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aciclovir + hydrocortisone (Xerese / Xerclear / Lipsovir)

✓ Approved

Lapidot Medical · NR3C1 · 小分子

什么是 aciclovir + hydrocortisone？

aciclovir + hydrocortisone 是一种小分子，由Lapidot Medical研发。该药已获批，用于治疗相关适应症，给药途径：Topical。

药物档案

商品名Xerese, Xerclear, Lipsovir
公司Lapidot Medical
药物类别小分子
分子靶点NR3C1, ,
给药途径Topical
状态Approved
来源： ClinicalTrials.gov, Lapidot Medical

作用机制

分子靶点

aciclovir + hydrocortisone 作用于 3 个分子靶点：

NR3C1nuclear receptor subfamily 3 group C member 1 (GR, GCCR)
(UL30)
(UL30)
需要更深入的分析？Noah AI 可解释复杂机制并与同类药物比较。

治疗适应症

aciclovir + hydrocortisone 针对 1 个适应症，涉及 1 个治疗领域。

治疗领域疾病/病症分期
Congenital, familial and genetic disordersCongenital herpes simplex infection✓ Approved

相关研究文献

PubMedGan to kagaku ryoho. Cancer & chemotherapy2026-09-11

[A Case of Isolated ACTH Deficiency after Conversion Surgery Following Gemcitabine, Cisplatin, and Pembrolizumab for Distal Cholangiocarcinoma].

Hotchi Shota S, Miura Takayuki T, Aoki Shuichi S, Sato Hideaki H et al.

We report the case of a 69-year-old man who was initially diagnosed with resectable distal cholangiocarcinoma, for which radical resection was planned. However, the disease was reclassified as an unresectable distal cholangiocarcinoma because peritoneal cytology was positive. After 8 courses of gemcitabine, cisplatin, and pembrolizumab (GCP) therapy, pancreaticoduodenectomy was performed as a conversion surgery because the peritoneal cytology was negative. During surgery, no non-curative factors were identified, and an R0 resection was achieved. On postoperative day 14, the patient developed a fever suspected of cholangitis, and the hyponatremia that appeared on day 20 became prolonged. Suspecting adrenal insufficiency, hydrocortisone replacement was initiated on day 27. The serum sodium levels gradually increased, which allowed tapering of the hydrocortisone dose. As only ACTH levels decreased among the anterior pituitary hormones examined, a diagnosis of isolated ACTH deficiency was made. Ten months postoperatively, the patient received S-1 as adjuvant chemotherapy, continued oral hydrocortisone, and is doing well without adverse events. Clinicians should be aware of irAEs during the perioperative period after ICI therapy. Serious complications can be prevented through multidisciplinary collaboration.

PMID 42723243
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PubMedInternal medicine journal2026-09-10

ANZTCT cytomegalovirus practice survey for allogeneic haemopoietic stem cell transplant and cellular therapy recipients in Australia and New Zealand.

Henden Andrea A, Chee Lynette L, Clark Julia J, Conyers Rachel R et al.

Despite pre-emptive treatment (PeT), cytomegalovirus (CMV) disease and reactivation remain a clinical concern. In Australia and New Zealand (ANZ), variability exists in the management of CMV for haematopoietic stem cell transplantation (HSCT) recipients. To understand the state of practice in Australia, a survey captured insights on detection, monitoring, prophylaxis and treatment from 21 sites, including 11 chimeric antigen receptor T-cell (CAR-T) therapy sites. Respondents reported 26 cases of CMV disease after HSCT and four cases after CAR-T in 2024. All HSCT sites and four CAR-T sites had CMV protocols. Commonly, CMV nucleic acid viral load (VL) testing was employed weekly. Sites utilised plasma (66%) or whole blood (33%). VL was reported as IU/mL (66%), copies/mL (29%) or not specified (5%). One third of respondents tested CMV DNAemia before HSCT. All recipients were monitored regardless of CMV serostatus. Half the sites employed post-HSCT CMV prophylaxis using letermovir (nine sites), (val)aciclovir (eight) and (val)ganciclovir (three). VL thresholds for PeT ranged from 100 to 5000 IU/mL. Most sites used (val)ganciclovir for PeT, with foscarnet second line. At 76% of HSCT sites, PeT continued until two consecutive negative results. Frontline therapy for CMV disease is ganciclovir; 86% of ANZ sites used (val)ganciclovir while three paediatric sites used foscarnet. For resistant or refractory CMV, guidelines recommend foscarnet or maribavir, although maribavir was not funded or used during the survey period. CMV-specific immunotherapy can be considered. Institutional preferences and medicine funding drives variability in ANZ practice. This leaves potential for healthcare inequity since newer antiviral agents are inconsistently used, contrasting with international guidelines.

