Publication: Journal of Infection and Chemotherapy
Abstract
Voriconazole dosing must be adjusted for liver dysfunction, but existing methods for assessing liver function in this context are not always practical. This study analyzed 126 plasma samples from 16 patients with liver dysfunction to develop a population pharmacokinetic model incorporating the albumin-bilirubin (ALBI) score, a liver function measure based only on albumin and bilirubin, using Phoenix NLME software. Incorporating the ALBI score into the model significantly improved its fit to clearance data, and Monte Carlo simulations indicated that maintenance doses should decrease progressively as ALBI scores worsen, from 100 mg twice daily down to below 50 mg twice daily. This is the first voriconazole population pharmacokinetic model to incorporate the ALBI score, offering a practical, objective tool for dose optimization in patients with liver dysfunction.
Author(s): Nashimoto S, Sugawara M, Takekuma Y.
Published: July 2, 2025
Phoenix NLME: Modeling Around Liver Function
Phoenix NLME incorporated a simple liver-function score directly into this voriconazole population model, translating it into practical, ALBI-based dose recommendations. Phoenix NLME is the engine behind population PK/PD modeling, combining the flexibility of code with the ease of a guided interface, part of a Phoenix platform built on more than 30 years of PK/PD expertise.
