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Table 1 Characteristics of included studies

From: Utility of posaconazole therapeutic drug monitoring and assessment of plasma concentration threshold for effective prophylaxis of invasive fungal infections: a meta-analysis with trial sequential analysis

Study

Year

Country

Study design

Patients

Population

Main underlying disease (%)

POS form

Indication of therapy

Assay method

Intervention following TDM result

Prophylaxis duration: (days)

Definition of successful outcome

Cut-off value of prophylaxis

AE incidence

Sengar

2016

India

SCP

45

A

AML

sus

P

HPLC

No

NA

EORTC/MSG

Css ≥ 0.7

NA

Döring

2017

Germany

SCR

63

C

HSCT

sus & tab

P

HPLC

No

median 106

EORTC/MSG

Css ≥ 0.5

hepatotoxicityd

Liebenstein

2017

USA

SCR

74

A

AML

sus & tab

P

NA

Yes

31 & 34

EORTC/MSG

Css ≥ 0.7

hepatotoxicity (4.1%)

Tverdek

2017

USA

SCR

76

A

AML (55%)

tab & iv

P

NA

Yes

median 8

EORTC/MSG

Css ≥ 0.7

NA

Thakuria

2016

UK

SCP

26

A

lung transplant

sus

P

LC-MS/MS

Yes

36.1

EORTC/MSG

Css ≥ 0.5

8/27 (29.6%)

Vanstraelen

2016

Belgium

SCP

14

C

AML (50), ALL (36)

sus

P

HPLC

No

21 (17–60)

NA

Css ≥ 0.7

0

Park

2016

Korea

MCP

114

A

AML (91), MDS (9)

sus

P

LC-MS/MS

Yes

≥ 8

EORTC/MSG

Css ≥ 0.5

NA

Cornely

2016

Global(15 countries)

MCP, phase III

210 (Css is, available in 186)

NA

AML (54), MDS (3), HSCT (43)

tab

P

LC-MS/MS

No

≥ 28

EORTC/MSG

Css ≥ 0.5a, Css ≥ 0.7a

84/210 (40%)

Hummert

2015

USA

SCR

29

A

AML

sus

P

NA

Yes

100

NA

Css ≥ 0.5, Css ≥ 0.7

0

Chae

2015

Korea

SCP

122

A

AML (94) + MDS (6)

sus

P

LC-MS/MS

No

25 (7–45)

EORTC/MSG

Css ≥ 0.5

NA

Maertens

2014

3 European countries

MCP, phase III

66

A

AML (94) + MDS (6)

inj

P

LC-MS/MS

No

1–14

EORTC/MSG

Css ≥ 0.5

200 mg/d, 44%, 300 mg/d, 33%

Duarte

2014

Western country

MCP, phase III

54

A

AML (91) + MDS (9)

tab

P

LC-MS/MS

No

NA, ≤ 28

EORTC/MSG

Css > 0.5

24/54 (44.4%)

Desplanques

2014

France

SCR

43

A

AML

sus

P

LC-MS/MS

No

NA

EORTC/MSG

Css > 0.5

NA

Bourdelin

2014

France

SCP

35

A + P

HM (AML 49%)

sus

P

HPLC

No

5–42

EORTC/MSG

Css ≥ 0.5

NA

Gross

2013

Germany

SCP

31 (27 P + 4 T)

A

AML (74), MDS (6)

sus

P + T

HPLC

No

NA

EORTC/MSG

Css ≥ 0.7

NA

Cattaneo

2013

Italy

SCP

50

NA

AML

sus

P

NA

No

NA

EORTC/MSG

Css ≥ 0.5

NA

Tonini

2013

France

SCR

29

A

HSCT

sus

P

LC-MS/MS

No

NA, ≥ 7

EORTC/MSG

Css ≥ 0.7

NA

Ross

2012

USA

SCP

54

A

AML (95), MDS (5)

sus

P

HPLC

No

NA, ≥ 7

EORTC/MSG

Css ≥ 0.5, Css ≥ 0.7

NA

Pavan

2012

Italy

SCR

50

NA

AML

sus

P

HPLC

Yes

NA

EORTC/MSG

Css ≥ 0.5

NA

Hoenigl

2012

Austria

SCP

34 (31 P + 3 T)

NA

AML/MDS (52), HSCT (48) for prophylaxis

sus

P + T

HPLC

No

NA

EORTC/MSG

Css ≥ 0.5

Hepatotoxicity (8.8%)

Eiden

2012

France

SCP

63 (50 samples on d7)

A

leukemia (48%), multiple myeloma (22)

sus

P

HPLC

No

median 14 (3–307)

EORTC/MSG

Css ≥ 0.5 b, Css ≥ 0.7 b

Hepatotoxicity (6.3%)

Shields

2011

USA

SCR

17 (11 P + 6 T)

A

16 lung transplant

sus

P + T

HPLC

Yes

NA

EORTC/MSG

Css ≥ 0.5, Css ≥ 0.7

NA

Fanci

2011

NA

SCP

13

NA

AML

sus

P

HPLC

No

mean 23

NA

Css ≥ 0.5

NA

Bryant

2011

USA

SCR

21

A

AML (95) + MDS (5)

sus

P

HPLC

Yes

≥ 7

EORTC/MSG

Css ≥ 0.5, Css ≥ 0.7

NA

Welzen

2011

Netherlands

MCP, phase II

12

C

CGD

sus

P

HPLC

Yes

≥ 30

NA

Css ≥ 0.5c, Css ≥ 0.7c

4/12 (33.3%)

Lebeaux

2009

France

SCR

54 (36 P + 18 T)

A

HM (69)

sus

P + T

HPLC

No

≥ 5

EORTC/MSG

Css ≥ 0.5

Hepatotoxicity (7.4%)

Ullmann & Jang

2007 & 2010

Global

RCT

291 P (Css is available in 252)

NA(> 95% adult)

HSCT

sus

P

LC-MS/MS

No

mean 80

EORTC/MSG

Css ≥ 0.7

107/301 (36%)

Cornely & Jang

2007 & 2010

Global

RCT

304 P (Css is available in 215)

NA

AML (84), MDS (16)

sus

P

LC-MS/MS

No

mean 29

EORTC/MSG

Css ≥ 0.7

19/304 SAE (6.2%)

  1. P prophylaxis, T therapeutic, Css steady-state concentrations, NA not available, SCR single-center retrospective, SCP single-center prospective, MCR multicenter retrospective, RCT randomized controlled trial, A adult, C children, HM hematological malignancy, AML acute myeloid leukemia, MDS myelodysplastic syndrome, HSCT hematopoietic stem cell transplantation, GVHD graft versus host disease, CGD chronic granulomatous disease, sus suspension, tab delayed-release tablet, inj injection
  2. a: concentration data gained on day 8
  3. b: data selected from the day 7 based on 50 samples
  4. c: data chosen from day 10
  5. d: the rate of the hepatotoxicity differs from different standards