移植患者伏立康唑对免疫抑制剂的浓度及临床结局影响

doi:10.19803/j.1672-8629.2022.02.17

中国药物警戒 ›› 2022, Vol. 19 ›› Issue (2): 193-195.
DOI: 10.19803/j.1672-8629.2022.02.17

移植患者伏立康唑对免疫抑制剂的浓度及临床结局影响

曹鑫^1,2,3, 崔向丽^1,*

¹首都医科大学附属北京友谊医院药学部,北京100050;
²首都医科大学药学院,北京100069;
³北京外国语大学医院药剂科,北京100081

收稿日期:2020-04-14 出版日期:2022-02-15 发布日期:2022-02-15
通讯作者: ^*崔向丽,女,博士,主任药师,临床药学。E-mail：cui10@163.com
作者简介:曹鑫,女,本科,主管药师,临床药学。
基金资助:
国家卫生健康委员会卫生技术评估重点实验室2019年度开放基金（FH019-02）; 北京市医院管理中心2020年培育项目（PG2020002）

Effects of voriconazole on immunosuppressive concentrations and clinical outcomes in transplant patients

CAO Xin^1,2,3, CUI Xiangli^1,*

¹Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China;
²College of Pharmaceutical Sciences, Capital Medical University, Beijing 100069, China;
³Department of Pharmacy, Hospital of Beijing Foreign Studies University, Beijing 100081, China

Received:2020-04-14 Online:2022-02-15 Published:2022-02-15

摘要/Abstract

摘要： 目的分析伏立康唑对免疫抑制剂的浓度及引起的临床不良结局,为临床安全合理应用提供参考。方法通过查阅国内外文献总结有关伏立康唑对免疫抑制剂影响以及各国指南推荐的联合用药剂量。结果伏立康唑对免疫抑制剂的影响个体差异很大,药品说明书及指南中的推荐剂量并不适合所有患者。结论伏立康唑和免疫抑制剂合用需要根据血药浓度和肝药酶基因多态性进行个体化给药。

关键词: 伏立康唑, 免疫抑制剂, 血药浓度, 药品不良反应

Abstract: Objective To review the concentrations of immunosuppressants when used with voriconazole and the adverse clinical outcomes caused by voriconazole in order to provide references for safe and rational clinical use of this drug. Methods Domestic and foreign literature about the effect of voriconazole on immunosuppressants as well as the combined dosage recommended in guidelines in different countries were reviewed. Results The effect of voriconazole on immunosuppressants varied widely from individual to individual. The dosage of voriconazole recommended in different instructions and guidelines was not applicable to each patient. Conclusion The combination of voriconazole and immunosuppressants requires individualized administration according to the blood concentration and genetic polymorphisms of enzymes in liver drugs

Key words: voriconazole, immunosuppressant, blood concentration, adverse drug reaction

中图分类号:

R978.5R994.11

曹鑫, 崔向丽. 移植患者伏立康唑对免疫抑制剂的浓度及临床结局影响[J]. 中国药物警戒, 2022, 19(2): 193-195.

CAO Xin, CUI Xiangli. Effects of voriconazole on immunosuppressive concentrations and clinical outcomes in transplant patients[J]. Chinese Journal of Pharmacovigilance, 2022, 19(2): 193-195.

