新型抗真菌药物caspofungin

caspofungin是新型葡聚糖合成酶抑制剂类抗真菌药物中第 1个上市的药物 ,它能有效抑制 β ( 1,3) D 葡聚糖的合成 ,从而干扰真菌细胞壁的合成。caspofungin在体内、外具有广泛的抗真菌活性 ,包括曲菌和念珠菌。多中心试验表明 ,caspofungin治疗难治性或不能耐受其他治疗的侵袭性曲菌感染病人的临床有效率为 4 0 .7%。 2个随机双盲试验表明 ,caspofungin能有效治疗咽或食道念珠菌感染。侵袭性曲菌病人对caspofungin的耐受性较好。本文综述了caspofungin的药效学、药动学特性、临床疗效和不良反应等。

A new class of antifungal agent: caspofungin

Caspofungin is the first launched drug in a new class of antifungal agents and the glucan synthesis inhibitors that interferes with fungal cell wall synthesis by inhibiting the synthesis of β-(1,3)-D-glucan. Caspofungin exhibited in vitro and in vivo efficacy against a wide range of fungi including Aspergillus and Candida species. The clinical effective rate of caspofungin was 40.7% in patients with invasive aspergillosis who did not respond to or did not tolerate other antifungal agents in a noncomparative multicentre study. Caspofungin was effective in patients with oropharyngeal or oesophageal candidiasis, according to the preliminary results of two randomized double-blind trials. Caspofungin was generally well tolerated by patients with invasive aspergillosis. The pharmacodynamic and pharmacokinetic profiles, clinical efficacy and adverse reactions of caspofungin are reviewed in this paper.