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iText® 5.5.13.2 ©2000-2020 iText Group NV (AGPL-version) CreationDate: Tue Feb 08 08:51:32 CET 2022 ModDate: Fri Feb 11 04:41:40 CET 2022 ID: 0xc6afddb09da6f8b01f64476283fb5f83, 0x326584fcdec9178ba69ab6389306c158 Filters: FilterPipeline: FlateDecode Images: Image: NisoImageMetadata: FormatName: image/png ImageWidth: 67 ImageHeight: 67 BitsPerSample: 8 BitsPerSampleUnit: integer Filter: FlateDecode Fonts: Type1: Font: BaseFont: PEKKLN+AdvOT65f8a23b.I FontSubset: true FirstChar: 46 LastChar: 121 FontDescriptor: FontName: PEKKLN+AdvOT65f8a23b.I Flags: Nonsymbolic FontBBox: -112, -250, 894, 873 FontFile3: true Encoding: WinAnsiEncoding Font: BaseFont: PEKLBA+AdvP7DA6 FontSubset: true FirstChar: 109 LastChar: 109 FontDescriptor: FontName: PEKLBA+AdvP7DA6 Flags: Nonsymbolic FontBBox: -20, -208, 1000, 770 FontFile3: true Encoding: WinAnsiEncoding Font: BaseFont: PEKKLP+AdvOT46dcae81+fb FontSubset: true FirstChar: 1 LastChar: 3 FontDescriptor: FontName: PEKKLP+AdvOT46dcae81+fb Flags: Symbolic 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FontBBox: -46, -250, 838, 879 FontFile3: true Encoding: WinAnsiEncoding XMP: Safety and Effectiveness of Isavuconazole Treatment for Fungal Infections in Solid Organ Transplant Recipients (ISASOT Study) 10.1128/spectrum.01784-21 Arnau Monforte Ibai Los-Arcos Maria Teresa Martín-Gómez David Campany-Herrero Judith Sacanell Cristina Berastegui Ester Márquez-Algaba Abiu Sempere Xavier Nuvials Maria Deu Lluís Castells Francesc Moreso Carles Bravo Joan Gavaldà Oscar Len Research Article Research Article isavuconazole fungal infection treatment solid organ transplantation American Society for Microbiology Monforte et al. Copyright © 2022 Monforte et al. This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International license. 20220216 2022 ABSTRACT Isavuconazole (ISA) is an alternative treatment for Aspergillus spp. and other fungal infections, but evidence regarding its use in solid organ transplant recipients (SOTR) is scarce. All SOTR who received ISA for treatment of a fungal infection (FI) at our center from December 2017 to January 2021 were included. The duration of the treatment depended on the type of infection. All patients were followed up to 3 months after treatment. Fifty-three SOTR were included, and the majority (44, 83%) were lung transplant recipients. The most frequently treated FI was tracheobronchitis (25, 46.3%). Aspergillus spp. (43, 81.1%); specially A. flavus (16, 37.2%) and A. fumigatus (12, 27.9%), was the most frequent etiology. Other filamentous fungi including one mucormycosis, and four yeast infections were treated. The median duration of treatment was 81 days (IQR 15-197). Mild gamma-glutamyltransferase elevation was the most frequent adverse event (34%). ISA was prematurely discontinued in six patients (11.3%) due to mild hepatotoxicity (2), fatigue (2), gastrointestinal intolerance (1) and myopathy (1). The mean tacrolimus dose decrease was 30% after starting ISA. Seven patients received ISA with mTOR inhibitors with good tolerability. Two patients developed breakthrough FI (3.8%). Among patients who completed the treatment, 27 (50.9%) showed clinical cure and 15 (34.1%) presented fungal persistence. Three patients (6%) died while on ISA due to FI. ISA was well tolerated and appeared to be an effective treatment for FI in SOTR. IMPORTANCE We describe 53 solid organ transplant recipients treated with isavuconazole for fungal infections. Because its use in clinical practice, there is scarce data of its use in solid organ transplant recipients, where interactions with calcineurin inhibitors and mTOR and adverse drug events have limited the use of other triazoles. To the best of our knowledge, this is the first article describing the safety regarding adverse events and drug interactions of isavuconazole for the treatment of fungal infections in a cohort of solid organ transplant recipients. Also, although this is a noncomparative study, we report some real world effectivity data of these patients, including treatment of non-Aspergillus fungal infections. 20211007 20211226 2165-0497 Pages: Page: Label: 1 Annotations: Annotation: Subtype: Link Rect: 124, 585, 177, 594 Annotation: Subtype: Link Rect: 417, 205, 513, 212 Annotation: Subtype: Link Rect: 400, 196, 456, 203 Annotation: Subtype: Link Rect: 452, 24, 533, 31 Annotation: Subtype: Link Rect: 508, 683, 544, 719 Page: Label: 2 Annotations: Annotation: Subtype: Link Rect: 352, 457, 356, 466 Destination: 28 Annotation: Subtype: Link Rect: 361, 457, 366, 466 Destination: 28 Annotation: Subtype: Link Rect: 44, 433, 49, 442 Destination: 28 Annotation: Subtype: Link Rect: 174, 421, 178, 430 Destination: 28 Annotation: Subtype: Link Rect: 333, 396, 337, 405 Destination: 28 Annotation: Subtype: Link Rect: 94, 372, 99, 381 Destination: 28 Annotation: Subtype: Link Rect: 105, 372, 109, 381 Destination: 28 Annotation: Subtype: 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