PMID 42717891
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PubMedJACC. Case reports2026-09-10

Not All Shocks Are Created Equal: Refractory Cardiogenic Shock Unmasking Panhypopituitarism Following Acute Coronary Syndrome.

Subramanian Seetha Devi SD, Chai Siew Yap SY, Kang Huan Yean HY, Mathews Gerard Jason GJ et al.

Adrenal insufficiency is an uncommon but reversible cause of shock that may coexist with cardiogenic shock in acute coronary syndrome and be overlooked once significant coronary artery disease is identified. A 59-year-old man presented with non-ST-segment elevation myocardial infarction complicated by cardiogenic shock. Despite successful percutaneous coronary intervention to critical left anterior descending and right coronary artery lesions, he remained in refractory shock requiring escalating inotropic support. Retrospective recognition of secondary hypothyroidism and a bitemporal visual field defect raised suspicion of pituitary insufficiency. Empiric hydrocortisone resulted in rapid hemodynamic recovery. Subsequent evaluation confirmed panhypopituitarism, whereas magnetic resonance imaging demonstrated a cystic sellar lesion compressing the pituitary gland. Secondary adrenal insufficiency should be considered when shock persists despite successful revascularization and cardiac recovery. Early glucocorticoid replacement may be lifesaving and should not await hormonal confirmation when adrenal crisis is suspected.

PMID 42720645
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PubMedJournal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & Practitioners2026-09-09

Cytotoxic Lesions of the Corpus Callosum Associated With Addison's Disease: A Case Report.

Yeniay Süt Nurşah N, Yıldırım Miraç M, Bektaş Ömer Ö, Özsu Elif E et al.

Cytotoxic Lesions of the Corpus Callosum (CLOCCs) are transient splenial lesions typically triggered by infections, trauma, or metabolic disturbances. This report documents a unique case of a 13-year-old girl with CLOCCs secondary to Addison's disease, an association not previously reported. The patient initially presented with lethargy, fever, and hyperpigmentation of the skin and gingiva. Investigations revealed profound hyponatremia (121 mmol/L) and hypoosmolality, while a brain MRI confirmed a cytotoxic lesion in the splenium. Although meningoencephalitis was initially suspected, markedly elevated adrenocorticotropic hormone (ACTH) and low cortisol levels ultimately confirmed primary adrenal insufficiency. The pathogenesis likely involves cytotoxic edema and blood-brain barrier dysfunction driven by severe electrolyte imbalance and hypocortisolism. Following hydrocortisone replacement therapy and gradual sodium correction, the patient achieved a rapid clinical recovery. A follow-up MRI demonstrated complete resolution of the lesion within one week. This case highlights the importance of considering adrenal insufficiency in the differential diagnosis of reversible splenial lesions, particularly when physical signs like hyperpigmentation are present.

PMID 42714357
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PubMedFederal practitioner : for the health care professionals of the VA, DoD, and PHS2026-09-09

Diagnostic Challenge of Immune Checkpoint Inhibitor-Induced Hypophysitis in Patient With Melanoma.

Rusz Alexandra A, Kirk Melanie M, Seog Woo Jin WJ, Baig Imran I et al.

