艾沙康唑在特定情况下开展治疗药物监测的研究进展

Research progress on therapeutic drug monitoring of isavuconazole in specific situations

艾沙康唑是最新的三唑类广谱抗真菌药物,已被批准用于治疗成年人侵袭性曲霉病和毛霉病。艾沙康唑在国外上市初期,多项国际指南未推荐或弱推荐其进行常规治疗药物监测,而近期多项研究以及专家共识强调特定人群可结合临床需求对艾沙康唑进行药物监测。本文结合国内外真实世界研究对有必要进行艾沙康唑治疗药物监测的具体情况进行综述,包括肝功能不全、体重指数过高或过低、儿童、CYP3A5*1/*3基因型、多种药物治疗、长期用药、接受特殊治疗或给药方案的患者,以期为艾沙康唑的临床合理应用提供参考。

Isavuconazole is the latest triazole broad-spectrum antifungal drug that has been approved for the treatment of invasive aspergillosis and mucormycosis in adults.When isavuconazole was initially marketed abroad,many international guidelines did not recommend or weakly recommended it for routine therapeutic drug monitoring.However,a number of recent studies and expert consensus have emphasized that specific populations can be monitored for the use of isavuconazole based on clinical needs.Based on domestic and international real-world studies,this article provided a review of the specific situations leading to therapeutic drug monitoring of isavuconazole,including liver insufficiency,abnormal body mass index,children,CYP3A5*1/*3 genotypes,multi-drug therapy,long-term medication,and receiving special treatment or medication regimens,in order to provide reference for the clinical rational application of isavuconazole.