Colon mucormycosis with renal spread resistant to lipid complex amphotericin and isavuconazole treatment in a heart transplant recipient

Lango-Maziarz, Anna; Kołaczkowska, Magdalena; Siondalski, Piotr; Duda, Maciej; Dubowik, Michał; Lango, Romuald

doi:10.20452/pamw.16156

Cited by 1 publication

(1 citation statement)

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“…We identified 20 studies which included at least one SOT recipient who received isavuconazole as treatment for an IMD (Figure 1). Overall, 13 studies met the inclusion criteria, including one prospective observational study which described 53 SOT recipients treated with isavuconazole for fungal infections [15], one multicenter retrospective study with 81 SOT recipients with proven or probable IMD treated with isavuconazole for ≥24 h as first-line or salvage therapy [16], and eleven case reports [17][18][19][20][21][22][23][24][25][26][27]. One case report was not included as it lacked most data related to the transplantation and six studies were excluded as they included both SOT and patients with hematologic malignancies and stem cell transplantation.…”

Section: Clinical Characteristics Of the Study Populationmentioning

confidence: 99%

Isavuconazole for Treating Invasive Mould Disease in Solid Organ Transplant Recipients

Silva,

Husain,

Aguado

2023

Transpl Int

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Solid organ transplant (SOT) recipients have a higher risk of developing invasive mould diseases (IMD). Isavuconazole is a novel broad-spectrum azole active against Aspergillus spp. and Mucor, well tolerated, with an excellent bioavailability and predictable pharmacokinetics, that penetrates in most tissues rapidly, and has few serious adverse effects, including hepatic toxicity. Contrary to other broad-spectrum azoles, such as voriconazole and posaconazole, isavuconazole appears to show significant smaller drug-drug interactions with anticalcineurin drugs. We have performed an extensive literature review of the experience with the use of isavuconazole in SOT, which included the SOTIS and the ISASOT studies, and published case reports. More than 140 SOT recipients treated with isavuconazole for IMD were included. Most patients were lung and kidney recipients treated for an Aspergillus infection. Isavuconazole was well tolerated (less than 10% of patients required treatment discontinuation). The clinical responses appeared comparable to that found in other high-risk patient populations. Drug-drug interactions with immunosuppressive agents were manageable after the reduction of tacrolimus and the adjustment of mTOR inhibitors at the beginning of treatment. In conclusion, isavuconazole appears to be a reasonable option for the treatment of IMD in SOT. More clinical studies are warranted.

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