泊沙康唑与伏立康唑预防异基因造血干细胞移植后侵袭性真菌感染的疗效和安全性

Efficacy and safety study of posaconazole and voriconazole for the prevention of invasive fungal infections after allogeneic hematopoietic stem cell transplantation

目的比较泊沙康唑与伏立康唑预防异基因造血干细胞移植(allo-HSCT)后侵袭性真菌感染(IFI)的疗效及安全性差异。方法回顾性分析2019年6月-2021年6月于我院行allo-HSCT且应用泊沙康唑或伏立康唑进行真菌预防的104例患者(泊沙康唑组54例,伏立康唑组50例),对比两组移植后180 d内IFI发生率、药物不良反应发生率等相关指标。结果泊沙康唑组和伏立康唑组IFI发生率分别为7.4%(4例)和20.0%(10例),差异无统计学意义(P=0.085);在IFI高危风险的患者中,两组IFI发生率为10.0%(3例)和34.9%(9例),差异有统计学意义(P=0.047);两组药物不良反应发生率为7.4%(4例)和18.0%(9例),差异无统计学意义(P=0.091)。结论泊沙康唑较伏立康唑可进一步降低allo-HSCT后高危风险患者的IFI发生率,且未增加药物相关不良反应发生率。

Objective To compare the clinical efficacy and safety differences between posaconazole and voriconazole for the prevention of fungal infections after allogeneic hematopoietic stem cell transplantation(allo⁃HSCT).Methods Retrospective analysis of 104 patients(54 in the posaconazole group and 50 in the voricon⁃azole group)who underwent allo⁃HSCT and applied posaconazole or voriconazole for fungal prophylaxis at our hospital from June 2019 to June 2021,comparing the incidence of IFI,the incidence of adverse drug reactions and other related indicators within 180 days after transplantation between the two groups.Results The incidence of IFI in the posaconazole and voriconazole groups was 7.4%(4 cases)and 20.0%(10 cases),respectively,with no statistical difference(P=0.085);in patients at high risk of IFI,the incidence of IFI in the two groups was 10.0%(3 cases)and 34.9%(9 cases),with a statistical difference(P=0.047);the incidence of adverse drug reactions in the two groups was 7.4%(4 cases)and 18.0%(9 cases),with no statistical difference(P=0.091).Conclusion Compared with voriconazole,posaconazole can further reduce the incidence of IFD in high⁃risk patients after trans⁃plantation without increasing the incidence of drug⁃related adverse reactions.