{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T08:14:18Z","timestamp":1771056858009,"version":"3.50.1"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T00:00:00Z","timestamp":1768262400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T00:00:00Z","timestamp":1768262400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"F2G, Inc."}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Mycopathologia"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Triazoles are widely used for treatment and prevention of invasive aspergillosis (IA) but can cause serious drug-drug interactions (DDIs) with chemotherapeutic (CT) and immunosuppressant (IS) agents via CYP3A4 inhibition. The frequency of triazole-CT or IS concurrent administration in hematologic malignancies (HM) patients newly admitted with IA is largely unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We studied US IQVIA claims including adults with\u2009\u2265\u20091 claim for an inpatient stay with a diagnosis code for IA from October 1, 2015-November 30, 2022 and evidence of systemic antifungal therapy for\u2009\u2265\u20093\u00a0days during the hospitalization. The cohort was limited to patients with\u2009\u2265\u20091 HM diagnosis code within 6\u00a0months prior to IA admission. Utilization of triazoles with CT and\/or ISs known to have moderate-to-severe pharmacokinetic (PK) interactions was described.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Triazoles, predominantly isavuconazole (61.0%) and voriconazole (53.6%), were administered in 97.2% of 317 patients with IA. Of these, 241 (78.2%) received an interacting CT and\/or IS. Potentially interacting agents administered with a triazole included corticosteroids (70.8%), calcineurin or mammalian target of rapamycin (mTOR) inhibitors (25.0%) (84.4% tacrolimus), alkylating agents (14.0%) (76.7% cyclophosphamide), venetoclax (9.7%), anthracyclines (6.2%), and vincristine (5.8%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Concurrent administration of triazole with potential PK interactions with CT or IS agents occurred in most HM patients admitted for IA. Choosing alternative antifungals, therapeutic drug monitoring of triazoles or selective ISs, and dosage adjustment of CT\/IS agents may mitigate the risk of adverse DDIs. New antifungal agents without serious DDIs with CT and\/or IS agents are needed for treatment of IA to reduce the risk of serious adverse events.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11046-025-01043-4","type":"journal-article","created":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T13:19:32Z","timestamp":1768310372000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Concurrent Administration of Triazoles with Chemotherapeutic and\/or Immunosuppressant Agents Known to Have Moderate-to-Severe Drug-Drug Interactions in Patients with Hematologic Malignancies Hospitalized for Invasive Aspergillosis"],"prefix":"10.1007","volume":"191","author":[{"given":"Thomas J.","family":"Walsh","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Craig I.","family":"Coleman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa D.","family":"Johnson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Belinda","family":"Lovelace","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara D.","family":"Alexander","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,1,13]]},"reference":[{"key":"1043_CR1","doi-asserted-by":"publisher","first-page":"e428","DOI":"10.1016\/S1473-3099(23)00692-8","volume":"24","author":"DW Denning","year":"2024","unstructured":"Denning DW. Global incidence and mortality of severe fungal disease. Lancet Infect Dis. 2024;24:e428\u201338.","journal-title":"Lancet Infect Dis"},{"key":"1043_CR2","doi-asserted-by":"publisher","first-page":"165rv13","DOI":"10.1126\/scitranslmed.3004404","volume":"4","author":"GD Brown","year":"2012","unstructured":"Brown GD, Denning DW, Gow NA, Levitz SM, Netea MG, White TC. Hidden killers: human fungal infections. Sci Transl Med. 2012;4:165rv13.","journal-title":"Sci Transl Med"},{"issue":"1S","key":"1043_CR3","doi-asserted-by":"publisher","first-page":"e33","DOI":"10.1016\/j.idc.2025.01.002","volume":"39","author":"S Herrera","year":"2025","unstructured":"Herrera S, Magyar U, Husain S. Invasive aspergillosis in the current era. Infect Dis Clin North Am. 2025;39(1S):e33\u201360.","journal-title":"Infect Dis Clin North Am"},{"key":"1043_CR4","doi-asserted-by":"publisher","first-page":"1367","DOI":"10.1093\/cid\/ciz1008","volume":"71","author":"JP