Immune checkpoint inhibitors (ICIs) have emerged as immunotherapy treatment modalities for several advanced malignancies. Although effective in cancer treatment, inhibition of cellular checkpoints can result in the loss of immunologic tolerance with consequent autoimmune disorders. Clinicians must be aware of immune-related adverse events (irAEs), such as hypophysitis, to ensure prompt treatment. A 73-year-old male with a history of metastatic melanoma who had received 5 cycles of pembrolizumab (anti-PD-1) and 2 cycles of combination ICI therapy with ipilimumab (anti-CTLA-4) and nivolumab (anti-PD-1) presented to a US Department of Veterans Affairs medical center 3 weeks after completing his second cycle of therapy with fatigue, headache, and hyponatremia. Laboratory evaluation revealed a low thyroid hormone level with suppressed thyrotropin, consistent with central hypothyroidism. Magnetic resonance imaging of the brain demonstrated pituitary enlargement suggestive of hypophysitis. The patient was treated with intravenous hydrocortisone for suspected central adrenal insufficiency. A subsequent cosyntropin stimulation test confirmed secondary adrenal insufficiency with low adrenocorticotropic hormone levels and a blunted cortisol response. Computed tomography and positron emission tomography showed normal adrenal glands without metastases. The patient's symptoms improved with glucocorticoid replacement, though he later experienced complications of steroid therapy. Patients presenting with evidence of new autoimmune disorders who have undergone ICI therapy should be immediately evaluated for irAEs. ICI-induced hypophysitis is irreversible, can impact quality of life, and requires maintenance replacement therapy. As ICI therapies become more prevalent in the treatment of solid cancers, it is expected that clinicians will see more cases of ICI-related irAEs, such as hypophysitis, and must become comfortable with diagnosis, treatment, and management.

PMID 42713228
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PubMedCureus2026-09-09

Thyroid Storm at Onset: An Uncommon Presentation of Graves' Disease.

Dalili Muhammad M, El-Toukhy Sara S, Rahman Shadman Sakib SS, Khalifa Hussam H et al.

Graves' disease is an autoimmune disorder causing hyperthyroidism through antibodies that stimulate thyroxine (T4) and triiodothyronine (T3) production and release, typically presenting with a short history of hypermetabolic symptoms. Thyroid storm is a rare, life-threatening emergency resulting from thyrotoxicosis that manifests with severe multisystem involvement. Thyroid storm as the initial manifestation of Graves' disease is uncommon and can mimic other acute medical conditions, making early diagnosis challenging. We report the case of a 62-year-old woman with a background of hypertension, heart failure with preserved ejection fraction, type 2 diabetes mellitus, and chronic obstructive pulmonary disease who presented with acute confusion, dyspnoea, chest pain, abdominal pain, and vomiting. Clinical examination demonstrated hypoxia, tachycardia, and fluid overload, and as such, she was treated for acute decompensated heart failure in the High Dependency Unit setting. Despite improvement in respiratory status with intravenous diuresis, her confusion rapidly worsened, and she developed new-onset atrial fibrillation with haemodynamic instability. Further investigation revealed marked thyrotoxicosis, with a subsequent thyroid ultrasound demonstrating an enlarged and hypervascular gland. The calculated Burch-Wartofsky score was 80, highly suggestive of thyroid storm. Treatment with carbimazole, hydrocortisone, and beta-blockade led to rapid biochemical and clinical improvement, with restoration of sinus rhythm and return towards cognitive baseline. Graves' disease was diagnosed after clinical resolution with a positive thyroid-stimulating hormone (TSH)-receptor antibody titre. This case, therefore, presents thyroid storm as the first presentation of Graves' disease, masquerading as acute decompensated heart failure and delirium. It emphasises the importance of considering endocrine causes in unexplained multisystem deterioration, as early recognition and prompt treatment are essential to reduce significant morbidity and mortality.

PMID 42712980
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