Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Waller, M.
Isavuconazole Treatment in a Mixed Patient Cohort with Invasive Fungal Infections: Outcome, Tolerability and Clinical Implications of Isavuconazole Plasma Concentrations
Humanmedizin; [ Diplomarbeit ] Graz Medical University; 2021. pp. 64
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Krause Robert
- Zurl Christoph Johann
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- Abstract:
- Background Isavuconazole (ISA) is a broadspectrum triazole antifungal agent with a favorable pharmacokinetic profile indicated for use in patients with invasive aspergillosis (IA) or mucormycosis. Previous studies have indicated that therapeutic drug monitoring (TDM) might not be necessary in daily clinical practice but supporting data in real-life use is scarce. The objective of this study was to evaluate ISA levels in a real world setting in a mixed patient cohort and to correlate findings with efficacy and safety outcomes. Methods A study group of the Medical University of Graz evaluated ISA serum levels in a mixed patient cohort undergoing ISA treatment. The investigation included 33 ISA treatment courses in 32 adult patients with hematological and other underlying diseases and assessed the clinical response, side effects, and ISA trough plasma concentrations. Results Complete response or partial treatment response was found in 87% of the patients, and ISA was generally well tolerated. The median ISA plasma concentration was 3.05μg/ml (IQR 1.93-4.35) in patients without renal replacement therapy (RRT) or extracorporeal membrane oxygenation (ECMO) and significantly lower in patients with RRT, including cases with additional ECMO or Cytosorb adsorber therapy (0.88μg/ml, IQR 0.71-1.21). Conclusion In addition to previous recommendations, we propose to monitor ISA plasma concentrations in special patient groups, including RRT, other extracorporeal treatments, and obesity.