三唑类抗真菌药物对再生障碍性贫血患者血浆浓度和环孢素用量的影响

IF 2.1 4区 医学 Q3 PHARMACOLOGY & PHARMACY Journal of Clinical Pharmacy and Therapeutics Pub Date : 2024-02-27 DOI:10.1155/2024/6850289
Yangxiu Tian, Yan Song, Yanan Qiao, Li Song, Qiang Zhao, Donghong Yin, Shuyun Wang, Ruigang Hou
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引用次数: 0

摘要

研究目的本研究旨在探讨不同三唑类抗真菌药物对再生障碍性贫血(AA)患者环孢素(CsA)血药浓度和用量的影响。研究方法这项回顾性研究招募了2018年1月至2022年12月期间同时接受CsA和三唑类抗真菌药物治疗的AA患者。比较了CsA血药浓度(纳克/毫升)与剂量(毫克/天)(C/D)合用与不合用唑类药物的比例。分析了不同三唑类抗真菌药物对 CsA 血液浓度和剂量的影响。结果显示与泊沙康唑(POS)合用时,CsA的平均C/D比值增加了1.97倍;与氟康唑(FCZ)合用时,CsA的平均C/D比值增加了1.76倍。与 CsA 单药治疗相比,使用唑类药物的患者 CsA 浓度有显著差异(P<0.05)。与 POS 和 FCZ 联合用药时,CsA 的平均剂量分别为 0.26(-0.25-1.05)毫克/千克/天和 0.18(-0.50-0.69)毫克/千克/天。唑类药物与 CsA 之间的药物相互作用程度存在很大的个体差异。结论虽然唑类药物会增加 CsA 的浓度,但在 CsA C/D 比值的患者中发现个体差异很大。因此,应通过密切监测与三唑类抗真菌药物合用的 CsA 的血药浓度来调整 CsA 的剂量。此外,我们观察到 POS 对 CsA 血液浓度的影响比 FCZ 更大。在临床实践中调整 CsA 的剂量时,应考虑 CsA 的血药浓度和合用三唑类抗真菌药物的类型。
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Effects of Triazole Antifungal Agents on the Plasma Concentration and Dosage of Cyclosporin in Patients with Aplastic Anaemia

Objectives. This study aimed to investigate the effects of different triazole antifungal agents on the blood concentration and dosage of cyclosporine (CsA) in patients with aplastic anaemia (AA). Methods. This retrospective study enrolled AA patients who received CsA and triazole antifungal agents simultaneously between January 2018 and December 2022. The ratio of CsA blood concentration (ng/mL) to dosage (mg/day) (C/D) co-administration with and without azoles was compared. The effects of different triazole antifungal agents on blood concentrations and dosages of CsA were analysed. Results. The mean C/D ratio of CsA increased 1.97 times when co-administered with posaconazole (POS), while the mean C/D ratio of CsA increased 1.76 times when co-administered with fluconazole (FCZ). Compared with CsA monotherapy, there was a significant difference in CsA concentrations among patients with azoles (P < 0.05). The mean dose of CsA decreased was 0.26 (−0.25—1.05) mg/kg/day and 0.18 (−0.50—0.69) mg/kg/day when co-administered with POS and FCZ, respectively. There is a wide interindividual variability in the magnitude of drug interaction between azoles and CsA. Conclusions. Although azoles increased CsA concentration, a wide individual variability was found in the patients with CsA C/D ratio. Therefore, the CsA dose should be adjusted by closely monitoring the blood levels of CsA co-administered with triazole antifungal agents. In addition, we observed that POS had a greater effect on the blood concentration of CsA than FCZ. When adjusting the dose of CsA in clinical practice, the blood concentration of CsA and the type of co-administered triazole antifungal agents should be considered.

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来源期刊
CiteScore
4.10
自引率
5.00%
发文量
226
审稿时长
6 months
期刊介绍: The Journal of Clinical Pharmacy and Therapeutics provides a forum for clinicians, pharmacists and pharmacologists to explore and report on issues of common interest. Reports and commentaries on current issues in medical and pharmaceutical practice are encouraged. Papers on evidence-based clinical practice and multidisciplinary collaborative work are particularly welcome. Regular sections in the journal include: editorials, commentaries, reviews (including systematic overviews and meta-analyses), original research and reports, and book reviews. Its scope embraces all aspects of clinical drug development and therapeutics, including: Rational therapeutics Evidence-based practice Safety, cost-effectiveness and clinical efficacy of drugs Drug interactions Clinical impact of drug formulations Pharmacogenetics Personalised, stratified and translational medicine Clinical pharmacokinetics.
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