fengtai District, Beijing, 100069, China.
Lijun PangBeijing Youan Hospital, Beijing Institute of Hepatology, Capital Medical University, Beijing, China.
Yulin ZhangDepartment of Respiratory and Critical Care Medicine, Beijing Youan Hospital, Capital Medical University, 8 Xitoutiao, Youanmenwai, Fengtai District, Beijing, 100069, China. yulinzhang@ccmu.edu.cn.

Funding

Beijing Research Center for Respiratory Infectious Diseases Project BJRID2024-001Beijing Research Ward Excellence Program BRWEP2024W042180101
6 · The paper itself

Abstract

backgroundInvasive pulmonary aspergillosis (IPA) is a common opportunistic infection in patients with severe liver disease (SLD), which increases the mortality of patients. The aim of this study was to evaluate the efficacy and safety of voriconazole for IPA in patients with SLD and explore an optimal antifungal regimen.

methodsThis was a retrospective cohort study of SLD patients diagnosed with proven or probable IPA at Beijing Youan Hospital, Capital Medical University between January 1, 2012 to January 31, 2023. Univariate and multivariate logistic regression analysis were performed to identify the impact of voriconazole on outcomes of SLD patients with IPA.

resultsA total of 142 patients were enrolled and categorized into voriconazole group (n = 92), echinocandins group (n = 26) and a combination of voriconazole and echinocandins group (n = 24). The 28-day all-cause mortality was lower in voriconazole group compared to the other groups (p = 0.033). Voriconazole monotherapy was associated with lower short-term mortality (OR 0.223, 95%CI 0.070-0.650, p = 0.008) and did not seem to exacerbate hepatic function deterioration in SLD patients with IPA (OR 0.259, 95%CI 0.094-0.674, p = 0.007) when compared to echinocandins monotherapy. Among the three subgroups of voriconazole monotherapy, no-loading dose regime demonstrated a superior response to IPA therapy compared to the standard-dose regimen (OR 0.264, 95%CI 0.068-0.845, p = 0.035).

conclusionVoriconazole monotherapy demonstrated good tolerability with lower mortality in SLD patients with IPA. A no-loading dose voriconazole regimen is proposed for IPA treatment in SLD patients, yet pharmacokinetic studies combined with prospective studies are needed for further validation.

Indexed as

Antifungal AgentsInvasive Pulmonary AspergillosisLiver DiseasesVoriconazoleAdultAgedFemaleHumansMaleMiddle AgedRetrospective StudiesTreatment OutcomeAntifungal AgentsVoriconazoleAntifungal agentsInvasive pulmonary aspergillosisMortalitySevere liver diseaseVoriconazole

Identifiers

PMID39819426
PMCPMC11740529

What Socratic holds

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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.