{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:45:21Z","timestamp":1753879521749,"version":"3.41.2"},"reference-count":19,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,12,7]],"date-time":"2023-12-07T00:00:00Z","timestamp":1701907200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:label\/><jats:p>The triazole antifungal isavuconazole (ISAVU) is used for prevention and treatment of fungal infections in solid organ transplant (SOT). SOT recipients commonly need to transition from one azole to another due to breakthrough infection, toxicity, or other reasons. The purpose of our study was to evaluate the effect of ISAVU on immunosuppressant concentrations in thoracic transplant recipients when ISAVU was started de novo or transitioned from another azole. We conducted a single\u2010center retrospective cohort study including 68 patients (51 lung, 14 heart, and 3 heart\/lung transplant). Concentration to dosage ratios (C\/D) of immunosuppressants were assessed at baseline, day 3, and weekly for 9 weeks. When starting ISAVU de novo, we observed a temporary doubling of tacrolimus exposure. Cyclosporine and sirolimus required dose decreases. Tacrolimus C\/D increased by 110% at day 3 in patients started on ISAVU de novo then returned to baseline C\/D \u00b1 17% weeks 2\u20109 (n = 8). One cyclosporine patient started on ISAVU de novo had variable C\/D, and C\/D increased by 219% \u00b1 72% in 2 sirolimus patients. When transitioning from other azoles, tacrolimus and cyclosporine required about twice the initial dose. After week 1, tacrolimus C\/D decreased by 53% \u00b1 6% in patients transitioned from posaconazole (n = 33), voriconazole (n = 14), or fluconazole (n = 2). Cyclosporine C\/D decreased by 45% \u00b1 16% in patients transitioning from other azoles (posaconazole [n = 2], voriconazole [n = 2], fluconazole [n = 1]). Sirolimus C\/D decreased by 73% \u00b1 13% in patients transitioned from posaconazole (n = 7). Aside from the initial loading phase, ISAVU had a lesser degree of interaction with immunosuppressants than other azoles in loading phase, ISAVU had a lesser degree of interaction with immunosuppressants than other azoles in adjustments for the 4\u2010week period after initiating antifungal therapy with ISAVU or switching from another agent.\n<jats:boxed-text content-type=\"graphic\" position=\"anchor\"><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/tid14209-gra-0001-m.png\"><jats:alt-text>image<\/jats:alt-text><\/jats:graphic><\/jats:boxed-text><\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.14209","type":"journal-article","created":{"date-parts":[[2023,12,8]],"date-time":"2023-12-08T04:07:23Z","timestamp":1702008443000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Difference in immunosuppressant dose requirement when transitioning to isavuconazole from other azoles in thoracic transplant recipients"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2381-5360","authenticated-orcid":false,"given":"Jade M.","family":"Kozuch","sequence":"first","affiliation":[{"name":"Department of Pharmacy University of California San Diego  La Jolla California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carrie","family":"Burt","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Scripps Memorial Hospital  La Jolla California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7574-0738","authenticated-orcid":false,"given":"Kamyar","family":"Afshar","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care University of California San Diego  La Jolla California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4051-5629","authenticated-orcid":false,"given":"Saima","family":"Aslam","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Global Public Health University of California San Diego  La Jolla California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gordon","family":"Yung","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care University of California San Diego  La Jolla California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Mariski","sequence":"additional","affiliation":[{"name":"Department of Pharmacy University of California San Diego  La Jolla California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eugene","family":"Golts","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery University of California San Diego  La Jolla California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashley","family":"Feist","sequence":"additional","affiliation":[{"name":"Skaggs School of Pharmacy and Pharmaceutical Sciences University of California San Diego  La Jolla California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,12,7]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13553"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ571"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mycmed.2018.02.002"},{"volume-title":"Cresemba (Isavuconazole Sulfate)","year":"2018","key":"e_1_2_7_5_1"},{"volume-title":"Noxafil (Posaconazole)","year":"2019","key":"e_1_2_7_6_1"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1086\/523576"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/1078155218801055"},{"volume-title":"Voriconazole","year":"2018","key":"e_1_2_7_9_1"},{"key":"e_1_2_7_10_1","unstructured":"Fluconazole.Micromedex (electronic version). IBM Watson Health.2023. Accessed May 1 2023.https:\/\/www.micromedexsolutions.com"},{"key":"e_1_2_7_11_1","unstructured":"For healthcare professionals FDA's examples of drugs that interact with CYP enzymes and transporter systems.FDA. June 5 2023. Accessed April 29 2023.https:\/\/www.fda.gov\/drugs\/drug\u2010interactions\u2010labeling\/healthcare\u2010professionals\u2010fdas\u2010examples\u2010drugs\u2010interact\u2010cyp\u2010enzymes\u2010and\u2010transporter\u2010systems"},{"key":"e_1_2_7_12_1","unstructured":"Tacrolimus. Micromedex solutions.Truven Health Analytics Inc. Accessed February 1 2019.http:\/\/www.micromedexsolutions.com"},{"key":"e_1_2_7_13_1","unstructured":"AbbVie Inc.GENGRAF Capsules.AbbVie Inc. February 2021."},{"key":"e_1_2_7_14_1","unstructured":"Sirolimus. Micromedex solutions.Truven Health Analytics Inc. Accessed February 1 2019.http:\/\/www.micromedexsolutions.com"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.12751"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpt.12308"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00970\u201017"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.13007"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/10781552211029046"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/0897190018790688"}],"container-title":["Transplant Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tid.14209","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T06:34:49Z","timestamp":1721198089000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tid.14209"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,7]]},"references-count":19,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,2]]}},"alternative-id":["10.1111\/tid.14209"],"URL":"https:\/\/doi.org\/10.1111\/tid.14209","archive":["Portico"],"relation":{},"ISSN":["1398-2273","1399-3062"],"issn-type":[{"type":"print","value":"1398-2273"},{"type":"electronic","value":"1399-3062"}],"subject":[],"published":{"date-parts":[[2023,12,7]]},"assertion":[{"value":"2023-05-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e14209"}}