High Variability in Isavuconazole Unbound Fraction in Clinical Practice: A Call to Reconsider Pharmacokinetic/Pharmacodynamic Targets and Breakpoints.

Anouk M E JansenRob Ter HeinePaul E VerweijRoger J M Brüggemann

Published in: Clinical pharmacokinetics (2023)

Isavuconazole exposure-response relationships have been studied with a focus on total rather than unbound exposure, assuming a constant unbound fraction of 1%. We observed a median (range) unbound fraction of 1.59% (0.42-5.30%) in patients. This highly variable protein binding asks for re-evaluation of current pharmacokinetic and pharmacodynamic targets for isavuconazole.

Keyphrases

end stage renal disease
clinical practice
ejection fraction
newly diagnosed
chronic kidney disease
peritoneal dialysis
patient reported
amino acid
protein protein