艾沙康唑与伏立康唑作为口服序贯治疗恶性血液病患者侵袭性曲霉菌病的疗效及安全性比较

The comparison of isavuconazole and voriconazole as oral sequential therapy for invasive aspergillosis in patients with hematological malignancies

目的:探究并分析比较口服艾沙康唑胶囊与伏立康唑片剂在血液病患者抗真菌口服序贯治疗的疗效及安全性。方法:回顾性分析中国医学科学院血液病医院干细胞移植中心2019年11月至2023年1月诊断为侵袭性曲霉菌病,并应用伏立康唑针剂抗真菌治疗的患者共45例。其中22例患者应用伏立康唑片口服序贯治疗,23例患者应用艾沙康唑胶囊口服序贯治疗。结果:艾沙康唑组中仅1例患者评价治疗无效,其余22例治疗有反应的患者中17例评估为完全缓解,治疗缓解率为95.65%(22/23),完全缓解率为73.91%(17/23)。伏立康唑治组的治疗缓解率为86.36%(19/22),完全缓解率为50.00%(11/22)。2组患者在治疗缓解率上差异无统计学意义,且2组患者服药期间耐受性良好。结论:应用伏立康唑针剂静脉抗真菌治疗后应用艾沙康唑胶囊口服序贯与伏立康唑片口服序贯治疗相比疗效相当,且安全性良好。

Objective To investigate and analyze the efficacy and safety of oral isavuconazole and voriconazole as oral sequential therapy for invasive aspergillosis in patients with hematological diseases.Methods The clinical data of 45 patients diagnosed as invasive aspergillosis and treated with voriconazole intravenously in the stem cell transplantation center of Hematology Hospital of Chinese Academy of Medical Sciences from November 2019 to January 2023 were retrospectively analyzed.Among them,22 patients were treated with oral sequential therapy of voriconazole tablets and 23 patients were treated with oral sequential therapy of isavuconazole capsules.Results Only 1 patient in the isavuconazole group was evaluated as ineffective,and 17 of the remaining 22 patients who responded to treatment were evaluated as complete remission.The overall remission rate was 95.65%(22/23),and the complete remission rate was 73.91%(17/23).The overall remission rate of voriconazole treatment group was 86.36%(19/22),and the complete remission rate was 50.00%(11/22).There was no significant difference in the remission rate between the two groups.Additionally,patients in both groups were well tolerated.Conclusion Isavuconazole has similar efficacy and good safety as oral sequential therapy compared to voriconazole tablets for invasive aspergillosis in patients with hematological diseases.