232 Voriconazole metabolism is associated with the number of skin cancers per patient

Abstract

Voriconazole is an antifungal medication often used in organ transplant recipients. Despite its widespread use, it is associated with an increased risk of skin cancer that is thought to be due to its primary metabolite voriconazole N-oxide (VNO), however it is unclear how this impacts the total number of skin cancers a patient will develop. We hypothesized that patients who metabolize voriconazole more rapidly would accumulate more VNO and develop an increased number of skin cancers. Using Vanderbilt’s Synthetic Derivative database, a de-identified mirror image of its electronic health record, we identified 1,778 self-reported white organ transplant recipients with known metabolizer phenotypes for CYP2C19, voriconazole’s primary metabolizer.