par Merlos, Romain 
;Amighi, Karim ;Wauthoz, Nathalie
Référence Current Fungal Infection Reports, 8, 4, page (331-342)
Publication Publié, 2014-08-19
;Amighi, Karim ;Wauthoz, Nathalie Référence Current Fungal Infection Reports, 8, 4, page (331-342)
Publication Publié, 2014-08-19
Article révisé par les pairs
| Résumé : | Invasive pulmonary aspergillosis (IPA) is a fungal infection that is seen with particular frequency in immunocompromised patients, and associated with high rates of mortality. To combat or prevent IPA, triazoles such as voriconazole or itraconazole and posaconazole have become accepted as first- and second-line therapy, respectively. However, triazoles are associated with issues of oral bioavailability, high liver metabolism, and/or drug–drug interactions, increasing the variability of systemic concentrations. As a way to overcome these issues, inhalation appears to be a promising route for delivery of triazoles for prophylactic or curative therapy in IPA. Indeed, pulmonary drug delivery drastically increases the drug in situ while decreasing the systemic exposure, thereby limiting drug metabolization, side effects, and drug–drug interactions. The development of triazoles for inhalation has focused on voriconazole and itraconazole, drugs which are both highly permeable but with significant different solubility. In this review, we describe the most advanced and promising pharmaceutical developments for voriconazole and itraconazole. |