参考文献

[1] BODRO M, SABE N, GOMILA A, et al.Risk factors, clinical characteristics, and outcomes of invasive fungal infections in solid organ transplant recipients[J]. Transplant Proc, 2012, 44(9): 2682-2685.
[2] PURKINS L, WOOD N, GREENHALGH K, et al.Voriconazole, a novel wide-spectrum triazole: oral pharmacokinetics and safety[J]. British Journal Of Clinical Pharmacology, 2003, 56(1): 10-16.
[3] JEONG S, NGUYEN PD, DESTA Z.Comprehensive in vitro analysis of voriconazole inhibition of eight cytochrome P450 ( CYP) enzymes: major effect on CYPs 2B6, 2C9, 2C19, and3A[J]. Antimicrobial Agents and Chemotherapy, 2009, 53(2) : 541-551.
[4] LIU ZY, CHEN K, LIU YY, et al.Pharmacokinetic impact of voriconazole on immunosuppressors: a systematic review[J]. Clinical Medication Journal(临床药物治疗杂志), 2016, 14(6): 21-26.
[5] CHAU MM, KONG DCM, HAL VAN SJ, et al.Consensus guidelines for optimising antifungal drug delivery and monitoring to avoid toxicity and improve outcomes in patients with haematological malignancy, 2014[J]. Internal Medicine Journal, 2014, 44(12b): 1364-1388.
[6] PATTERSON TF, THOMPSON GR, DENNING DW, et al.Practice guidelines for the diagnosis and management of aspergillosis: 2016 update by the infectious diseases society of America[J]. Clin Infect Dis, 2016, 63(4): e1-e60.
[7] CHEN K, ZHANG X, KE X, et al.Individualized medication of voriconazole: a practice guideline of the division of therapeutic drug monitoring, Chinese pharmacological society[J]. Ther Drug Monit, 2018, 40(6): 663-674.
[8] LAVERDIERE M, BOW EJ, ROTSTEIN C, et al.Therapeutic drug monitoring for triazoles: a needs assessment review and recommendations from a Canadian perspective[J]. Can J Infect Dis Med Microbiol, 2014, 25(6): 327-343.
[9] ULLMANN AJ, AGUADO JM, ARIKAN-AKDAGLI S, et al.Diagnosis and management of aspergillus diseases: executive summary of the 2017 ESCMID-ECMM-ERS guideline[J]. Clin Microbiol Infect, 2018, 24(Suppl 1): e1-e38.
[10] Voriconazole for injection (Vfend) [EB/OL]. (2016-05-11)[2018-10-08]. http://www.nbdyf.com/yaopinmulu/3429.html.
[11] HAMADA Y, TOKIMATSU I, MIKAMO H, et al.Practice guidelines for therapeutic drug monitoring of voriconazole: a consensus review of the Japanese Society of Chemotherapy and the Japanese Society of Therapeutic Drug Monitoring[J]. Journal of Infection and Chemotherapy: official journal of the Japan Society of Chemotherapy, 2013, 19(3): 381-392.
[12] SHI BY, YUAN M.Guidelines for immunosuppressive therapy for renal transplant recipients in China(2016)[J]. Organ Transplantation(器官移植), 2016, 7(5): 327-331.
[13] ROMERO AJ, LE PP, NILSSON LG, et al.Effect of voriconazole on thepharmacokinetics of cyclosporine in renal transplant patients[J]. Clin Pharmacol Ther, 2002, 71(4): 226-234.
[14] KIKUCHI T, MORI T, YAMANE A, et al.Variable magnitude of drug interaction between oral voriconazole and cyclosporine A in recipients of allogeneic hematopoietic stem cell transplantation[J]. Clin Transplant, 2012, 26(5): E544-548.
[15] WANG Y, PEI YP, FANG Y, et al.Correlation between blood concentrations of ciclosporin and its adverse drug reactions in immunosuppressive treatment of hematopoietic stem cell transplantation recipients[J]. Pharmaceutical Care and Research(药学服务与研究), 2008, 8(1): 21-23.
[16] VANHOVE T, BOUWSMA H, HILBRANDS L, et al.Determi-nants of the magnitude of interaction between tacrolimus and voriconazole /posaconazole in solid organ recipients[J]. Am J Transplant,2017, 17(9) : 2372-2380.
[17] GROLL AH, TOWNSEND R, DESAI A, et al.Drug-drug interactions between triazole antifungal agents used to treat invasive aspergillosis and immunosuppressants metabolized by cytochrome P450 3A4[J]. Transpl Infect Dis, 2017, 19(5): e12751.
[18] DAVIS S, GRALLA J, KLEM P, et al.Lower tacrolimus exposure and time in therapeutic range increase the risk of de novo donor-specific antibodies in the first year of kidney transplantation[J].Am J Transplant,2018,18(4) : 907-915.
[19] RAMAN V, SHIMIN Z, TIMOTHY G, et al.Voriconazole Inhibition of the metabolism of tacrolimus in a liver transplant recipient and in human liver microsomes[J]. Antimicrob Agents Chemother, 2002, 46(9) : 3091-3093.
[20] CAPONE D,TARANTINO G,GENTILE A, et al.Effects of voriconazole on tacrolimus metabolism in a kidney transplant recipient[J]. Journal of Clinical Pharmacy and Therapeutics, 2010, 35(1) : 121-124.
[21] ZHANG YQ, LI XL, LIN XY, et al.Case analysis of the interaction between voriconazole and tacrolimus in renal transplantation patients[J]. Strait Pharmaceutical Journal(海峡药学), 2018, 30(4): 122-124.
[22] IWAMOTO T, MONMA F, FUJIEDA A, et al.Effect of genetic polymorphism of CYP3A5 and CYP2C19 and concomitant use of voriconazole on blood tacrolimus concentration in patients receiving hematopoietic stem cell transplantation[J]. Ther Drug Monit, 2015, 37(5) : 581-588.
[23] SADABA B, CAMPANERO MA, QUETGLAS EG, et al.Clinical relevance of sirolimus drug interactions in transplant patients[J]. Transplant Proc, 2004, 36(10): 3226-3228.
[24] MARTY FM, LOWRY CM, CUTLER CS, et al.Voriconazole and sirolimus coadministration after allogeneic hematopoietic stem cell transplantation[J]. Biol Blood Marrow Transplant, 2006, 12(5): 552-559.
[25] SUROWIEC D, DEPESTEL DD, CARVER PL.Concurrent administration of sirolimus and voriconazole: a pilot study assessing safety and approaches to appropriate management[J]. Pharmacotherapy, 2008, 28(6): 7197-7229.

