A case report of voriconazole therapy failure in a homozygous ultrarapid CYP2C19*17/*17 patient comedicated with carbamazepine

摘要

Recently this journal published an article in which the authors examined by literature search the clinical implication of the ultrarapid CYP2C19* 17 variant allele. The authors concluded that the CYP2C19* 17 increased enzyme activity is unlikely to be clinically significant for voricona-zole. However, a comment to this article replied that in the case of voriconazole the variant allele CYP2C19* 17 certainly is clinically relevant and that data have shown that in subjects carrying a single CYP2C79*17allele,exposure may be reduced by up to 50 percent compared with normal metabo-lizers.The authors of the comment also mention that they are not aware of published studies of homozygous CVP2C79*17/*17 patients; and they assume that these subjects would display further reduced voriconazole exposure. In this case report we present a case of voriconazole therapy failure in a homozygous CYP2C19*17/*17 patient comedicated with carbamazepine.