Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan.
Department of Pharmacy, Osaka City University Hospital, Osaka, Japan.
Br J Clin Pharmacol. 2017 Sep;83(9):2000-2007. doi: 10.1111/bcp.13303. Epub 2017 May 24.
Small-scale clinical studies have reported on drug interactions between caspofungin (CPFG) and calcineurin inhibitors in healthy subjects; however, little is known about these interactions in allogeneic haematopoietic cell transplantation (allo-HCT) patients.
We retrospectively assessed the drug interactions and safety profiles in allo-HCT recipients treated concomitantly with CPFG and calcineurin inhibitors.
Ninety-one consecutive cases were evaluated. There were no statistically significant differences in the plasma concentration/dose (C/D) ratios of tacrolimus (TAC) in 34 patients before and after co-administration with CPFG (median: 575.6-672.4, P = 0.200). In contrast, the median C/D ratio of cyclosporin A (CsA) in 16 patients was significantly elevated after co-administration with CPFG (median: 62.8-74.9, P = 0.016). There were no serious adverse effects on liver or renal function associated with the therapy.
Our data show that CPFG did not affect the pharmacokinetics of TAC and that it could mildly increase CsA blood concentrations in allo-HCT patients.
小型临床研究已经报道了在健康受试者中卡泊芬净（CPFG）与钙调磷酸酶抑制剂之间的药物相互作用；然而，对于异基因造血细胞移植（allo-HCT）患者中的这些相互作用知之甚少。
我们回顾性评估了同时接受 CPFG 和钙调磷酸酶抑制剂治疗的 allo-HCT 受者的药物相互作用和安全性特征。
评估了 91 例连续病例。34 例患者在与 CPFG 联合使用前后，他克莫司（TAC）的血浆浓度/剂量（C/D）比值无统计学显著差异（中位数：575.6-672.4，P=0.200）。相比之下，16 例患者环孢素 A（CsA）的 C/D 比值在与 CPFG 联合使用后显著升高（中位数：62.8-74.9，P=0.016）。与治疗相关的肝肾功能无严重不良影响。
我们的数据表明 CPFG 不影响 TAC 的药代动力学，并且在 allo-HCT 患者中可能轻度增加 CsA 的血药浓度。
