Comparison of voriconazole with isavuconazole in treatment of invasive pulmonary aspergillosis
Zhai Jian-xia
Zhao Jun-ge
Song Yong-na
Li Min
Abstract：Objective To compare the efficacy of voriconazole with that of isavuconazole in treatment of invasive pulmonary as-pergillosis(IPA).Methods Eighty-two IPA patients admitted to Zhengzhou Central Hospital affiliated to Zhengzhou University from January 2021 to January 2024 were randomly divided into the voriconazole group(n=41,treated with oral voriconazole)and the isavu-conazole group(n=41,treated with oral isavuconazole).The serum galactomannan(GM)and 1,3-β 3-β-D glucan(BG)levels were com-pared between the two groups.Levels of inflammatory factors such as interleukin-6(IL-6),interleukin-8(IL-8),tumor necrosis factor-α(TNF-α),lung function indexes such as total lung capacity(TLC),carbon monoxide diffusion volume(DLCO),oxygen saturation(SaO2),clinical efficacy and drug safety were also compared between the two groups.Results After treatment,the levels of GM and BG,and inflammatory factors such as IL-6,IL-8 and TNF-α in the isavuconazole group((0.30±0.17)μg·L-1,(16.15±4.32)pg·mL-1,(32.88±3.06)pg·mL-1,(32.06±3.92)pg·mL-1,(94.31±9.37)pg·mL-1)were lower than those in the voriconazole group((0.41±0.11)μg·L-1,(20.75±5.48)pg·mL-1,(37.52±3.54)pg·mL-1,(39.15±4.12)pg·mL-1,(100.82±10.15)pg·mL-1)(t=3.479,4.221,6.349,7.983,3.018,all P<0.05).The positive rate of the voriconazole group(26.82%(11/41))was higher than that of the isavuconazole group(9.76%(4/41))(χ2=3.998,P<0.05).TLC,DLCO and SaO2 lung function indexes((75.18±4.98)%,(67.01±4.13)%,(96.17±9.12)%)were higher than those in the voriconazole group((69.34±5.81)%,(63.52±3.17)%,(90.27±8.55)%)(t=4.887,4.292,3.02,all P<0.05).As for the clinical efficacy,it was better in the isavuconazole group(95.12%(39/41))than in the voriconazole group(78.05%(32/41))(χ2=5.145,P<0.05).The incidence of adverse reactions in the voriconazole group(31.71%(13/41))was significantly higher than that in the isavuconazole group(12.20%(5/41))(χ2=4.556,P<0.05).Conclusion For the treatment of IPA patients,the efficacy of isavuconazole is better than that of voriconazole,which can not only significantly reduce the serum BG and GM levels of patients,alleviate the inflammatory reac-tion of the body and alleviate the lung function damage,but also has better tolerance and fewer adverse drug events.
Keywords：VoriconazoleIsavuconazoleLung functionInflammatory factorClinical efficacyTolerance
Publication Date：2025-02-24
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 47-50 )