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Meta-analysis of the safety of voriconazole in definitive, empirical, and prophylactic therapies for invasive fungal infections

Overview of attention for article published in BMC Infectious Diseases, December 2017
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Title
Meta-analysis of the safety of voriconazole in definitive, empirical, and prophylactic therapies for invasive fungal infections
Published in
BMC Infectious Diseases, December 2017
DOI 10.1186/s12879-017-2913-8
Pubmed ID
Authors

Yuanming Xing, Lu Chen, Yan Feng, Yan Zhou, Yajing Zhai, Jun Lu

Abstract

Voriconazole has been used in the treatment and prophylaxis of invasive fungal infections (IFIs) while its wide use was limited by some frequent adverse events, especially neurotoxicity, hepatotoxicity and even renal disruption. The aim of this study was to comprehensively compare voriconazole-induced toxicity, including tolerability, neurotoxicity, visual toxicity, hepatotoxicity and nephrotoxicity with the composite of other antifungals commonly used in clinic. Bibliography databases were searched to select randomized controlled trials providing information about the incidence of toxicity referred above. A total of 4122 patients from 16 studies were included in the meta-analysis. Analysis of individual types of toxicity showed that there was a significant difference between voriconazole and the composite of other antifungal agents. The primary outcome, the tolerability of voriconazole was slightly inferior (OR = 1.71, 95% CI = 1.21-2.40, P = 0.002) and it is noteworthy that the probabilities of neurotoxicity and visual toxicity were around twice higher and six-fold for voriconazole compared with the counterpart (OR = 1.99, 95% CI = 1.05-3.75, P = 0.03 and OR = 6.50, 95% CI = 2.93-14.41, P < 0.00001, respectively). Hepatotoxicity was more common in voriconazole group (OR = 1.60, 95% CI = 1.17-2.19, P = 0.003) whereas its pooled risk of nephrotoxicity was about half of the composite of other five antifungal agents (OR = 0.46, 95% CI = 0.26-0.84, P = 0.01). Our analysis has revealed differences in multiple types of toxicity induced by VRC versus other antifungals and quantified the corresponding pooled risks, which could provide an alternative for patients with a certain antifungal intolerance and help the clinician to select the optimal intervention.

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Mendeley readers

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The data shown below were compiled from readership statistics for 41 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 41 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 5 12%
Student > Bachelor 5 12%
Other 4 10%
Student > Postgraduate 4 10%
Student > Doctoral Student 3 7%
Other 8 20%
Unknown 12 29%
Readers by discipline Count As %
Medicine and Dentistry 14 34%
Pharmacology, Toxicology and Pharmaceutical Science 7 17%
Biochemistry, Genetics and Molecular Biology 3 7%
Nursing and Health Professions 2 5%
Immunology and Microbiology 1 2%
Other 2 5%
Unknown 12 29%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 02 January 2018.
All research outputs
#20,458,307
of 23,015,156 outputs
Outputs from BMC Infectious Diseases
#6,520
of 7,723 outputs
Outputs of similar age
#377,608
of 441,976 outputs
Outputs of similar age from BMC Infectious Diseases
#132
of 160 outputs
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