Busca Alessandro, Lessi Federica, Verga Luisa, Candoni Anna, Cattaneo Chiara, Cesaro Simone, Dragonetti Giulia, Delia Mario, De Luca Alessio, Guglielmi Gaspare, Tumbarello Mario, Martino Giordana, Nadali Gianpaolo, Fanci Rosa, Picardi Marco, Potenza Leonardo, Nosari Annamaria, Aversa Franco, Pagano Livio
a A.O.U Citta' della Salute e della Scienza , Torino , Italy.
b Ematologia ed Immunologia Clinica, Azienda Ospedaliera di Padova , Italy.
Leuk Lymphoma. 2017 Dec;58(12):2859-2864. doi: 10.1080/10428194.2017.1318438. Epub 2017 May 16.
Posaconazole demonstrated clinical superiority over fluconazole and itraconazole for prophylaxis of mold infections, although concerns exist regarding the high acquisition cost for posaconazole. In this respect, we sought to analyze the costs of antifungal prophylaxis in patients with acute myeloid leukemia (AML) who received prophylactic posaconazole (n = 510, 58%), itraconazole (n = 120, 14%) or fluconazole (n = 175, 20%) during induction chemotherapy. The estimated cost of antifungal prophylaxis as well as the costs of subsequent systemic antifungal therapy for treatening an invasive fungal infections (IFI) was higher in the posaconazole group compared to itraconazole and fluconazole groups. Based on the Monte Carlo simulations, the itraconazole group had the highest cost, followed by the posaconazole and fluconazole group, although the overall survival was higher in the posaconazole group as compared to the other groups. In conclusion, the cost of prophylaxis with posaconazole in AML patients compares favorably with conventional antifungal agents.
泊沙康唑在预防霉菌感染方面显示出比氟康唑和伊曲康唑更具临床优势，尽管人们对泊沙康唑的高购置成本存在担忧。在这方面，我们试图分析急性髓系白血病（AML）患者在诱导化疗期间接受预防性泊沙康唑（n = 510，58%）、伊曲康唑（n = 120，14%）或氟康唑（n = 175，20%）治疗时的抗真菌预防成本。与伊曲康唑和氟康唑组相比，泊沙康唑组的抗真菌预防估计成本以及后续用于治疗侵袭性真菌感染（IFI）的全身抗真菌治疗成本更高。基于蒙特卡洛模拟，伊曲康唑组成本最高，其次是泊沙康唑组和氟康唑组，尽管泊沙康唑组的总生存率高于其他组。总之，AML患者使用泊沙康唑进行预防的成本与传统抗真菌药物相比具有优势。
