Efficacy and Safety of Isavuconazole in the Treatment of Invasive Fungal Infection:Meta-Analysis
OBJECTIVE:To evaluate the efficacy and safety of isavuconazole(ISA)in the treatment of invasive fungal infection(IFI),so as to provide evidence-based basis for the selection of clinical treatment strategies.METHODS:Embase,PubMed,Web of Science,the Cochrane Library,VIP,CNKI,Wanfang Data and SinoMed were retrieved to collect the randomized controlled trial(RCT),cohort studies and case-control studies of ISA in the treatment of IFI(the observation group was treated with ISA alone,while the control group received voriconazole or amphotericin B alone)up to May 2023.Quality evaluation and data extraction were performed for the included literature,and Meta-analysis was performed by using RevMan 5.4.1 software.RESULTS:A total of 3 RCT,3 cohort studies and 1 case-control studies were enrolled,including 914 patients.Meta-analysis showed that there were no significant differences in the total effective rate(RR=1.00,95%CI=0.84-1.17,P=0.96)and all-cause mortality(RR=0.95,95%CI=0.76-1.18,P=0.62)between the observation group and control group.In terms of safety,the overall incidence of adverse drug reactions in the observation group was lower than that in control group(RR=0.76,95%CI=0.58-0.99,P=0.05).The incidences of visual abnormality(RR=0.47,95%CI=0.34-0.67,P<0.000 1)and liver function injury(RR=0.56,95%CI=0.38-0.83,P=0.004)in the observation group were significantly lower than those in the control group,the difference was statistically significant.However,there was no statistically significant difference in the incidence of neurological adverse reactions between two groups(RR=1.04,95%CI=0.83-1.31,P=0.71).CONCLUSIONS:The efficacy of ISA in the treatment of IFI is similar to that of voriconazole,and the overall safety is better than voriconazole,especially the incidences of liver function injury and visual abnormality are lower than voriconazole.However,it is still necessary to pay attention to the adverse drug reactions of the nervous system during clinical application.
万方数据
维普
