在肺移植接受者中使用伊萨武可纳的经验,在呼吸道样本中与阿斯伯吉勒斯菌隔离:一个多中心的观察性研究
Jose Tiago Silva1,2, Francisco López-Medrano1,2, Alicia de Pablo3
1Unit of Infectious Diseases, University Hospital "12 de Octubre," Instituto de Investigación Hospital "12 de Octubre" (imas12), School of Medicine, Universidad Complutense, Madrid, Spain.
伊萨夫可纳 (ISA) 是安全有效的治疗肺移植接受者 (LuTRs) 侵袭性阿斯伯吉勒斯综合征. 这项研究表明,在接受ISA的LuTR中,具有良好的临床,真菌学和放射学反应,并具有较低的不良事件.
科学领域:
- 医学真菌学 医学真菌学
- 传染性疾病 传染性疾病
- 移植医学 移植医学
背景情况:
- 阿斯珀吉勒斯是一种危险的机会性病原体,在肺移植接受者 (LuTRs).
- 伊萨夫可纳 (ISA) 是一种具有良好的安全性特征的宽谱三醇抗真菌药物.
- 关于ISA在LuTRs中的使用,临床数据有限.
研究的目的:
- 评估Isavuconazole (ISA) 在肺移植接受者 (LuTRs) 的安全性和有效性.
- 评估ISA在治疗侵入性肺阿斯伯吉洛症 (IPA),气管支气管阿斯伯吉洛症 (TBA) 和LuTRs的预防性治疗中的作用.
主要方法:
- 从2019年6月到2024年6月,在西班牙5个中心进行了一项宏观的观察研究.
- 包括成年LuTRs与阿斯伯吉勒斯种类. 隔离和ISA治疗的指示.
- 安全结果包括治疗出现的不良事件 (trAEs) 和塔克罗利斯剂量调整. 有效性结果评估了临床,真菌学和放射学反应.
主要成果:
- 50名LuTR接受ISA治疗,IPA,TBA或预防性治疗的中位数为101天.
- 任何trAE的发病率为24.0%,其中10.0%需要提前停止治疗.
- 在66.7%,84.2%和64.3%的可评估患者中,分别观察到临床,真菌学和放射学反应. 由于阿斯伯吉洛症而导致的死亡率为12.0%.
结论:
- 伊萨夫可纳 (ISA) 在肺移植接受者 (LuTRs) 中表现出良好的耐受性.
- 在这种LuTR群体中,ISA在治疗侵袭性阿斯伯吉路斯综合征方面被证明是有效的.
- 这些发现支持ISA作为阿斯伯吉勒斯感染肺移植后可行的治疗选择.
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