Identification of Risk Factors for Daptomycin-Associated Creatine Phosphokinase Elevation and Development of a Risk Prediction Model for Incidence Probability
Abstract Background In this study, we investigated the risk factors for daptomycin-associated creatine phosphokinase (CPK) elevation and established a risk score for CPK elevation. Methods Patients who received daptomycin at our hospital were classified into the non-elevated or elevated CPK group ba...
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| Veröffentlicht in: | Open Forum Infectious Diseases 2021-12, Vol.8 (12), p.ofab568-ofab568 |
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| creator | Samura, Masaru Hirose, Naoki Kurata, Takenori Takada, Keisuke Nagumo, Fumio Koshioka, Sakura Ishii, Junichi Uchida, Masaki Inoue, Junki Enoki, Yuki Taguchi, Kazuaki Higashita, Ryuji Kunika, Norifumi Tanikawa, Koji Matsumoto, Kazuaki |
| description | Abstract
Background
In this study, we investigated the risk factors for daptomycin-associated creatine phosphokinase (CPK) elevation and established a risk score for CPK elevation.
Methods
Patients who received daptomycin at our hospital were classified into the non-elevated or elevated CPK group based on their peak CPK levels during daptomycin therapy. Univariable and multivariable analyses were performed, and a risk score and prediction model for the incidence probability of CPK elevation were calculated based on logistic regression analysis.
Results
The non-elevated and elevated CPK groups included 181 and 17 patients, respectively. Logistic regression analysis revealed that concomitant statin use (odds ratio [OR], 4.45 [95% confidence interval {CI}, 1.40–14.47]; risk score 4), concomitant antihistamine use (OR, 5.66 [95% CI, 1.58–20.75]; risk score 4), and trough concentration (Cmin) between 20 and |
| doi_str_mv | 10.1093/ofid/ofab568 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8651170</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A775975150</galeid><oup_id>10.1093/ofid/ofab568</oup_id><sourcerecordid>A775975150</sourcerecordid><originalsourceid>FETCH-LOGICAL-c549t-ad8913d10ec72aa5c186e16e21f1dfb27aa0e5ec5543fec69d7ea1c7a5e052b23</originalsourceid><addsrcrecordid>eNp9kkFvFCEUgCdGY5vam2fDTQ9OhZllYC4mm22rm9TYGD2TN_DoYmdghNlN9s_4W2U7a1MvhgQIfO97j_CK4jWjF4y29YdgnckTdLyRz4rTqq5kKVsunj_ZnxTnKf2klDJGORXty-KkXkgpF7Q-LX6vDfrJWadhcsGTYMk3l-7JNegpxERsiOQSxikMe-18uUwpaAcTGrKKmEM8kttNSOMm3DsPCclVj7tZBd6QS9xhH8Yh5zioYZbfRjROP0BfgsH-Icvaa5dr0VkYQwed6920f1W8sNAnPD-uZ8WP66vvq8_lzddP69XyptR80U4lGNmy2jCKWlQAXDPZIGuwYpYZ21UCgCJHzfmitqib1ggEpgVwpLzqqvqs-Dh7x203oNG53gi9GqMbIO5VAKf-vfFuo-7CTsmGMyZoFrw7CmL4tcU0qcEljX0PHsM2qaqhkteNqGRGL2b0DnpUztuQjToPg4PTwaN1-XwpBG8FZ_zgfj8H6BhSimgf62JUHdpAHdpAHdsg42-evuUR_vvpGXg7A2E7_l_1B5Tgwbs</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2608536728</pqid></control><display><type>article</type><title>Identification of Risk Factors for Daptomycin-Associated Creatine Phosphokinase Elevation and Development of a Risk Prediction Model for Incidence Probability</title><source>DOAJ Directory of Open Access Journals</source><source>Oxford Journals Open Access Collection</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><creator>Samura, Masaru ; Hirose, Naoki ; Kurata, Takenori ; Takada, Keisuke ; Nagumo, Fumio ; Koshioka, Sakura ; Ishii, Junichi ; Uchida, Masaki ; Inoue, Junki ; Enoki, Yuki ; Taguchi, Kazuaki ; Higashita, Ryuji ; Kunika, Norifumi ; Tanikawa, Koji ; Matsumoto, Kazuaki</creator><creatorcontrib>Samura, Masaru ; Hirose, Naoki ; Kurata, Takenori ; Takada, Keisuke ; Nagumo, Fumio ; Koshioka, Sakura ; Ishii, Junichi ; Uchida, Masaki ; Inoue, Junki ; Enoki, Yuki ; Taguchi, Kazuaki ; Higashita, Ryuji ; Kunika, Norifumi ; Tanikawa, Koji ; Matsumoto, Kazuaki</creatorcontrib><description>Abstract
Background
In this study, we investigated the risk factors for daptomycin-associated creatine phosphokinase (CPK) elevation and established a risk score for CPK elevation.