Donnelly","year":"2020","unstructured":"Donnelly JP, Chen SC, Kauffman CA, Steinbach WJ, Baddley JW, Verweij PE, et al. Revision and update of the consensus definitions of invasive fungal disease from the European Organization for research and treatment of cancer and the mycoses study group education and research consortium. Clin Infect Dis. 2020;71:1367\u201376.","journal-title":"Clin Infect Dis"},{"issue":"6","key":"1043_CR5","doi-asserted-by":"publisher","first-page":"550","DOI":"10.1016\/j.jinf.2018.02.012","volume":"76","author":"RJ van de Peppel","year":"2018","unstructured":"van de Peppel RJ, Visser LG, Dekkers OM, de Boer MGJ. The burden of invasive aspergillosis in patients with haematological malignancy: a meta-analysis and systematic review. J Infect. 2018;76(6):550\u201362.","journal-title":"J Infect"},{"key":"1043_CR6","doi-asserted-by":"publisher","first-page":"1685","DOI":"10.3324\/haematol.2011.044636","volume":"96","author":"MC Nicolle","year":"2011","unstructured":"Nicolle MC, B\u00e9net T, Thiebaut A, Bienvenu AL, Voirin N, Duclos A, et al. Invasive aspergillosis in patients with hematologic malignancies: incidence and description of 127 cases enrolled in a single institution prospective survey from 2004 to 2009. Haematologica. 2011;96:1685\u201391.","journal-title":"Haematologica"},{"key":"1043_CR7","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1093\/cid\/ciw326","volume":"63","author":"TG Patterson","year":"2016","unstructured":"Patterson TG, Thompson GR, Denning DW, Fishman JA, Hadley S, Herbrecht R, et al. Practice guidelines for the diagnosis and management of aspergillosis: 2016 update by the Infectious Diseases Society of America. Clin Infect Dis. 2016;63:e1\u201360.","journal-title":"Clin Infect Dis"},{"issue":"Suppl 1","key":"1043_CR8","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1016\/j.cmi.2018.01.002","volume":"24","author":"AJ Ullmann","year":"2018","unstructured":"Ullmann AJ, Aguado JM, Arikan-Akdagli S, Denning DW, Groll AH, Lagrou K, et al. Diagnosis and management of Aspergillus diseases: executive summary of the 2017 ESCMID-ECMM-ERS guideline. Clin Microbiol Infect. 2018;24(Suppl 1):e1\u201338.","journal-title":"Clin Microbiol Infect"},{"key":"1043_CR9","doi-asserted-by":"publisher","first-page":"1203","DOI":"10.1093\/jac\/dkae103","volume":"79","author":"R Lewis","year":"2024","unstructured":"Lewis R, Niazi-Ali S, McIvor A, Kanj SS, Maertens J, Bassetti M, et al. Triazole antifungal drug interactions-practical considerations for excellent prescribing. J Antimicrob Chemother. 2024;79:1203\u201317.","journal-title":"J Antimicrob Chemother"},{"key":"1043_CR10","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1016\/j.jtct.2025.01.892","volume":"31","author":"AP Douglas","year":"2025","unstructured":"Douglas AP, Lamoth F, John TM, Groll AH, Shigle TL, Papanicolaou GA, et al. American Society of Transplantation and Cellular Therapy Series: #8-management and prevention of non-Aspergillus molds in hematopoietic cell transplantation recipients. Transplant Cell Ther. 2025;31:194\u2013223.","journal-title":"Transplant Cell Ther"},{"key":"1043_CR11","unstructured":"IQVIA. Available IQVIA data. Available at: https:\/\/www.iqvia.com\/insights\/the-iqvia-institute\/available-iqvia-data. Accessed 23 May 2024."},{"key":"1043_CR12","unstructured":"National Aspergillosis Centre, Antifungal Trust\u2019s Antifungal Interactions Database. Available at: https:\/\/www.antifungalinteractions.org (Last accessed on April 28, 2025)."},{"key":"1043_CR13","first-page":"204993612110106","volume":"8","author":"S Niazi-Ali","year":"2021","unstructured":"Niazi-Ali S, Atherton GT, Walczak M, Denning DW. Drug-drug interaction database for safe prescribing of systemic antifungal agents. Ther Adv Infect Dis. 2021;8:20499361211010604.","journal-title":"Ther Adv Infect Dis"},{"key":"1043_CR14","doi-asserted-by":"publisher","first-page":"236","DOI":"10.37201\/req\/013.2023","volume":"36","author":"JR Azanza","year":"2023","unstructured":"Azanza JR, Mensa J, Barber\u00e1n J, V\u00e1zquez L, de P\u00e9rez Oteyza J, Kwon M, et al. Recommendations on the use of azole antifungals in hematology-oncology patients. Rev Esp Quimioter. 2023;36:236\u201358.","journal-title":"Rev Esp Quimioter"},{"key":"1043_CR15","doi-asserted-by":"publisher","first-page":"e58","DOI":"10.1016\/S2352-3026(21)00232-5","volume":"9","author":"RJ Br\u00fcggemann","year":"2022","unstructured":"Br\u00fcggemann RJ, Verheggen R, Boerrigter E, Stanzani M, Verweij PE, Blijlevens NMA, et al. Management of drug-drug interactions of targeted therapies for haematological malignancies and triazole antifungal drugs. Lancet Haematol. 