艾沙康唑临床应用专家共识(2023版)  

Consensus recommendations for the clinical application of isavuconazole(2023)

作　　者：中华医学会血液学分会抗感染学组 陈欣 林韧[3] 冯四洲 刘启发[3] Anti Infection Group,Chinese Society of Hematology,Chinese Medical Association;FENG Sizhou;LIU Qifa(不详;Blood Diseases Hospital,Chinese Academy of Medical Sciences,Tianjin,300020,China;Department of Hematology,Nanfang Hospital,Southern Medical University,Guangzhou,510515,China)

机构地区：[1]不详 [2]中国医学科学院血液病医院,天津300020 [3]南方医科大学南方医院血液科,广州510515

出　　处：《临床血液学杂志》2023年第5期295-302,共8页Journal of Clinical Hematology

摘　　要：随着免疫抑制患者数量的增加,侵袭性霉菌感染的发病率也呈上升趋势,且患者常伴随高死亡率和临床预后不佳。艾沙康唑是权威指南推荐治疗侵袭性曲霉病和侵袭性毛霉病的一线药物,并兼顾较好的耐受性,同时具有线性药代动力学特性和与免疫抑制剂更小的药物相互作用,为长期接受免疫抑制剂治疗的患者提供了较稳定的药物浓度。Ⅲ期临床试验和病例对照研究分别证实艾沙康唑具有与伏立康唑治疗侵袭性曲霉病及两性霉素B治疗侵袭性毛霉病相似的临床疗效,并具有较好的安全性。临床研究同时也证实其在侵袭性真菌病高危人群的预防和侵袭性念珠菌病的序贯治疗中具有潜在的应用价值。本共识综合已发表的临床研究和药代动力学/药效学数据,对该药物在临床应用中的15个常见问题给予建议。With a growing population of immunocompromised hosts,incidence of invasive mold infection is increasing,leading to a high mortality and poor clinical outcomes.Isavuconazole is the first-line drug recommended for the treatment of invasive aspergillosis(IA)and invasive mucormycosis(IM),along with its linear pharmacokinetic properties and less drug interaction with immunosuppressive agents,providing a more stable drug concentration for patients receiving long-term immunosuppressants.A phaseⅢtrial and a case-control study demonstrated that isavuconazole showed similar clinical efficacy to voriconazole(IA treatment)and amphotericin B(IM treatment),respectively.Clinical studies have also confirmed its potential value in invasive fungal disease prophylactic treatment and oral sequential therapy of invasive candidiasis.This consensus synthesizes published clinical studies and pharmacokinetic/pharmacodynamic data to give recommendations for 15 common questions of the drug in clinical practice.

关 键 词：侵袭性真菌病 免疫抑制宿主 侵袭性霉菌感染 曲霉病 毛霉病 艾沙康唑 

分 类 号：R978.5[医药卫生—药品]