Department of Haematology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
J Antimicrob Chemother. 2012 Mar;67(3):519-20. doi: 10.1093/jac/dkr540. Epub 2011 Dec 20.
Mucormycosis can be devastating and, as yet, there are no ideal therapies available. Observations that iron chelation may be a useful adjunct to antifungal treatment encouraged Spellberg et al. (J Antimicrob Chemother 2012; 715-22) to undertake a trial of deferasirox combined with liposomal amphotericin B (AmBisome(®)) as short-term therapy for mucormycosis. The results were disappointing as patients treated with deferasirox had a higher mortality rate at 90 days, leading the authors to conclude that the data did not support a role for initial, adjunctive deferasirox therapy for mucormycosis. We review the issues arising from this study to help decide whether the evidence that now exists supports further studies or represents the end of this line of enquiry.
毛霉病可能是毁灭性的，而且目前尚无理想的治疗方法。铁螯合可能是抗真菌治疗的有用辅助手段的观察结果，促使 Spellberg 等人（J Antimicrob Chemother 2012; 715-22）进行了一项临床试验，即在短期治疗毛霉病时联合使用地拉罗司和脂质体两性霉素 B（AmBisome®）。结果令人失望，因为接受地拉罗司治疗的患者在 90 天时死亡率更高，这使得作者得出结论，数据不支持毛霉病初始辅助性地拉罗司治疗的作用。我们回顾了这项研究中出现的问题，以帮助确定现有证据是否支持进一步的研究，或者是否代表这一研究方向的结束。