Methods
Patients who received daptomycin at our hospital were classified into the non-elevated or elevated CPK group based on their peak CPK levels during daptomycin therapy. Univariable and multivariable analyses were performed, and a risk score and prediction model for the incidence probability of CPK elevation were calculated based on logistic regression analysis.
Results
The non-elevated and elevated CPK groups included 181 and 17 patients, respectively. Logistic regression analysis revealed that concomitant statin use (odds ratio [OR], 4.45 [95% confidence interval {CI}, 1.40–14.47]; risk score 4), concomitant antihistamine use (OR, 5.66 [95% CI, 1.58–20.75]; risk score 4), and trough concentration (Cmin) between 20 and <30 µg/mL (OR, 14.48 [95% CI, 2.90–87.13]; risk score 5) and ≥30.0 µg/mL (OR, 24.64 [95% CI, 3.21–204.53]; risk score 5) were risk factors for daptomycin-associated CPK elevation. The predicted incidence probabilities of CPK elevation were <10% (low risk), 10%–<25% (moderate risk), and ≥25% (high risk) with total risk scores of ≤4, 5–6, and ≥8, respectively. The risk prediction model exhibited a good fit (area under the receiver operating characteristic curve, 0.85 [95% CI, .74–.95]).
Conclusions
These results suggested that concomitant use of statins with antihistamines and Cmin ≥20 µg/mL were risk factors for daptomycin-associated CPK elevation. Our prediction model might aid in reducing the incidence of daptomycin-associated CPK elevation.</description><identifier>ISSN: 2328-8957</identifier><identifier>EISSN: 2328-8957</identifier><identifier>DOI: 10.1093/ofid/ofab568</identifier><identifier>PMID: 34888403</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><subject>Antihistamines ; Complications and side effects ; Creatine ; Creatine kinase ; Major ; Medical research ; Medicine, Experimental ; Methicillin ; Statins</subject><ispartof>Open Forum Infectious Diseases, 2021-12, Vol.8 (12), p.ofab568-ofab568</ispartof><rights>The Author(s) 2021. Published by Oxford University Press on behalf of Infectious Diseases Society of America. 2021</rights><rights>The Author(s) 2021. Published by Oxford University Press on behalf of Infectious Diseases Society of America.</rights><rights>COPYRIGHT 2021 Oxford University Press</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c549t-ad8913d10ec72aa5c186e16e21f1dfb27aa0e5ec5543fec69d7ea1c7a5e052b23</citedby><cites>FETCH-LOGICAL-c549t-ad8913d10ec72aa5c186e16e21f1dfb27aa0e5ec5543fec69d7ea1c7a5e052b23</cites><orcidid>0000-0002-3575-0448 ; 0000-0002-5934-0670</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8651170/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8651170/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,1604,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34888403$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Samura, Masaru</creatorcontrib><creatorcontrib>Hirose, Naoki</creatorcontrib><creatorcontrib>Kurata, Takenori</creatorcontrib><creatorcontrib>Takada, Keisuke</creatorcontrib><creatorcontrib>Nagumo, Fumio</creatorcontrib><creatorcontrib>Koshioka, Sakura</creatorcontrib><creatorcontrib>Ishii, Junichi</creatorcontrib><creatorcontrib>Uchida, Masaki</creatorcontrib><creatorcontrib>Inoue, Junki</creatorcontrib><creatorcontrib>Enoki, Yuki</creatorcontrib><creatorcontrib>Taguchi, Kazuaki</creatorcontrib><creatorcontrib>Higashita, Ryuji</creatorcontrib><creatorcontrib>Kunika, Norifumi</creatorcontrib><creatorcontrib>Tanikawa, Koji</creatorcontrib><creatorcontrib>Matsumoto, Kazuaki</creatorcontrib><title>Identification of Risk Factors for Daptomycin-Associated Creatine Phosphokinase Elevation and Development of a Risk Prediction Model for Incidence Probability</title><title>Open Forum Infectious Diseases</title><addtitle>Open Forum Infect Dis</addtitle><description>Abstract
Background
In this study, we investigated the risk factors for daptomycin-associated creatine phosphokinase (CPK) elevation and established a risk score for CPK elevation.
Methods
Patients who received daptomycin at our hospital were classified into the non-elevated or elevated CPK group based on their peak CPK levels during daptomycin therapy. Univariable and multivariable analyses were performed, and a risk score and prediction model for the incidence probability of CPK elevation were calculated based on logistic regression analysis.
