Service d'Hématologie Clinique, Centre d'Investigation Clinique en Cancérologie (CI2C), Centre Hospitalier et Universitaire (CHU) de Nantes, CHU Hotel-Dieu, Nante, France
Unité de pharmacie clinique oncologique, Centre Hospitalier Universitaire de Nantes, CHU Hotel-Dieu, Nantes, France.
Antimicrob Agents Chemother. 2018 Jan 25;62(2). doi: 10.1128/AAC.01746-17. Print 2018 Feb.
Posaconazole is an antifungal drug used in both prophylaxis and treatment of invasive fungal infections. Its oral formulation requires therapeutic drug monitoring. To overcome gastric acidity, a gastro-resistant posaconazole tablet has recently been developed. POSANANTES was a prospective noninterventional study that aimed to monitor plasma concentration trough level () of posaconazole tablets used prophylactically in patients with hematological malignancies. Fifty patients were included. Group A ( = 31) included patients receiving induction chemotherapy for myeloid malignancies, and group B ( = 19) included patients treated for graft-versus-host disease after allogeneic hematopoietic stem cells transplantation. In multivariate analysis, female sex, group B assignment, and evaluation of at day 8 (versus any other day planned by the analysis) were associated with a higher , while diarrhea was associated with a lower ( < 0.05). Thirty-four percent ( = 17) of all included patients had to prematurely stop treatment, mainly in group A. In conclusion, this real-life prospective study showed good absorption of posaconazole tablets used for prophylaxis in patients with hematological malignancies, even though this strategy was somewhat limited due to the high number of patients in group A who had to stop their treatment in an untimely fashion.
泊沙康唑是一种抗真菌药物,用于预防和治疗侵袭性真菌感染。其口服制剂需要治疗药物监测。为了克服胃酸,最近开发了一种胃耐受力的泊沙康唑片剂。POSANANTES 是一项前瞻性非干预性研究,旨在监测用于血液恶性肿瘤患者预防的泊沙康唑片剂的血药浓度谷值()。共纳入 50 例患者。A 组(n=31)包括接受髓系恶性肿瘤诱导化疗的患者,B 组(n=19)包括接受异基因造血干细胞移植后移植物抗宿主病治疗的患者。多变量分析显示,女性、B 组分配和第 8 天(与分析计划的任何其他日期相比)评估与较高的 相关,而腹泻与较低的 相关(<0.05)。所有纳入患者中有 34%(n=17)不得不提前停止治疗,主要发生在 A 组。总之,这项真实世界的前瞻性研究表明,泊沙康唑片剂用于预防血液恶性肿瘤患者的吸收良好,尽管由于 A 组中许多患者不得不提前不恰当地停止治疗,这种策略受到一定限制。