Longitudinal changes in laboratory parameters and QTc during isavuconazole therapy in Japanese patients with

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Published on: April 5, 2011

Koichi Ohata1, Ryo Kobayashi1,2, Daichi Watanabe1

  • 1Department of Pharmacy, Gifu University Hospital, Gifu, Japan.

Plos One
|July 29, 2026
PubMed
Abstract

Insights

Isavuconazole (ISCZ) is a safe antifungal for Japanese patients with hematologic malignancies. It demonstrated a favorable safety profile, even when used with QT-prolonging therapies like arsenic trioxide.

Area of Science:

  • Pharmacology
  • Clinical Medicine
  • Infectious Diseases

Background:

  • Isavuconazole (ISCZ) is an azole antifungal known for low QTc prolongation risk and no need for renal dose adjustment.
  • Limited real-world data exists for ISCZ in Asian patient populations.

Purpose of the Study:

  • To evaluate the safety and efficacy of Isavuconazole (ISCZ) in Japanese patients with hematologic malignancies.
  • To assess the impact of ISCZ on QTc interval, particularly when co-administered with arsenic trioxide (ATO).

Main Methods:

  • Retrospective evaluation of 45 patients receiving ISCZ between April 2023 and March 2025.
  • Analysis of laboratory parameters and QTc values (QTcB/QTcF) using linear mixed-effects models.
  • Comparison of QTc trajectories in patients receiving ATO alone, ATO with ISCZ, and ATO with other antifungals.

Main Results:

  • Transient, grade ≥2 elevations in AST (11.1%) and ALT (13.3%) were observed, with no significant laboratory deterioration.
  • In the ATO subgroup, ISCZ was associated with lower QTc values compared to ATO alone (p < 0.001).
  • No clinically significant cardiac events were reported during the study period.

Conclusions:

  • Isavuconazole (ISCZ) exhibits a favorable safety profile in Japanese patients with hematologic malignancies.
  • ISCZ appears to be a safe therapeutic option, even during concurrent QT-prolonging treatments.

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