2022;9:e58\u201372.","journal-title":"Lancet Haematol"},{"key":"1043_CR16","doi-asserted-by":"publisher","first-page":"1292163","DOI":"10.3389\/fphar.2024.1292163","volume":"15","author":"BN Huo","year":"2024","unstructured":"Huo BN, Shu L, Xiao JW, Yin NG, Ai ML, Jia YT, et al. Clinical drug interactions between voriconazole and 38 other drugs: a retrospective analysis of adverse events. Front Pharmacol. 2024;15:1292163.","journal-title":"Front Pharmacol"},{"key":"1043_CR17","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1016\/j.clinthera.2017.01.003","volume":"39","author":"SK Agarwal","year":"2017","unstructured":"Agarwal SK, DiNardo CD, Potluri J, Dunbar M, Kantarjian HM, Humerickhouse RA, et al. Management of Venetoclax-Posaconazole interaction in acute myeloid leukemia patients: evaluation of dose adjustments. Clin Ther. 2017;39:359\u201367.","journal-title":"Clin Ther"},{"key":"1043_CR18","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1182\/hematology.2020000120","volume":"2020","author":"K Fischer","year":"2020","unstructured":"Fischer K, Al-Sawaf O, Hallek M. Preventing and monitoring for tumor lysis syndrome and other toxicities of venetoclax during treatment of chronic lymphocytic leukemia. Hematol Am Soc Hematol Educ Program. 2020;2020:357\u201362.","journal-title":"Hematol Am Soc Hematol Educ Program"},{"key":"1043_CR19","doi-asserted-by":"publisher","first-page":"1898","DOI":"10.1177\/10781552221082295","volume":"28","author":"A Krapfl","year":"2022","unstructured":"Krapfl A, McLeod C, Myers R, Venugopal P, Seddon A. Venetoclax ramp-up with concurrent voriconazole in a patient with chronic lymphocytic leukemia. J Oncol Pharm Pract. 2022;28:1898\u2013901.","journal-title":"J Oncol Pharm Pract"},{"key":"1043_CR20","first-page":"1","volume":"2025","author":"D Huang","year":"2025","unstructured":"Huang D, Zhang Y, Liu L, Yang M, Zeng T, Wang S. Attention to the interactions between vincristine and triazole antifungals: perspectives from real-world retrospective analysis and pharmacovigilance assessment. Expert Opin Drug Saf. 2025;2025:1\u201312.","journal-title":"Expert Opin Drug Saf"},{"key":"1043_CR21","doi-asserted-by":"publisher","first-page":"290","DOI":"10.1111\/j.1439-0507.2011.02158.x","volume":"55","author":"B Moriyama","year":"2012","unstructured":"Moriyama B, Henning SA, Leung J, Falade-Nwulia O, Jarosinski P, Penzak SR, et al. Adverse interactions between antifungal azoles and vincristine: review and analysis of cases. Mycoses. 2012;55:290\u20137.","journal-title":"Mycoses"},{"key":"1043_CR22","doi-asserted-by":"publisher","first-page":"e877","DOI":"10.1111\/j.1439-0507.2011.02016.x","volume":"54","author":"B Moriyama","year":"2011","unstructured":"Moriyama B, Falade-Nwulia O, Leung J, Penzak SR, JJingo C, Huang X, et al. Prolonged half-life of voriconazole in a CYP2C19 homozygous poor metabolizer receiving vincristine chemotherapy: avoiding a serious adverse drug interaction. Mycoses. 2011;54:e877\u20139.","journal-title":"Mycoses"},{"issue":"Suppl 2","key":"1043_CR23","doi-asserted-by":"publisher","first-page":"ofad500.2152","DOI":"10.1093\/ofid\/ofad500.2152","volume":"10","author":"MP Choules","year":"2023","unstructured":"Choules MP, Otsuka Y, Kovanda L, Bonate P, Sinnar S, Desai A. Physiological-based pharmacokinetic analysis of drug\u2013drug interactions between isavuconazole and vincristine in pediatric subjects. Open Forum Infect Dis. 2023;10(Suppl 2):ofad500.2152.","journal-title":"Open Forum Infect Dis"},{"key":"1043_CR24","unstructured":"Astellas Pharma US, Inc. CRESEMBA (isavuconazonium sulfate) prescribing information. Northbrook, IL: Astellas Pharma US, Inc.; 2025. Available from: https:\/\/www.astellas.us\/docs\/cresemba.pdf. Accessed 9 Nov 2025."},{"key":"1043_CR25","doi-asserted-by":"publisher","first-page":"3160","DOI":"10.1002\/ijc.33119","volume":"147","author":"AA Abu Rmilah","year":"2020","unstructured":"Abu Rmilah AA, Lin G, Begna KH, Friedman PA, Herrmann J. Risk of QTc prolongation among cancer patients treated with tyrosine kinase inhibitors. Int J Cancer. 