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Title: Voriconazoleの概要
Other Titles: Overview of voriconazole
Authors: 河野, 茂
Authors (alternative): Kohno, Shigeru
Issue Date: Nov-2005
Publisher: 日本化学療法学会 / Japanese Society of Chemotherapy
Citation: 日本化学療法学会雑誌, 53(S2), pp.1-3; 2005
Abstract: Voriconazole(VRCZ)は,日本では2005年4月に承認された新しいトリアゾール系抗真菌薬である。バイオアベイラビリティの高さと広範な抗真菌スペクトルが特徴であり,従来の抗真菌薬が効きにくいCandida glabrata,Candida krusei,ならびにアスペルギルス属,フサリウム属,スケドスポリウム属にも抗真菌作用を発揮する。注射薬と経口薬の両剤形があるため,静注療法から経口療法への切り替えも可能である。深在性真菌症の感染部位となる肺,肝,腎,脳,眼などへの組織移行性に優れている。VRCZの血清中濃度は個人差が大きいが,血清中濃度と有効性・安全性との相関は見出されていない。造血幹細胞移植(HSCT)例での深在性真菌症の治療には,日本では現在フルコナゾールまたはアムホテリシンBが用いられているが,VRCZは,特にアスペルギルス症の治療での有効性が期待されている。深在性真菌症にVRCZを使用した日本の第III相臨床試験では,VRCZは忍容性が良好であり,アスペルギルス症,カンジダ症,クリプトコックス症において優れた有効性が確認され,侵襲性肺アスペルギルス症にも有効であった。HSCT後の免疫抑制患者に発症した侵襲性アスペルギルス症にVRCZとアムホテリシンBを使用した海外の試験では,VRCZのほうが有意に高い有効率を示した。VRCZは,わが国の深在性真菌症治療を一新する可能性をもち,今後の深在性真菌症の治療において優れた臨床効果を示すことが期待されている。 / Voriconazole (VRCZ) is a new triazole antifungal agent that was approved in Japan in April 2005. VRCZ is characterized by a high bioavailability and a broad spectrum of antifungal activity that includes a number of species that are refractory to other currently available antifungals, such as Candida glabrata and Candida krusei as well as Aspergillus, Fusarium, and Scedosporium species. VRCZ is available in both intravenous and oral formulations, facilitating a smooth switch from drip infusion to oral therapy. It shows excellent penetration into tissues that are sites of deep-seated mycoses, such as the lung, liver, kidney, brain and eyes. Although serum VRCZ concentrations may vary greatly, no correlation has been found between serum concentrations and efficacy or safety. For the treatment of deep-seated mycoses in patients with hematopoietic stem cell transplantation (HSCT), which is currently treated in Japan using fluconazole or amphotericin B, VRCZ is anticipated to be particularly effective for empiric and targeted therapy. A phase III clinical trial in Japan of VRCZ for the treatment of deep-seated mycoses showed that VRCZ was well tolerated and was extremely effective against aspergilloses, candidiasis, and cryptococcosis as well as against invasive pulmonary aspergillosis. An international trial of VRCZ and amphotericin B for the treatment of invasive aspergilloses that developed in immunocompromised patients after HSCT showed that VRCZ was significantly more effective. VRCZ promises to improve the treatment of deep-seated mycoses in Japan and is expected to exhibit excellent clinical effects in the future treatment of this condition.
Keywords: voriconazole (VRCZ)
URI: http://hdl.handle.net/10069/26666
ISSN: 13407007
Type: Journal Article
Text Version: publisher
Appears in Collections:Articles in academic journal

Citable URI : http://hdl.handle.net/10069/26666

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