Results
The non-elevated and elevated CPK groups included 181 and 17 patients, respectively. Logistic regression analysis revealed that concomitant statin use (odds ratio [OR], 4.45 [95% confidence interval {CI}, 1.40–14.47]; risk score 4), concomitant antihistamine use (OR, 5.66 [95% CI, 1.58–20.75]; risk score 4), and trough concentration (Cmin) between 20 and <30 µg/mL (OR, 14.48 [95% CI, 2.90–87.13]; risk score 5) and ≥30.0 µg/mL (OR, 24.64 [95% CI, 3.21–204.53]; risk score 5) were risk factors for daptomycin-associated CPK elevation. The predicted incidence probabilities of CPK elevation were <10% (low risk), 10%–<25% (moderate risk), and ≥25% (high risk) with total risk scores of ≤4, 5–6, and ≥8, respectively. The risk prediction model exhibited a good fit (area under the receiver operating characteristic curve, 0.85 [95% CI, .74–.95]).
Conclusions
These results suggested that concomitant use of statins with antihistamines and Cmin ≥20 µg/mL were risk factors for daptomycin-associated CPK elevation. Our prediction model might aid in reducing the incidence of daptomycin-associated CPK elevation.</description><subject>Antihistamines</subject><subject>Complications and side effects</subject><subject>Creatine</subject><subject>Creatine kinase</subject><subject>Major</subject><subject>Medical research</subject><subject>Medicine, Experimental</subject><subject>Methicillin</subject><subject>Statins</subject><issn>2328-8957</issn><issn>2328-8957</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>TOX</sourceid><recordid>eNp9kkFvFCEUgCdGY5vam2fDTQ9OhZllYC4mm22rm9TYGD2TN_DoYmdghNlN9s_4W2U7a1MvhgQIfO97j_CK4jWjF4y29YdgnckTdLyRz4rTqq5kKVsunj_ZnxTnKf2klDJGORXty-KkXkgpF7Q-LX6vDfrJWadhcsGTYMk3l-7JNegpxERsiOQSxikMe-18uUwpaAcTGrKKmEM8kttNSOMm3DsPCclVj7tZBd6QS9xhH8Yh5zioYZbfRjROP0BfgsH-Icvaa5dr0VkYQwed6920f1W8sNAnPD-uZ8WP66vvq8_lzddP69XyptR80U4lGNmy2jCKWlQAXDPZIGuwYpYZ21UCgCJHzfmitqib1ggEpgVwpLzqqvqs-Dh7x203oNG53gi9GqMbIO5VAKf-vfFuo-7CTsmGMyZoFrw7CmL4tcU0qcEljX0PHsM2qaqhkteNqGRGL2b0DnpUztuQjToPg4PTwaN1-XwpBG8FZ_zgfj8H6BhSimgf62JUHdpAHdpAHdsg42-evuUR_vvpGXg7A2E7_l_1B5Tgwbs</recordid><startdate>20211201</startdate><enddate>20211201</enddate><creator>Samura, Masaru</creator><creator>Hirose, Naoki</creator><creator>Kurata, Takenori</creator><creator>Takada, Keisuke</creator><creator>Nagumo, Fumio</creator><creator>Koshioka, Sakura</creator><creator>Ishii, Junichi</creator><creator>Uchida, Masaki</creator><creator>Inoue, Junki</creator><creator>Enoki, Yuki</creator><creator>Taguchi, Kazuaki</creator><creator>Higashita, Ryuji</creator><creator>Kunika, Norifumi</creator><creator>Tanikawa, Koji</creator><creator>Matsumoto, Kazuaki</creator><general>Oxford University Press</general><scope>TOX</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IAO</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-3575-0448</orcidid><orcidid>https://orcid.org/0000-0002-5934-0670</orcidid></search><sort><creationdate>20211201</creationdate><title>Identification of Risk Factors for Daptomycin-Associated Creatine Phosphokinase Elevation and Development of a Risk Prediction Model for Incidence Probability</title><author>Samura, Masaru ; Hirose, Naoki ; Kurata, Takenori ; Takada, Keisuke ; Nagumo, Fumio ; Koshioka, Sakura ; Ishii, Junichi ; Uchida, Masaki ; Inoue, Junki ; Enoki, Yuki ; Taguchi, Kazuaki ; Higashita, Ryuji ; Kunika, Norifumi ; Tanikawa, Koji ; Matsumoto, Kazuaki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c549t-ad8913d10ec72aa5c186e16e21f1dfb27aa0e5ec5543fec69d7ea1c7a5e052b23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Antihistamines</topic><topic>Complications and side effects</topic><topic>Creatine</topic><topic>Creatine kinase</topic><topic>Major</topic><topic>Medical