Marco Schiuma

High frequency of isavuconazole use over voriconazole for chronic pulmonary aspergillosis: a retrospective observational study on tolerability and therapeutic drug monitoring

Federico Fama, Claudia Conflitti, Aurora Civati, Dario Cattaneo et autres

Chronic pulmonary aspergillosis (CPA) is a progressive fungal infection associated with significant morbidity and mortality. Voriconazole, a standard first-line treatment, is limited by poor tolerability, unpredictable pharmacokinetics, and extensive drug-drug interactions. Isavuconazole, a newer triazole with a more favorable safety profile, is …

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Impact of NAT2 acetylation phenotype on toxicity in tuberculosis therapy: a systematic review and meta-analysis

Sofia Dinegro, Sara Dal Molin, Ilaria Mariani, Giulia Mosini et autres

Adverse drug reactions (ADRs) remain a major challenge in tuberculosis treatment and frequently compromise therapeutic adherence and outcomes. Hepatotoxicity represents the most clinically significant toxicity. Genetic variability in N‑acetyltransferase 2 (NAT2), the key enzyme involved in isoniazid metabolism, has been associated with …

Impact of NAT2 acetylation phenotype on toxicity in tuberculosis therapy: a systematic review and meta-analysis

Sofia Dinegro, Sara Dal Molin, Ilaria Mariani, Giulia Mosini et autres

Adverse drug reactions (ADRs) remain a major challenge in tuberculosis treatment and frequently compromise therapeutic adherence and outcomes. Hepatotoxicity represents the most clinically significant toxicity. Genetic variability in N‑acetyltransferase 2 (NAT2), the key enzyme involved in isoniazid metabolism, has been associated with …

Impact of NAT2 acetylation phenotype on toxicity in tuberculosis therapy: a systematic review and meta-analysis

Sofia Dinegro, Sara Dal Molin, Ilaria Mariani, Giulia Mosini et autres

INTRODUCTION: Adverse drug reactions (ADRs) remain a major challenge in tuberculosis treatment and frequently compromise therapeutic adherence and outcomes. Hepatotoxicity represents the most clinically significant toxicity. Genetic variability in N‑acetyltransferase 2 (NAT2), the key enzyme involved in isoniazid metabolism, has been associated …

Impact of NAT2 acetylation phenotype on toxicity in tuberculosis therapy: a systematic review and meta-analysis

Sofia Dinegro, Sara Dal Molin, Ilaria Mariani, Giulia Mosini et autres

INTRODUCTION: Adverse drug reactions (ADRs) remain a major challenge in tuberculosis treatment and frequently compromise therapeutic adherence and outcomes. Hepatotoxicity represents the most clinically significant toxicity. Genetic variability in N‑acetyltransferase 2 (NAT2), the key enzyme involved in isoniazid metabolism, has been associated …

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An outbreak of acute pulmonary histoplasmosis after exposure to guano in a hollow tree in Ecuador

Cristina Gervasoni, Giacomo Casalini, Alessandro Torre, Marco Schiuma et autres

BACKGROUND: Outside of classic endemic areas, histoplasmosis has gained attention due to an increased incidence in immunocompetent travellers, attributable to changes in behaviours during travel. METHODS: A cluster of five patients who presented with acute pulmonary histoplasmosis after travelling to the Ecuadorian …

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Rifampicin drug monitoring in TB patients: new evidence for increased dosage?

Marco Schiuma, Marta Colaneri, Dario Cattaneo, Marta Fusi et autres

BACKGROUND The standard 10 mg/kg rifampicin (RIF) dose for TB treatment may be insufficient. Higher doses improve microbiological efficacy without increasing adverse effects. Therapeutic drug monitoring (TDM) may help to optimise RIF dosing by measuring 2, 4, and 6 h post-dose concentrations …

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NAT2 Acetylation Status Predicts Hepatotoxicity During Antituberculosis Therapy: Cumulative Risk Analysis of a Multiethnic Cohort

Marco Schiuma, Sofia Dinegro, Vera Battini, Alessandro Torre et autres

Antituberculosis drug-induced hepatotoxicity (ATDH) is a common adverse drug reaction often requiring treatment interruption, complicating tuberculosis management. The slow acetylator phenotype, characterized by reduced N-acetyltransferase 2 (NAT2) enzyme activity, is associated with increased hepatotoxicity risk, while rapid acetylators are associated with a …

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NAT2 Slow Acetylator Phenotype as a Significant Risk Factor for Hepatotoxicity Caused by Antituberculosis Drugs: Results From a Multiethnic Nested Case-Control Study

Stefania Cheli, Alessandro Torre, Marco Schiuma, Cristina Montrasio et autres

BACKGROUND: Under standard therapies, the incidence of drug-induced liver injury (DILI) in patients with tuberculosis ranges from 2% to 28%. Numerous studies have identified the risk factors for antituberculosis DILI; however, none have been conducted in a multiethnic real-world setting. The primary …

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Assessing the prevalence of schistosomiasis and strongyloidiasis in a tuberculosis clinic: the TB-TROPIcare study

Camilla Genovese, Marta Colaneri, Simone Pagano, Marco Schiuma et autres

Introduction In recent years, Europe has experienced a significant flux of migrants, often hailing from regions endemic for schistosomiasis and strongyloidiasis, diseases frequently overshadowed by tuberculosis (TB) in healthcare priorities. While TB remains a prevalent concern among this population, chronic schistosomiasis and …

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Drugs for treating infections caused by non-tubercular mycobacteria: a narrative review from the study group on mycobacteria of the Italian Society of Infectious Diseases and Tropical Medicine

Andrea Calcagno, N. Coppola, Loredana Sarmati, Marina Tadolini et autres

BACKGROUND: Non-tuberculous mycobacteria (NTM) are generally free-living organism, widely distributed in the environment, with sporadic potential to infect. In recent years, there has been a significant increase in the global incidence of NTM-related disease, spanning across all continents and an increased mortality …

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Management of Polypharmacy and Potential Drug–Drug Interactions in Patients with Pulmonary Aspergillosis: A 2-Year Study of a Multidisciplinary Outpatient Clinic

Dario Cattaneo, Alessandro Torre, Marco Schiuma, Aurora Civati et autres

Pulmonary aspergillosis mainly affects elderly patients, patients with pulmonary complications, patients with hematological malignancies, organ transplant recipients, or critically ill patients. Co-morbidities may result in a high rate of polypharmacy and a high risk of potential drug-drug interaction (pDDI)-related antifungal azoles, which …

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