Isavuconazole for Treating Invasive Mould Disease in Solid Organ Transplant Recipients

Area of Science:

• Mycology
• Transplantation Medicine
• Infectious Diseases

Background:

• Solid organ transplant (SOT) recipients face an elevated risk of invasive mould diseases (IMD).
• Isavuconazole is a novel broad-spectrum azole with favorable pharmacokinetic properties and a good safety profile.
• It exhibits fewer drug-drug interactions with immunosuppressants compared to other azoles.

Purpose of the Study:

• To review the clinical experience of using isavuconazole for treating IMD in SOT recipients.
• To evaluate its efficacy, tolerability, and drug-drug interaction profile in this specific patient population.

Main Methods:

• Extensive literature review including SOTIS and ISASOT studies, and published case reports.
• Analysis of data from over 140 SOT recipients treated with isavuconazole for IMD.
• Focus on lung and kidney transplant recipients, primarily treated for Aspergillus infections.

Main Results:

• Isavuconazole was generally well-tolerated, with less than 10% of patients discontinuing treatment.
• Clinical responses were comparable to those observed in other high-risk populations.
• Drug-drug interactions with immunosuppressants like tacrolimus and mTOR inhibitors were manageable with dose adjustments.

Conclusions:

• Isavuconazole presents a reasonable therapeutic option for managing IMD in SOT recipients.
• Its favorable tolerability and manageable drug interaction profile support its use.
• Further clinical studies are recommended to solidify its role in SOT patient care.