Retrospective evaluation of caspofungin therapy in invasive aspergillosis (RECAM-IA).
To evaluate caspofungin in high-risk invasive aspergillosis (IA) patient, a retrospective review of patient characteristics, antifungal therapies and clinical outcomes on hospitalised patients at sites in Russia, Canada, Germany, and Thailand was performed. Fifty-five patients were included, six with proven and 49 with probable aspergillosis; 76.4% had haematological diseases, 80% were on immunosuppressive drugs, 32.7% were neutropenic at caspofungin initiation. Median duration of prior antifungal therapy was 9 days (range 1-232). Reasons for initiating caspofungin included: disease refractory to first-line antifungal (49.1%) and toxicities with prior antifungals (18.2%). Median caspofungin therapy duration was 14 days (range 2-62), with a median of 13 days (range 1-62) as monotherapy. Favourable responses were observed in 45.5% of the patients, complete responses in 40% and partial responses in 5.5%; 74.5% survived 7 days after completion of caspofungin therapy with 69.1% having been successfully discharged from the hospital. Few patients (14.6%) on caspofungin switched because of suspected resistance, lack of response or adverse events. There were no increases in hospital stay as a result of adverse events or drug-drug interactions related to caspofungin; 7.3% of patients had a mean value of 13 (± 14.11) days of increased stay attributable to treatment failure. Caspofungin was well-tolerated. It exhibited effectiveness and high survival in treating severe IA patients.
Wisniewski
Tami
T
Merck & Co, Inc, Whitehouse Station, NJ, USA. tami_wisniewski@merck.com
Klimko
Nikolay
N
Laverdiere
Michel
M
Kiertiburanakul
Sasisopin
S
Kliasova
Galina
G
Trenschel
Rudolf
R
Kumar
Ritesh N
RN
D000935:Antifungal Agents / Q000008:administration & dosage* / Q000009:adverse effects; D002170:Canada; D000077336:Caspofungin; D054714:Echinocandins / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005858:Germany; D019337:Hematologic Neoplasms / Q000150:complications; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D055744:Invasive Pulmonary Aspergillosis / Q000188:drug therapy*; D055666:Lipopeptides; D008297:Male; D012189:Retrospective Studies; D012426:Russia; D016019:Survival Analysis; D013785:Thailand; D013997:Time Factors; D016896:Treatment Outcome
D000935:Antifungal Agents; D054714:Echinocandins; D007166:Immunosuppressive Agents; D055666:Lipopeptides; D000077336:Caspofungin