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Erratum: A probable drug-to-drug interaction between voriconazole and haloperidol in a slow metabolizer of CYP2C19 patient
No full textErratum Following publication of the original article (Infez Med. volume 23, issue 4, pages 367-369, year 2015) we became aware of the following errors which we wish to correct. These corrections have no impact over the study results, their interpretation or conclusions. Title The correct title is the following: A probable drug-to-drug interaction between voriconazole and haloperidol in a CYP2C19 poor metabolizing patient Summary The correct summary is the following: SUMMARY We present a case of Aspergillus fumigatus renal abscess treated with voriconazole. Following haloperidol treatment we observed an unexpected increase in voriconazole - trough concentrations and liver function tests. CYP2C19*2 loss of function allele was stated and the introduction of haloperidol, a weak CYP3A4 inhibitor, probably explains this interaction.. Therapeutic drug monitoring and CYP2C19 genotyping may be suggested when administering voriconazole to complex patients
A probable drug-to-drug interaction between voriconazole and haloperidol in a slow metabolizer of CYP2C19
No full textWe present a case of Aspergillus fumigatus renal abscess treated with voriconazole of a HIV-positive 43-year-old male patient. Following haloperidol treatment we observed an unexpected increase in voriconazole through concentrations and liver function tests. CYP2C19*2 loss of function allele was stated, an interaction probably explained by the introduction of haloperidol, a weak CYP3A4 inhibitor. Therapeutic drug monitoring and CYP2C19 genotyping may be suggested when administering voriconazole to complex patients
UPLC-MS/MS method with automated on-line SPE for the isomer-specific quantification of the first-generation anti-HCV protease inhibitors in peripheral blood mononuclear cells
No full textHCV infection affects over 170 million people worldwide. The current standard for treatment of genotype 1 infection is the association of the first generation protease inhibitors boceprevir or telaprevir to ribavirin and peginterferon α. Although the response rate has been improved with these new drugs, some pharmacokinetic/pharmacodinamic issues emerged in the past years. To date, some analytical methods are available for the quantification of these drugs in plasma; however, the real active concentrations of the two drugs are those in hepatocytes. Being the withdrawal of hepatocytes too invasive, in this work we aimed to develop and validate a chromatographic method coupled with tandem mass spectrometry capable of quantifying boceprevir and telaprevir isomers in peripheral blood mononuclear cells, used as an "in-vivo" cellular model of compartmentalization. The method used an on-line solid phase extraction protocol based on the new OSM(®) platform and was fully validated following FDA guidelines. This method showed mean intra- and inter-day inaccuracy and imprecision both lower than 15%, high and stable recovery and contained matrix effect, with a run time of 6min, comprehensive of SPE extraction. The method was then applied on 35 real samples from patients treated with boceprevir or telaprevir, with good analytical performances, thus assessing its eligibility for a possible future routine use. Peculiar pharmacokinetic data have been observed, suggesting the usefulness of investigating intracellular pharmacokinetics of these drugs. Further studies will be required to test the correlation of intracellular concentrations with effectiveness and toxicity of triple therapy
Pharmacokinetics of caspofungin increased dosage in a patient on rifampin-containing anti-tubercular treatment
No full textSingle-nucleotide polymorphism PXR 7635G>A influences plasma concentrations of Efavirenz in CYP2B6 516G>T carriers
No full textUndetectable Ritonavir Plasma Concentrations in Different Boosted PI-based Regimens as a Marker of Non-Adherence: analysis of a large TDM Registry
No full textA UPLC-MS-MS method for the simultaneous quantification of first-line antituberculars in plasma and in PBMCs
No full textTB is currently the second cause of death among patients affected with infectious diseases. Quantification of drug levels in plasma and in cells where Mycobacterium tuberculosis persists and grows may be useful in understanding the appropriateness of dosage regimens. We report a new and fully validated chromatographic method to quantify first-line antituberculars in plasma and PBMCs. The method was used for plasma and cell quantification of antituberculars in patients undergoing treatment with standard oral therapy
Single-nucleotide polymorphisms ABCB1 3435C>T, 1236C>T and CYP2B6 516G>T influence plasma concentrations of Efavirenz (EFV)
No full textVitamin D pathway gene variants and HCV-2/3 therapy outcomes
No full textBACKGROUND:
The combination of ribavirin and pegylated-interferon-α is considered the standard of care for HCV-2/3 genotypes treatment. The immune system plays a key role in the achievement of the sustained virological response (SVR). Vitamin D seems to influence antiviral response in chronic hepatitis C and its pathway is controlled by polymorphic genes as CYP27B1, CYP24A1 and VDR. In this study, we have investigated the correlation among the treatment outcomes and single nucleotide polymorphisms (SNPs) in the above mentioned genes and IL28B ones.
METHODS:
One hundred and twelve HCV-2/3 patients treated with interferon plus ribavirin were retrospectively studied; allelic discrimination was performed by real-time PCR.
RESULTS:
CYP24A1rs2585428, IL28Brs12979860 and rs8099917 SNPs affected the non response and BMI, Metavir score, IL28Brs8099917TT and CYP24A1rs2585428GG were the only factors able to predict it. SVR was predicted by Metavir score, HCV-RNA at baseline and early virological response (EVR). IL28Brs12979860 SNP and HCV-RNA were also related to rapid virological response (RVR). EVR was predicted by BMI, Metavir score and CYP24A1rs2585428 SNP. IL28Brs8099917TT and FokITT were relapse prediction factors.
CONCLUSIONS:
As well as to non genetic factors, SNPs in vitamin D pathway seem to have a role in HCV-2/3 therapy outcomes. This study reveals the likely usefulness of pharmacogenetic-based ribavirin and interferon therapy to help identify patients for whom therapy could be successful or not, also considering the new future expensive therapy options. To date, no similar data were published on these viral genotypes, but further studies in different and bigger cohorts are needed
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