Safety and Effectiveness of Isavuconazole Treatment for Invasive Fungal Infections in Chinese Patients with Haematologic Diseases: A Case Series

Pan Luo,1 Jia Wei,2 Guangjie Wu,1 Dong Xu,3 Dong Liu,1 Xuepeng Gong,1 Yan He1 1Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China; 2Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China; 3Department of Infection Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of ChinaCorrespondence: Yan He, Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People’s Republic of China, Email [email protected]: Isavuconazole (ISZ), a newer antifungal agent approved for treating invasive aspergillosis and mucormycosis, has been available in China since 2022. However, real-world data on ISZ use among Chinese patients with hematological diseases remain limited. In this study, we present our experience with ISZ for invasive fungal infection (IFI) management in hematology patients.Methods: Data on patient characteristics, ISZ administration variables, IFI treatment response to ISZ, and potential ISZ-associated adverse events in hematology patients from our center were retrospectively analyzed.Results: A total of 25 hematology patients treated with ISZ were included. One (4.0%) patient had proven IFI, 13 (52.0%) had probable IFI, and the remaining 11 (44.0%) were classified as having possible IFI. ISZ was used as primary therapy in 8 cases (32.0%) and salvage therapy in 17 cases (68.0%). The switch to ISZ as salvage therapy was driven by refractoriness to primary therapy in 70.6% of cases and by refractoriness and intolerance to prior antifungal treatment in 29.4%. Clinical improvement was observed in 16 (64.0%) patients. Five patients died during hospitalization, and four discontinued therapy due to clinical deterioration. Adverse events potentially attributable to ISZ occurred in 5 patients (20.0%), including nephrotoxicity, hepatotoxicity, and blurred vision (1 case each), and with the remaining two cases involving combined hepatorenal toxicity.Conclusion: ISZ demonstrates promising clinical efficacy and a favorable safety profile for IFI treatment in Chinese patients with hematologic diseases.Keywords: Isavuconazole, invasive fungal infections, hematological diseases, antifungal, Chinese patients