移植患者伏立康唑对免疫抑制剂的浓度及临床结局影响

Effects of voriconazole on immunosuppressive concentrations and clinical outcomes in transplant patients

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

[1]	贾晋生, 刘红亮, 王青, 侯永芳, 李馨龄. 基于知识图谱联合ERNIE-DPCNN模型的药品不良反应自动关联性评价方法研究[J]. 中国药物警戒, 2024, 21(2): 163-166.
[2]	李应芬, 韩雷. 319例注射用脑蛋白水解物药品不良反应报告分析[J]. 中国药物警戒, 2024, 21(2): 195-198.
[3]	徐伟佳, 彭崎, 黄海渝, 张磊姣, 肖华, 吴雪. 285例新型抗肿瘤药物不良反应分析[J]. 中国药物警戒, 2024, 21(2): 199-203.
[4]	郭清华, 彭笑笑, 朱萍, 刘西霖, 杨颖华, 陈志海. 氨氯地平过量致多器官功能障碍综合征1例分析[J]. 中国药物警戒, 2024, 21(2): 204-207.
[5]	方美琳, 郑慧敏, 王存泽, 王凌, 阮君山. 注射用奥沙利铂致全身肌肉疼痛1例分析[J]. 中国药物警戒, 2024, 21(2): 208-210.
[6]	陈玉艳, 张明霞, 张涛, 张晋. 斯鲁利单抗注射液致间质性肺炎不良反应1例分析[J]. 中国药物警戒, 2024, 21(2): 213-215.
[7]	曹桂萍, 邓琳琳, 朱干红, 陆颖, 马爽, 陈玲玲, 刘丽丽. 天麻首乌片致严重肝损伤1例分析[J]. 中国药物警戒, 2024, 21(2): 216-218.
[8]	高云娟, 赵旭, 白天凯, 柏兆方, 王伽伯, 宋海波, 肖小河. 基于不良反应监测大数据的药品安全风险发现与识别策略[J]. 中国药物警戒, 2024, 21(1): 1-5.
[9]	郭龙鑫, 高云娟, 吴承钊, 龙敏娟, 祝胜凯, 宋海波, 赵旭, 肖小河. 基于不良反应监测大数据的中药药源性肝损伤风险信号新发现及易感因素初探[J]. 中国药物警戒, 2024, 21(1): 15-19.
[10]	蒋文硕, 杨莉. 694例癫痫医师药师联合门诊患者药品不良反应分析[J]. 中国药物警戒, 2024, 21(1): 102-106.
[11]	陈华炎, 江东波, 郭春连, 杨家琪, 黎雨欣, 蔡伟明. 326例奈玛特韦片/利托那韦片治疗新型冠状病毒感染安全性分析[J]. 中国药物警戒, 2024, 21(1): 107-110.
[12]	刘赛月, 吕小琴, 周耘. 疑似药品不良反应死亡病例调查及报告实施要点[J]. 中国药物警戒, 2023, 20(9): 971-974.
[13]	里筱竹, 王蔷, 逄瑜, 张轶菁. 个例药品不良反应报告管理浅析与思考[J]. 中国药物警戒, 2023, 20(9): 975-977.
[14]	逄瑜, 刘博, 吕少俐, 王涛, 邢颖, 秦星宇, 田月洁, 吴文宇. 基于国际药物警戒经验探讨收集患者报告的意义[J]. 中国药物警戒, 2023, 20(9): 978-981.
[15]	刘文东, 崔欢欢, 王晓晗, 苏娴, 王海学. 我国儿童用药临床试验期间药物警戒监管体系现状及思考[J]. 中国药物警戒, 2023, 20(9): 1002-1006.