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Hepatotoxicity: 3 case reports In a single-centre, retrospective analysis involving 513 patients who had haematologic malignancy (high-risk) and who had received prophylaxis with posaconazole between June 2016 and December 2017 at a hospital in South Korea, three patients [ages and sexes not stated] were described, who developed hepatotoxicity secondary to posaconazole. Two of these patients had received atorvastatin and cytarabine (1 patient each) along with posaconazole, which might also have contributed to the development of hepatotoxicity. All the 3 patients, who had haematologic malignancy (high-risk), started receiving prophylactic therapy with posaconazole delayed-release tablets at a loading dose of 300mg twice a day on the first day, followed by maintenance doses of 300mg once a day, thereafter. One of these patients had also been receiving cytarabine; while another patient had also been receiving atorvastatin [routes not stated; not all dosages and indications stated]. All the 3 patients subsequently developed grade 3 hepatotoxicity [durations of treatments to reactions onsets not stated]. The patient, who had been receiving posaconazole and atorvastatin, required discontinuation of posaconazole therapy. However, this patient’s liver enzyme levels remained elevated for 10 days following discontinuation of posaconazole. The development of grade 3 hepatotoxicity in this patient was attributed to both the drugs (i.e. posaconazole and atorvastatin). The two remaining patients, who had been receiving posaconazole (1 patient) and posaconazole and cytarabine (1 patient), subsequently exhibited normalisation of their liver enzyme levels in spite of continuing posaconazole therapy. The development of grade 3 hepatotoxicity in these 2 patients was attributed to the treatment with posaconazole (1 patient) and to posaconazole and cytarabine (1 patient), respectively. Chae H, et al. Evaluation of posaconazole plasma concentrations achieved with the delayed-release tablets in Korean high-risk patients with haematologic malignancy. 803506596 Mycoses 63: 131-138, No. 2, Feb 2020. Available from: URL: http://doi.org/10.1111/myc.13031

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Reactions 17 Oct 2020 No. 1826