Evidence mapPaperPMID 42326051Full record

ArticleInfection and drug resistance2026

Risk Factors for Subtherapeutic Exposure and Hepatotoxicity Threshold of Posaconazole: A Real-World Study in Chinese Patients with Invasive Pulmonary Fungal Infection.

Bingqing Wang, Shuting Li, Jing Wang, Jing Zhang, Hang Liu, Lu Jin

Abstract read
In one paragraph

Article in Infection and drug resistance, 2026. 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

What it found

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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

6 authors.

Bingqing Wang *Department of Pharmacy, Nanjing Drum Tower Hospital, Nanjing Drum Tower Hospital Clinical College, Nanjing University of Chinese Medicine, Nanjing, 210008, People's Republic of China.ORCID 0009-0001-5470-9029
Shuting Li *Department of Pharmacy, Nanjing Drum Tower Hospital, Nanjing Drum Tower Hospital Clinical College, Nanjing University of Chinese Medicine, Nanjing, 210008, People's Republic of China.ORCID 0009-0008-1510-1302
Jing WangDepartment of Pharmacy, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210008, People's Republic of China.
Jing ZhangDepartment of Pharmacy, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210008, People's Republic of China.
Hang LiuDepartment of Pharmacy, Nanjing Drum Tower Hospital, Nanjing Drum Tower Hospital Clinical College, Nanjing University of Chinese Medicine, Nanjing, 210008, People's Republic of China.
Lu JinDepartment of Pharmacy, Nanjing Drum Tower Hospital, Nanjing Drum Tower Hospital Clinical College, Nanjing University of Chinese Medicine, Nanjing, 210008, People's Republic of China.ORCID 0000-0001-7933-0309

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Posaconazole exhibits substantial pharmacokinetic variability, particularly with oral formulations. Real-world data on target attainment across formulations and on specific toxicity thresholds remain limited. This study aimed to evaluate posaconazole target attainment rates, identify independent predictors of subtherapeutic exposure, and explore potential hepatotoxicity exposure thresholds in a real-world Chinese cohort. Methods: This single-centre, retrospective observational study conducted at Nanjing Drum Tower Hospital, China, between January 2023 and August 2025 enrolled 148 patients with IPFI. Posaconazole was administered for prophylaxis with a target trough concentration of ≥0.5 mg/L, or for treatment with a target of ≥1.0 mg/L. Multivariable logistic regression was utilised to identify independent predictors of subtherapeutic exposure. Results: Subtherapeutic trough concentrations were observed in 24.0% of the prophylaxis group and 23.3% of the treatment group. Concomitant proton pump inhibitor (PPI) use was the dominant independent risk factor for subtherapeutic exposure in both prophylaxis (OR 17.97, 95% CI 4.22-76.53, Conclusion: Subtherapeutic posaconazole exposure remains common. PPI use is a critical risk factor that may not be fully overcome by delayed-release or intravenous formulations. Our findings suggest a potential exposure-hepatotoxicity relationship around 1.95 mg/L for Chinese patients, highlighting the need for individualised TDM.

Indexed as

hepatotoxicityposaconazoleproton pump inhibitorstherapeutic drug monitoring

Identifiers

PMID42326051
PMCPMC13281766

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.