2023年临床血液学杂志36卷5期J Clin Hematol (China)·295*·指南写共只·艾沙康唑临床应用专家共识(2023版)》中华医学会血液学分会抗感染学组[摘要]随着免疫抑制患者数量的增加，侵装性霉菌感染的发病率也呈上升趋势，且患者常伴随高死亡率和临床预后不佳，艾沙康唑是权威指南推荐治疗侵袭性曲霉病和侵袭性毛霉病的一线药物，并兼顾较好的耐受性，同时具有线性药代动力学特性和与免疫抑制剂更小的药物相互作用，为长期接受免疫抑制剂治疗的患者提供了较稳定的药物浓度，Ⅲ期临床试验和病例对照研究分别证实艾沙康唑具有与伏立康唑治疗侵袭性曲霉病及两性霉素B治疗侵装性毛霉病相似的临床疗效，并具有较好的安全性，临床研究同时也证实其在侵装性真菌病高危人群的预防和侵袭性念珠菌病的序贯治疗中具有潜在的应用价值，本共识综合已发表的临床研究和药代动力学/药效学数据，对该药物在临床应用中的15个常见问题给予建议，[关键间]侵装性真菌病：免疫抑制宿主：侵装性霉菌感染：曲霉病，毛霉病：艾沙康座D0I:10.13201/j.issn.1004-2806.2023.05.001[中图分类号]R978.5[文献标志码]AConsensus recommendations for the clinical application ofisavuconazole(2023)Anti Infection Group,Chinese Society of Hematology,Chinese Medical AssociationCorresponding author:FENG Sizhou,Blood Diseases Hospital,Chinese Academy of MedicalSciences,Tianjin,300020,China,E-mail:szfeng@ihcams.ac.cn;LIU Qifa,Department ofHematology,Nanfang Hospital,Southern Medical University,Guangzhou,510515,China,E-mail:liuqifa628@163.comAbstract With a growing population of immunocompromised hosts,incidence of invasive mold infection isincreasing,leading to a high mortality and poor clinical outcomes.Isavuconazole is the first-line drug recommendedfor the treatment of invasive aspergillosis(1A)and invasive mucormycosis(IM),along with its linear pharmacoki-netic properties and less drug interaction with immunosuppressive agents,providing a more stable drug concentra-tion for patients receiving long-term immunosuppressants.A phase l trial and a case-control study demonstratedthat isavuconazole showed similar clinical efficacy to voriconazole(IA treatment)and amphotericin B(IM treat-ment),respectively.Clinical studies have also confirmed its potential value in invasive fungal disease prophylactictreatment and oral sequential therapy of invasive candidiasis.This consensus synthesizes published clinical studiesand pharmacokinetic/pharmacodynamic data to give recommendations for 15 common questions of the drug in clin-ical practice.Key words invasive fungal disease:immunocompromised host:invasive mold infection:aspergillosis:mu-cormycosis:isavuconazole近年来侵袭性真菌病(invasive fungal disease,母菌和双向真菌均有活性6-)。2015年FDA批准IFD)发病率呈上升趋势，死亡率居高不下。其该药一线治疗侵袭性曲霉病(invasive aspergillo-中侵袭性霉菌感染(invasive mold infection,IMI)sis,IA)和侵袭性毛霉病(invasive mucormycosis,尤为突出，免疫低下人群罹患IMI的死亡率为IM),2021年国家药品监督管理局(NMPA)以相同30%~70%,侵袭性毛霉菌死亡率可高达35%~适应证批准该药胶囊剂型在中国大陆上市，针剂剂100%]。艾沙康唑(ISA)作为最新一代三唑类抗型于2022年获批上市[]。中华医学会血液学分会真菌药物，抗菌谱广，对常见致病真菌包括霉菌、酵抗感染学组邀请国内相关领域专家学者，就ISA的执笔人：陈欣，中国医学科学院血液病医院，天津，300020，E-mail:chenxint@ihcams.ac.m林初，南方医科大学南方医院血液科，广州，510515，E-mail:lansinglinren@163.com通信作者：冯四洲，中国医学科学院血液病医院，天津，300020，EB-mil:szfeng@hcams.ac.cn刘启发，南方医科大学南方医院血液科，广州，510515，E-mail:liuqifa628@163.com引用本文：中华医学会血液学分会抗感染学组.艾沙康唑临床应用专家共识(2023版)[J门.临床血液学杂志，2023,36(5):295-302.D01:10.13201/j.issn.1004-2806.2023.05.001.