research</topic><topic>Medicine, Experimental</topic><topic>Methicillin</topic><topic>Statins</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Samura, Masaru</creatorcontrib><creatorcontrib>Hirose, Naoki</creatorcontrib><creatorcontrib>Kurata, Takenori</creatorcontrib><creatorcontrib>Takada, Keisuke</creatorcontrib><creatorcontrib>Nagumo, Fumio</creatorcontrib><creatorcontrib>Koshioka, Sakura</creatorcontrib><creatorcontrib>Ishii, Junichi</creatorcontrib><creatorcontrib>Uchida, Masaki</creatorcontrib><creatorcontrib>Inoue, Junki</creatorcontrib><creatorcontrib>Enoki, Yuki</creatorcontrib><creatorcontrib>Taguchi, Kazuaki</creatorcontrib><creatorcontrib>Higashita, Ryuji</creatorcontrib><creatorcontrib>Kunika, Norifumi</creatorcontrib><creatorcontrib>Tanikawa, Koji</creatorcontrib><creatorcontrib>Matsumoto, Kazuaki</creatorcontrib><collection>Oxford Journals Open Access Collection</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale Academic OneFile</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Open Forum Infectious Diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Samura, Masaru</au><au>Hirose, Naoki</au><au>Kurata, Takenori</au><au>Takada, Keisuke</au><au>Nagumo, Fumio</au><au>Koshioka, Sakura</au><au>Ishii, Junichi</au><au>Uchida, Masaki</au><au>Inoue, Junki</au><au>Enoki, Yuki</au><au>Taguchi, Kazuaki</au><au>Higashita, Ryuji</au><au>Kunika, Norifumi</au><au>Tanikawa, Koji</au><au>Matsumoto, Kazuaki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Identification of Risk Factors for Daptomycin-Associated Creatine Phosphokinase Elevation and Development of a Risk Prediction Model for Incidence Probability</atitle><jtitle>Open Forum Infectious Diseases</jtitle><addtitle>Open Forum Infect Dis</addtitle><date>2021-12-01</date><risdate>2021</risdate><volume>8</volume><issue>12</issue><spage>ofab568</spage><epage>ofab568</epage><pages>ofab568-ofab568</pages><issn>2328-8957</issn><eissn>2328-8957</eissn><abstract>Abstract
Background
In this study, we investigated the risk factors for daptomycin-associated creatine phosphokinase (CPK) elevation and established a risk score for CPK elevation.
Methods
Patients who received daptomycin at our hospital were classified into the non-elevated or elevated CPK group based on their peak CPK levels during daptomycin therapy. Univariable and multivariable analyses were performed, and a risk score and prediction model for the incidence probability of CPK elevation were calculated based on logistic regression analysis.
Results
The non-elevated and elevated CPK groups included 181 and 17 patients, respectively. Logistic regression analysis revealed that concomitant statin use (odds ratio [OR], 4.45 [95% confidence interval {CI}, 1.40–14.47]; risk score 4), concomitant antihistamine use (OR, 5.66 [95% CI, 1.58–20.75]; risk score 4), and trough concentration (Cmin) between 20 and <30 µg/mL (OR, 14.48 [95% CI, 2.90–87.13]; risk score 5) and ≥30.0 µg/mL (OR, 24.64 [95% CI, 3.21–204.53]; risk score 5) were risk factors for daptomycin-associated CPK elevation. The predicted incidence probabilities of CPK elevation were <10% (low risk), 10%–<25% (moderate risk), and ≥25% (high risk) with total risk scores of ≤4, 5–6, and ≥8, respectively. The risk prediction model exhibited a good fit (area under the receiver operating characteristic curve, 0.85 [95% CI, .74–.95]).
Conclusions
These results suggested that concomitant use of statins with antihistamines and Cmin ≥20 µg/mL were risk factors for daptomycin-associated CPK elevation. Our prediction model might aid in reducing the incidence of daptomycin-associated CPK elevation.</abstract><cop>US</cop><pub>Oxford University Press</pub><pmid>34888403</pmid><doi>10.1093/ofid/ofab568</doi><orcidid>https://orcid.org/0000-0002-3575-0448</orcidid><orcidid>https://orcid.org/0000-0002-5934-0670</orcidid><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 2328-8957 |
| ispartof | Open Forum Infectious Diseases, 2021-12, Vol.8 (12), p.ofab568-ofab568 |
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| source | DOAJ Directory of Open Access Journals; Oxford Journals Open Access Collection; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Antihistamines Complications and side effects Creatine Creatine kinase Major Medical research Medicine, Experimental Methicillin Statins |
| title | Identification of Risk Factors for Daptomycin-Associated Creatine Phosphokinase Elevation and Development of a Risk Prediction Model for Incidence Probability |
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