Posaconazole salvage therapy: The Posifi study.
Administration, Oral
Adult
Aged
Aged, 80 and over
Antifungal Agents
/ administration & dosage
Blood Chemical Analysis
Drug-Related Side Effects and Adverse Reactions
/ epidemiology
Female
Humans
Male
Middle Aged
Mycoses
/ drug therapy
Retrospective Studies
Salvage Therapy
/ methods
Spain
Tertiary Care Centers
Treatment Outcome
Triazoles
/ administration & dosage
Withholding Treatment
/ statistics & numerical data
aspergillosis
intolerant therapy
posaconazole
refractory therapy
salvage therapy
yeast
zygomycosis
Journal
Mycoses
ISSN: 1439-0507
Titre abrégé: Mycoses
Pays: Germany
ID NLM: 8805008
Informations de publication
Date de publication:
Jun 2019
Jun 2019
Historique:
received:
19
11
2018
revised:
12
02
2019
accepted:
01
03
2019
pubmed:
14
3
2019
medline:
10
8
2019
entrez:
14
3
2019
Statut:
ppublish
Résumé
Posaconazole (PCZ) is used mainly for the prevention of invasive fungal infection (IFI). A multicentre retrospective, investigational study using a non-randomized, single-arm design carried out in six tertiary hospitals in Spain to evaluate the use of PCZ in different forms of administration in the (non-prophylactic) treatment of IFI. Over an eight-year-period, 67 patients were included in this study. PCZ was administered as salvage therapy (intolerant or refractory to a previous antifungal agent) in 65/67 (97%); of these, it was used against Aspergillosis (68.6%), Zygomycosis (13.4%), other moulds (8.9%) and yeast (10.5%). The median duration of PCZ therapy was 75 days. The oral solution was associated with low serum levels (<0.7 mg/L) in 63% of available patients. Clinical response at 3 and 12 months of PCZ therapy were for aspergillosis: 47.8% and 41.3%; for zygomycosis: 55.5% and 55.5%; and for other mycoses: 69.2% and 69.2%, respectively. Suspension by toxicity was only observed in 6% and 7.5% of patients at 3 and 12 months, respectively, mainly with grade III/IV elevations of liver function test (LFTs). Posaconazole salvage therapy, especially oral tablets, can be an effective alternative option for patients with IFI who cannot tolerate or do not respond to other antifungal therapies.
Sections du résumé
BACKGROUND
BACKGROUND
Posaconazole (PCZ) is used mainly for the prevention of invasive fungal infection (IFI).
METHODS
METHODS
A multicentre retrospective, investigational study using a non-randomized, single-arm design carried out in six tertiary hospitals in Spain to evaluate the use of PCZ in different forms of administration in the (non-prophylactic) treatment of IFI.
RESULTS
RESULTS
Over an eight-year-period, 67 patients were included in this study. PCZ was administered as salvage therapy (intolerant or refractory to a previous antifungal agent) in 65/67 (97%); of these, it was used against Aspergillosis (68.6%), Zygomycosis (13.4%), other moulds (8.9%) and yeast (10.5%). The median duration of PCZ therapy was 75 days. The oral solution was associated with low serum levels (<0.7 mg/L) in 63% of available patients. Clinical response at 3 and 12 months of PCZ therapy were for aspergillosis: 47.8% and 41.3%; for zygomycosis: 55.5% and 55.5%; and for other mycoses: 69.2% and 69.2%, respectively. Suspension by toxicity was only observed in 6% and 7.5% of patients at 3 and 12 months, respectively, mainly with grade III/IV elevations of liver function test (LFTs).
CONCLUSIONS
CONCLUSIONS
Posaconazole salvage therapy, especially oral tablets, can be an effective alternative option for patients with IFI who cannot tolerate or do not respond to other antifungal therapies.
Substances chimiques
Antifungal Agents
0
Triazoles
0
posaconazole
6TK1G07BHZ
Types de publication
Journal Article
Multicenter Study
Observational Study
Langues
eng
Pagination
526-533Subventions
Organisme : Institutional Review Board of Hospital Ramon y Cajal
ID : GEM-POSE-2017-01
Organisme : Plan Nacional de I+D+i 2013-2016
Organisme : Instituto de Salud Carlos III
Organisme : Subdirección General de Redes y Centros de Investigación Cooperativa
Organisme : Ministerio de Ciencia, Innovación y Universidades
Organisme : Spanish Network for Research in Infectious Diseases
ID : REIPI RD16/0016; RD16
Organisme : European Development Regional Fund "A way to achieve Europe", Operative Program Intelligent Growth
ID : 2014-2020
Informations de copyright
© 2019 Blackwell Verlag GmbH.