Personalized Dosing of Linezolid to Reduce the Risk of Thrombocytopenia: A Systematic Review and Meta-Analysis.

IF 2.4 4区医学 Q2 MEDICAL LABORATORY TECHNOLOGY Therapeutic Drug Monitoring Pub Date : 2025-01-23 DOI:10.1097/FTD.0000000000001300

Kazutaka Oda, Takeru Tsuruta, Yuki Hanai, Tomoyuki Yamada, Toshiaki Komatsu, Shoji Kondo, Hirofumi Jono, Hideyuki Saito

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Abstract

Background: Linezolid-induced thrombocytopenia (LIT) occurs in a dose-dependent manner. There is no consensus regarding personalized dosing of linezolid in the real world. This study investigated the usefulness of personalized dosing for the potential mitigation of LIT compared with standard dosing.

Methods: A systematic review and meta-analysis were performed using 4 medical electronic databases. Inclusion criteria were original research articles published up to October 23, 2023, whereas nonoriginal articles were excluded. Eligible participants included adults who were administered linezolid. A random-effects model was used to synthesize the results.

Results: Four studies were eligible for inclusion. There were 208 patients in the personalized dosing (intervention) group and 195 patients in the standard dosing (comparison) group. The odds ratio for the intervention was 0.648 (95% confidence interval: 0.150-2.797), although significant heterogeneity was observed ( I2 = 83.3%). An ad hoc analysis was performed by excluding one study with a significant bias risk in the treatment duration. The odds ratio for the intervention in the ad hoc analysis was 0.356 (95% confidence interval: 0.179-0.708) with little heterogeneity, showing a lower incidence risk of LIT.

Conclusions: Personalized dosing in linezolid therapy may mitigate the risk of LIT.

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利奈唑胺个体化剂量降低血小板减少风险：系统回顾和荟萃分析。

背景：利奈唑胺诱导的血小板减少症（LIT）以剂量依赖的方式发生。在现实世界中，关于利奈唑胺的个体化剂量尚无共识。本研究调查了与标准给药相比，个性化给药对潜在的LIT缓解的有用性。方法：采用4个医学电子数据库进行系统综述和meta分析。纳入标准为2023年10月23日前发表的原创研究文章，非原创文章排除在外。符合条件的参与者包括使用利奈唑胺的成年人。采用随机效应模型对结果进行综合。结果：4项研究符合纳入条件。个体化给药（干预）组208例，标准给药（比较）组195例。干预的优势比为0.648(95%可信区间：0.150-2.797)，但存在显著异质性（I2 = 83.3%）。通过排除一项在治疗期间存在显著偏倚风险的研究，进行了一项特别分析。在特别分析中，干预的优势比为0.356(95%可信区间：0.179-0.708)，异质性较小，表明利奈唑胺治疗的个体化剂量可以降低LIT的发生风险。

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来源期刊

Therapeutic Drug Monitoring 医学-毒理学

CiteScore

5.00

自引率

8.00%

发文量

213

审稿时长

4-8 weeks

期刊介绍： Therapeutic Drug Monitoring is a peer-reviewed, multidisciplinary journal directed to an audience of pharmacologists, clinical chemists, laboratorians, pharmacists, drug researchers and toxicologists. It fosters the exchange of knowledge among the various disciplines–clinical pharmacology, pathology, toxicology, analytical chemistry–that share a common interest in Therapeutic Drug Monitoring. The journal presents studies detailing the various factors that affect the rate and extent drugs are absorbed, metabolized, and excreted. Regular features include review articles on specific classes of drugs, original articles, case reports, technical notes, and continuing education articles.