Paxlovid对实体器官移植患者伏立康唑血药浓度的影响

Effect of paxlovid on blood concentration of voriconazole in patients with solid organ transplantation

目的 探讨奈玛特韦片/利托那韦片组合包装(Paxlovid)与伏立康唑联用对伏立康唑血药谷浓度的影响。方法 回顾性分析3例中日友好医院实体器官移植受者感染COVID-19后Paxlovid与伏立康唑联合治疗期间进行伏立康唑血药谷浓度监测的情况,对患者的基本情况及伏立康唑血药谷浓度监测情况进行分析。结果 联合应用paxlovid与伏立康唑时,2例患者伏立康唑的血药谷浓度能够达到目标范围(1~5.5μg/ml),1例患者通过对伏立康唑的血药谷浓度监测,及时调整伏立康唑的剂量,也能够使伏立康唑血药谷浓度调整到目标浓度范围内。3例患者均未发生伏立康唑暴露量显著降低的情况。结论 Paxlovid与伏立康唑联合应用的收益大于风险时,可在监测伏立康唑血药谷浓度的基础上,进行Paxlovid与伏立康唑的短期联合治疗。

Objective To investigate the effect of nematavir/ritonavir tablet combination package(paxlovid)in combination with voriconazole on voriconazole blood trough concentrations.Methods Retrospective analysis was performed in three patients who underwent voriconazole blood trough concentration monitoring during combination therapy with paxlovid and voriconazole after COVID-19 infection in solid organ transplant recipients at China-Japan Friendship Hospital.The general condition of the patients and the monitoring of voriconazole blood trough concentrations were collected and analyzed.Results In two patients,voriconazole blood trough concentrations were directly within the target range(1~5.5μg/ml)when paxlovid and voriconazole were used together,and in one patient,voriconazole blood trough concentrations were adjusted to the target range by monitoring voriconazole blood trough concentrations and adjusting the voriconazole dose in a timely manner;no significant decrease in voriconazole exposure occurred in any of the three patients.Conclusion Short-term combination therapy of paxlovid with voriconazole can be performed with the help of voriconazole blood trough concentration monitoring when the benefits of paxlovid in combination with voriconazole outweigh the risks.