A single- center retrospective cohort research examined the actual relationship between therapeutic drug monitoring and the antifungal medication posaconazole's clinical results

Abstract

Patients receiving hematopoietic stem cell transplantation (HSCT) should take posaconazole as a first line of defense against invasive fungal disease (IFD). There is a lack of data on how therapeutic drug monitoring (TDM) affects the prevention of IFD with posaconazole in retrospective investigations. Using real-world data, this research aimed to assess posaconazole's effectiveness, safety, and cost-efficiency in avoiding IFD.
Methods: Researchers from Shandong Provincial Qianfoshan Hospital, which is affiliated with Shandong First Medical University, looked at posaconazole as a fungal prevention treatment for HSCT patients in this retrospective cohort research. Based on their TDM status, patients were categorized into two groups: TDM and non-TDM. Propensity score matching (PSM) was used to examine clinical data in order to better understand the function of TDM in posaconazole prevention.
Conclusions: Following PSM, the prophylactic success rate was 100% in the TDM group compared to 52.9% in the non-TDM group (P = 0.003). Both groups had similar levels of gastrointestinal, liver, and kidney side effects (P > 0.05). When comparing the TDM group to the non-TDM group, we find that the former had reduced overall treatment costs and prescription costs.

In conclusion, real-world data show that TDM modestly lowers treatment costs and improves posaconazole's efficacy in avoiding IFD in HSCT patients.