Efficacy of caspofungin and itraconazole as secondary antifungal prophylaxis: analysis of data from a multinational case registry

Patients surviving invasive fungal disease (IFD) and needing further antineoplastic chemotherapy are at high risk of recurrent fungal infection. In the absence of randomised controlled trials in this area, secondary prophylactic regimens are diverse. From 448 patients registered with the Multination...

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Autores: Vehreschild, JJ, Sieniawski, M, Reuter, S, Arenz, D, Reichert, D, Maertens, J, Bohme, A, Silling, G, Martino, R, Maschmeyer, G, Rueping, MJGT, Ullmann, AJ, Cornely, OA
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2009
País:España
Institución:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p13082
Acceso en línea:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=13082
https://hal.science/hal-00556353
Access Level:acceso abierto
Palabra clave:Antifungal prophylaxis
Stem cell transplantation
Aspergillosis
Itraconazole
Caspofungin
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spelling Efficacy of caspofungin and itraconazole as secondary antifungal prophylaxis: analysis of data from a multinational case registryVehreschild, JJSieniawski, MReuter, SArenz, DReichert, DMaertens, JBohme, ASilling, GMartino, RMaschmeyer, GRueping, MJGTUllmann, AJCornely, OAAntifungal prophylaxisStem cell transplantationAspergillosisItraconazoleCaspofunginPatients surviving invasive fungal disease (IFD) and needing further antineoplastic chemotherapy are at high risk of recurrent fungal infection. In the absence of randomised controlled trials in this area, secondary prophylactic regimens are diverse. From 448 patients registered with the Multinational Case Registry of Secondary Antifungal Prophylaxis, we performed an analysis of patients receiving caspofungin (CAS) or itraconazole (ITC). All patients had an underlying haematological malignancy and had been diagnosed with an episode of IFD earlier in their course of treatment. Data collected comprised demographics, underlying disease, first episode of IFD, antifungal prophylaxis, incidence and outcome of breakthrough IFD and survival. A total of 75 patients were evaluated, comprising 28 receiving CAS and 47 receiving ITC. Patients in the CAS group were more likely to have had progression of underlying disease (32.1% vs. 8.5%; P = 0.028) as well as incomplete response of initial IFD at baseline (85.7% vs. 57.4%; P = 0.005). Allogeneic stem cell transplantation was more prevalent in patients receiving CAS (46.4% vs. 14.9%; P = 0.010). There was no difference in the occurrence of breakthrough IFD between both groups (32.1% vs. 31.9%). Treatment outcomes for recurrent IFD and overall mortality did not differ between groups. Both ITC and CAS were equally effective in preventing second episodes of IFD. Patients with uncontrolled first IFD, uncontrolled underlying disease or those receiving stem cell transplantation were more likely to have received CAS prophylaxis. Despite antifungal prophylaxis, risk of breakthrough IFD was high in both groups. (C) 2009 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.ELSEVIER2009info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=13082https://hal.science/hal-00556353INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTSISSN: 09248579ISSNe: 18727913reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pauinstname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)Inglésinfo:eu-repo/semantics/openAccessoai:iibsantpau.fundanetsuite.com:p130822026-06-14T12:41:47Z
dc.title.none.fl_str_mv Efficacy of caspofungin and itraconazole as secondary antifungal prophylaxis: analysis of data from a multinational case registry
title Efficacy of caspofungin and itraconazole as secondary antifungal prophylaxis: analysis of data from a multinational case registry
spellingShingle Efficacy of caspofungin and itraconazole as secondary antifungal prophylaxis: analysis of data from a multinational case registry
Vehreschild, JJ
Antifungal prophylaxis
Stem cell transplantation
Aspergillosis
Itraconazole
Caspofungin
title_short Efficacy of caspofungin and itraconazole as secondary antifungal prophylaxis: analysis of data from a multinational case registry
title_full Efficacy of caspofungin and itraconazole as secondary antifungal prophylaxis: analysis of data from a multinational case registry
title_fullStr Efficacy of caspofungin and itraconazole as secondary antifungal prophylaxis: analysis of data from a multinational case registry
title_full_unstemmed Efficacy of caspofungin and itraconazole as secondary antifungal prophylaxis: analysis of data from a multinational case registry
title_sort Efficacy of caspofungin and itraconazole as secondary antifungal prophylaxis: analysis of data from a multinational case registry
dc.creator.none.fl_str_mv Vehreschild, JJ
Sieniawski, M
Reuter, S
Arenz, D
Reichert, D
Maertens, J
Bohme, A
Silling, G
Martino, R
Maschmeyer, G
Rueping, MJGT
Ullmann, AJ
Cornely, OA
author Vehreschild, JJ
author_facet Vehreschild, JJ
Sieniawski, M
Reuter, S
Arenz, D
Reichert, D
Maertens, J
Bohme, A
Silling, G
Martino, R
Maschmeyer, G
Rueping, MJGT
Ullmann, AJ
Cornely, OA
author_role author
author2 Sieniawski, M
Reuter, S
Arenz, D
Reichert, D
Maertens, J
Bohme, A
Silling, G
Martino, R
Maschmeyer, G
Rueping, MJGT
Ullmann, AJ
Cornely, OA
author2_role author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Antifungal prophylaxis
Stem cell transplantation
Aspergillosis
Itraconazole
Caspofungin
topic Antifungal prophylaxis
Stem cell transplantation
Aspergillosis
Itraconazole
Caspofungin
description Patients surviving invasive fungal disease (IFD) and needing further antineoplastic chemotherapy are at high risk of recurrent fungal infection. In the absence of randomised controlled trials in this area, secondary prophylactic regimens are diverse. From 448 patients registered with the Multinational Case Registry of Secondary Antifungal Prophylaxis, we performed an analysis of patients receiving caspofungin (CAS) or itraconazole (ITC). All patients had an underlying haematological malignancy and had been diagnosed with an episode of IFD earlier in their course of treatment. Data collected comprised demographics, underlying disease, first episode of IFD, antifungal prophylaxis, incidence and outcome of breakthrough IFD and survival. A total of 75 patients were evaluated, comprising 28 receiving CAS and 47 receiving ITC. Patients in the CAS group were more likely to have had progression of underlying disease (32.1% vs. 8.5%; P = 0.028) as well as incomplete response of initial IFD at baseline (85.7% vs. 57.4%; P = 0.005). Allogeneic stem cell transplantation was more prevalent in patients receiving CAS (46.4% vs. 14.9%; P = 0.010). There was no difference in the occurrence of breakthrough IFD between both groups (32.1% vs. 31.9%). Treatment outcomes for recurrent IFD and overall mortality did not differ between groups. Both ITC and CAS were equally effective in preventing second episodes of IFD. Patients with uncontrolled first IFD, uncontrolled underlying disease or those receiving stem cell transplantation were more likely to have received CAS prophylaxis. Despite antifungal prophylaxis, risk of breakthrough IFD was high in both groups. (C) 2009 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.
publishDate 2009
dc.date.none.fl_str_mv 2009
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=13082
https://hal.science/hal-00556353
url https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=13082
https://hal.science/hal-00556353
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv ELSEVIER
publisher.none.fl_str_mv ELSEVIER
dc.source.none.fl_str_mv INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS
ISSN: 09248579
ISSNe: 18727913
reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
instname_str Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
reponame_str r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
collection r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
repository.name.fl_str_mv
repository.mail.fl_str_mv
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