Ignite Creation Date:
2024-05-05 @ 5:02 PM
Last Modification Date:
2024-10-26 @ 9:27 AM
Study NCT ID:
NCT00371605
Status:
TERMINATED
Last Update Posted:
2007-12-17
First Post:
2006-08-31
Brief Title:
An Assessment of Voriconazole Pharmacokinetics and Pharmacogenetics in Liver Transplant Recipients - Pilot Study
Sponsor:
University of Pittsburgh
Organization:
University of Pittsburgh
Study Overview
Official Title:
An Assessment of Voriconazole Pharmacokinetics and Pharmacogenetics in Liver Transplant Recipients - Pilot Study
Status:
TERMINATED
Status Verified Date:
2007-12
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Enrolled requested number of patients and completed study In analysis
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
A fixed-dosing regimen of voriconazole is routinely used as prophylaxis against aspergillosis in liver transplant patients admitted to the transplant intensive care unit at UPMC We hypothesize that use of a fixed-dosing regimen of voriconazole will lead to a large degree of variability in drug exposure among liver transplant patients due to 1 variability in absorption and elimination caused by physiological characteristics unique to this patient population 2 its non-linear pharmacokinetics and 3 the potential for polymorphism in the genes that encode for cytochrome P-450 enzymes that metabolize voriconazole This is a pilot clinical pharmacokinetic evaluation that will 1 characterize the plasma concentration versus time profile of voriconazole in liver transplant patients receiving a fixed-dosing regimen to assess for extremes in systemic exposure 2 determine the oral bioavailability of voriconazole in liver transplant patients 3 assess for functionally significant allelic variation of the cytochrome P-450 enzymes that metabolize voriconazole CYP2C9 CYP2C19 and CYP3A45 in both recipient blood and allograft tissue that may contribute extremes in systemic exposure among liver transplant patients This evaluation will allow for an assessment of the adequacy of the prophylactic regimen in achieving therapeutic drug concentrations in all subjects Additionally the utility of genotyping as a clinical tool to identify patients at risk for extremes in voriconazole exposure will be evaluated The characterization of the pharmacokinetics in liver transplant patients may be utilized to define an optimal therapeutic regimen that will be individualized to target specific concentrations to maximize efficacy and minimize side-effects
Detailed Description:
All liver transplant patients receiving voriconazole prophylaxis are eligible to participate in this study We propose a single-center observational study in 15 liver transplant patients who are admitted to the ICU and receiving voriconazole prophylaxis as part of standard care Each patient will undergo blood sampling 27 mL on one occasion Pharmacokinetic Study I while receiving oral voriconazole A small portion of blood 1 mL collected during this blood sampling period will be retained for genotyping specific aim III
Voriconazole prophylaxis is most often administered to liver transplant patients via the oral route 200 mg twice daily However circumstances may arise necessitating the administration of intravenous doses of voriconazole for a subset of patients as part of their standard care Thus these patients will undergo blood sampling on a maximum two additional occasions 1 surrounding an intravenous dose dose 27 mL 2 surrounding an oral dose 27 mL
The amount of voriconazole present in the blood samples will be measured via high pressure liquid chromatography Individual plasma concentration time profiles will be determined following oral and intravenous dosing respectively Pharmacokinetic parameter estimates will be derived via population and individual pharmacokinetic data analysis
The use dose and frequency of the medication voriconazole is up to the clinical staff We will not be altering the delivery dose or use of the drug Therefore we cannot provide you with the requested information because it will all depend on the clinical team We are not intervening to enroll subjects Subjects will only be enrolled if they are placed on voriconazole and they agreed to participate
Voriconazole prophylaxis is most often administered to liver transplant patients via the oral route 200 mg twice daily However circumstances may arise necessitating the administration of intravenous doses of voriconazole for a subset of patients as part of their standard care Thus these patients will undergo blood sampling on a maximum two additional occasions 1 surrounding an intravenous dose dose 27 mL 2 surrounding an oral dose 27 mL
The amount of voriconazole present in the blood samples will be measured via high pressure liquid chromatography Individual plasma concentration time profiles will be determined following oral and intravenous dosing respectively Pharmacokinetic parameter estimates will be derived via population and individual pharmacokinetic data analysis
The use dose and frequency of the medication voriconazole is up to the clinical staff We will not be altering the delivery dose or use of the drug Therefore we cannot provide you with the requested information because it will all depend on the clinical team We are not intervening to enroll subjects Subjects will only be enrolled if they are placed on voriconazole and they agreed to participate
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
None
Is a FDA Regulated Device?:
None
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None