2020;147:3160\u20137.","journal-title":"Int J Cancer"},{"key":"1043_CR26","doi-asserted-by":"publisher","first-page":"1989","DOI":"10.1007\/s00277-020-04186-0","volume":"99","author":"JE Meg\u00edas-Vericat","year":"2020","unstructured":"Meg\u00edas-Vericat JE, Solana-Altabella A, Ballesta-L\u00f3pez O, Mart\u00ednez-Cuadr\u00f3n D, Montesinos P. Drug-drug interactions of newly approved small molecule inhibitors for acute myeloid leukemia. Ann Hematol. 2020;99:1989\u20132007.","journal-title":"Ann Hematol"},{"key":"1043_CR27","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1186\/s12941-019-0311-3","volume":"18","author":"ET Van Matre","year":"2019","unstructured":"Van Matre ET, Evans SL, Mueller SW, MacLaren R, Fish DN, Kiser TH. Comparative evaluation of isavuconazonium sulfate, voriconazole, and posaconazole for the management of invasive fungal infections in an academic medical center. Ann Clin Microbiol Antimicrob. 2019;18:13.","journal-title":"Ann Clin Microbiol Antimicrob"},{"issue":"10","key":"1043_CR28","doi-asserted-by":"publisher","first-page":"1083","DOI":"10.1002\/jcph.2299","volume":"63","author":"Z Zhou","year":"2023","unstructured":"Zhou Z, Slattum PW, Ke A, Zhang L. Managing drug-drug interactions in older adults. J Clin Pharmacol. 2023;63(10):1083\u201390. https:\/\/doi.org\/10.1002\/jcph.2299.","journal-title":"J Clin Pharmacol"},{"issue":"14","key":"1043_CR29","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1016\/S0140-6736(07)61092-7","volume":"370","author":"L Mallet","year":"2007","unstructured":"Mallet L, Spinewine A, Huang A. The challenge of managing drug interactions in elderly people. Lancet. 2007;370(14):185\u201391. https:\/\/doi.org\/10.1016\/S0140-6736(07)61092-7.","journal-title":"Lancet"},{"key":"1043_CR30","first-page":"215","volume":"5","author":"SK Gandhi","year":"1999","unstructured":"Gandhi SK, Salmon JW, Kong SX, Zhao SZ. Administrative databases and outcomes assessment: an overview of issues and potential utility. J Manag Care Pharm. 1999;5:215\u201322.","journal-title":"J Manag Care Pharm"},{"key":"1043_CR31","doi-asserted-by":"publisher","first-page":"106568","DOI":"10.1016\/j.jinf.2025.106568","volume":"91","author":"JC Zuniga-Moya","year":"2025","unstructured":"Zuniga-Moya JC, Papadopoulos B, Atkinson A, Mazi PB, Rauseo AM, Spec A. Geographic distribution and associated mortality of invasive aspergillosis and mucormycosis among Medicare enrollees in the United States (2008\u20132015). J Infect. 2025;91:106568.","journal-title":"J Infect"}],"container-title":["Mycopathologia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11046-025-01043-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11046-025-01043-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11046-025-01043-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T07:53:17Z","timestamp":1771055597000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11046-025-01043-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,13]]},"references-count":31,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["1043"],"URL":"https:\/\/doi.org\/10.1007\/s11046-025-01043-4","relation":{},"ISSN":["0301-486X","1573-0832"],"issn-type":[{"value":"0301-486X","type":"print"},{"value":"1573-0832","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,13]]},"assertion":[{"value":"29 September 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 December 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 January 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The funder of this study had no role in the decision to publish this work.  B.L. is an employee of F2G, Inc. and served as an author on this paper.  B.D.A.: Consultant: Scynexis, GSK, Astellas, Merck, HealthTrackRx, Basilea, F2G, Inc.; Research Grant to My Institution: Karius; Clinical Trials (Site PI\/Study PI): Scynexis, F2G, Inc.; Royalties (Chapter Author): UpToDate. M.J.: Research Grant to my Institution: Scynexis; Author Royalties: UpToDate; Licensed Technology: Biomeme, Patent Pending for gene expression classifiers of fungal infection. B.L.: Employee of F2G, Inc. C.I.C.: Consultant: F2G, Inc.  TJW has received grant funding and consulting fees from the Henry Schueler Foundation; F2G, Inc., Omeros, Abbott Laboratories, Partner Therapeutics, Scynexis, Statera, T2 Biosystems, Shionogi, and Basilea.  He has a leadership or fiduciary role at Medical Mycological Societies of the Americas, Center for Innovative Therapeutics and Diagnostics, ISHAM\/ECMM Osteoarticular Mycoses Working Group, Henry Schueler Foundation, Save Our Sick Kids Foundation and the Mycoses Study Group Education and Research Consortium (MSG-ERC).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"18"}}