Unexpected renal influence on isavuconazole trough concentrations: two case reports and literature review

Q: What type of study is this?

This is a Case Report study (also classified as: Literature Review).

Hui Li; Xiaodong He; Qiuya Lu; Ling Wang; Jhih-Hua Jiang; Wenhui Gao; Lining Wang; Jiong Hu; Jie Fang; Xiaolan Bian

doi:10.3389/fmed.2025.1625697

August 19, 2025Frontiers in MedicineOpen Access

Unexpected renal influence on isavuconazole trough concentrations: two case reports and literature review

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Key Points

In two patients, isavuconazole trough concentrations correlated inversely with renal function, indicating possible pharmacokinetic adjustments.
Trough levels exceeded safety thresholds, leading to adverse drug reactions and highlighting the need for careful monitoring.
The findings challenge assumptions about renal influence on isavuconazole, calling for larger studies to validate the observations.
Individually tailored therapeutic drug monitoring may enhance treatment efficacy and reduce toxicity in patients with renal impairment.],
simple_explanation':'Isavuconazole is a medication used to treat serious fungal infections. In some patients with kidney issues, the levels of this drug in the body can become too high, leading to side effects. This means doctors might need to check the drug levels more often, especially in people with poor kidney function. Understanding this could help make treatments safer and more effective. 🦠'} } `` } } } } } , } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } ,} } } } } } , } } , } } , } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } }}

Implication

Case reports reveal an inverse relationship between isavuconazole trough concentrations and renal function, suggesting a need for tailored monitoring strategies.

Abstract

Isavuconazole (ISA) is a first-line treatment for invasive aspergillosis, with routine therapeutic drug monitoring (TDM) typically deemed unnecessary. Although the drug label and prior studies suggest renal function does not affect ISA pharmacokinetics, our findings in two high-risk patients challenge this perspective, showing an inverse correlation between ISA trough concentrations and estimated glomerular filtration rate (eGFR). Trough concentrations exceeding the reported toxicity threshold were associated with adverse drug reactions (ADRs). Given the limited sample size, large-scale retrospective and prospective studies are urgently needed to confirm the impact of renal function on ISA and to develop individualized TDM strategies that optimize efficacy and minimize toxicity.

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Cite This Study

Li et al. (2025) studied this question.

synapsesocial.com/papers/68af4546ad7bf08b1ead3137 https://doi.org/10.3389/fmed.2025.1625697

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Unexpected renal influence on isavuconazole trough concentrations: two case reports and literature review

Key Points

Implication

Abstract

Discussion

Cite This Study

Unexpected renal influence on isavuconazole trough concentrations: two case reports and literature review

Key Points

Implication

Abstract

Discussion

Cite This Study

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