A multicenter, open-label clinical study of micafungin (FK463) in the treatment of deep-seated mycosis in Japan.
The efficacy and safety of micafungin (FK463), which is a new lipopeptide antifungal agent of the echinocandin class and is active against both Aspergillus and Candida species, were investigated in patients with deep-seated mycosis in this study. 70 patients were treated with micafungin 12.5-150 mg/d intravenously for up to 56 d. The overall clinical response rates were 60% (6/10) in invasive pulmonary aspergillosis, 67% (6/9) in chronic necrotizing pulmonary aspergillosis, 55% (12/22) in pulmonary aspergilloma, 100% (6/6) in candidemia, and 71% (5/7) in esophageal candidiasis. The response rates for patients with prior antifungal treatment which was considered ineffective or toxic, were similar to rates for patients without prior treatment. Mycological eradication was observed in patients infected with Aspergillus fumigatus, Aspergillus flavus, Aspergillus terreus, Aspergillus niger, Candida albicans, Candida glabrata, or Candida krusei. Adverse events related to micafungin were reported in 21 patients (30%), and there was no dose-related occurrence of any adverse event. It is concluded that treatment with micafungin as monotherapy seems to be effective and safe in patients with deep-seated mycosis.
Section of Molecular and Clinical Microbiology, Department of Microbiology and Immunology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. s-kohno@net.nagasaki-u.ac.jp
Shigeru
S
Kohno
Toru
T
Masaoka
Hideyo
H
Yamaguchi
Takeshi
T
Mori
Akio
A
Urabe
Akira
A
Ito
Yoshihito
Y
Niki
Hideo
H
Ikemoto
D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000008:administration & dosage*; D001228:Aspergillosis / Q000175:diagnosis / Q000188:drug therapy; D002177:Candidiasis / Q000175:diagnosis / Q000188:drug therapy; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D054714:Echinocandins; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007262:Infusions, Intravenous; D055666:Lipopeptides; D008074:Lipoproteins / Q000008:administration & dosage*; D008297:Male; D000077551:Micafungin; D008875:Middle Aged; D009181:Mycoses / Q000175:diagnosis* / Q000188:drug therapy*; D010456:Peptides, Cyclic / Q000008:administration & dosage*; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D008074:Lipoproteins; D010456:Peptides, Cyclic; D000077551:Micafungin