Bilirubin-Guided Voriconazole Dosing Improves Target Attainment in Liver Dysfunction
This observational validation study suggests a total bilirubin-stratified initial voriconazole regimen nearly doubles first-trough target attainment and halves toxicity versus routine dosing in hepatic impairment.
Optimized voriconazole dosing enhances outcomes in liver dysfunction.
Managing dosing for voriconazole in patients with liver dysfunction can be challenging due to altered drug metabolism, affecting safety and therapeutic outcomes. The VALID regimen achieved higher target trough concentrations (89.7% vs. 48.7%, P < 0.001) and fewer adverse events (15.4% vs. 38.5%, P = 0.022) compared to routine dosing. The study suggests the VALID regimen could optimize voriconazole therapy in liver dysfunction, but its findings are preliminary and need further validation. VALID voriconazole dosing shows promise in liver dysfunction, improving target attainment and reducing adverse events.
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Authors:Li J, Zhao Y, Liu H, Zhang Y, Ma J, Jiang Y, Zhao J, Zhang B, Yan M
Citation:Li J, Zhao Y, Liu H, et al. VALID regimen of voriconazole optimizes therapeutic target attainment and minimizes adverse events in patients with liver dysfunction. Frontiers in pharmacology. 2026;17:1895947. doi:10.3389/fphar.2026.1895947
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Executive Summary
Study Design
Patient Population
Primary Outcomes
Secondary Outcomes & Safety Profile
Pharmacist Implications
Clinical Pearls
Limitations
Controversies & Evidence Gaps
Cost & Logistics
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