Frontiers in pharmacology
The pharmacokinetics and pharmacogenomics of voriconazole in pediatric Saudi patients: advancing toward precision medicine
By Albassam A, Alharbi A, Al Anizi H and 9 others.
Abstract
Background
Voriconazole is a broad-spectrum triazole antifungal. It is used to prevent and treat invasive fungal infections in immunocompromised pediatric patients. Its clinical use is limited due to its nonlinear pharmacokinetics, high variability, and a narrow therapeutic index. Data on pharmacogenomic effects in pediatric patients are limited, particularly in the Saudi population. This study aimed to evaluate voriconazole pharmacokinetics in pediatric patients and to assess the impact of CYP2C19 genotypes on drug concentrations and clearance.
Methods
A prospective observational study was conducted from October 2022 to October 2024 at two tertiary care centers in Riyadh, Saudi Arabia. Saudi pediatric patients aged between 1 and 14 years receiving voriconazole were enrolled after informed consent from guardians. Trough blood samples were collected on the fifth day of therapy and CYP2C19 genotyping (*2, *3, *17) was performed. The metabolizer status was assigned according to the Clinical Pharmacogenetics Implementation Consortium guidelines.