title: Efficacy and safety of micafungin for invasive candida infections: a meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  Invasive fungal infections such as candidiasis and mold infections cause significant morbidity and mortality in seriously ill patients. Micafungin is an echinocandin antifungal agent with potent activity against most species of Candida and Aspergillus. We did this meta-analysis to clarify whether micafungin offers superior efficacy and safety compared with other antifungal agent for treating infections associated with invasive candidiasis.
  
  
  METHODS
  We did a meta-analysis of randomized controlled trials to examine whether micafungin has superior efficacy and safety compared with other antifungal agents recommended by the treatment guidelines for fungal infection. Seven trials involving 2913 patients were included in this analysis. Odds ratios (OR) and 95% confidence intervals (CI) were calculated.
  
  
  RESULTS
  Micafungin was associated with significantly better treatment success compared with the comparator antifungal agents (modified intention to treat, 2851 patients; random-effects model, OR 1.20, 95%CI 1.00 - 1.45, P = 0.0487). In addition, micafungin was more effective than the comparators for antifungal prophylaxis of neutropenic patients undergoing hematopoietic stem cell transplantation (OR 1.47, 95%CI 1.08 - 2.00, P = 0.01). Although there was no significant difference between the compared regimens in terms of the incidence of adverse drug effects (OR 0.94, 95%CI 0.77 - 1.11), fewer patients treated with micafungin withdrew from the studies because of adverse events (OR 0.64, 95%CI 0.44 - 0.94).
  
  
  CONCLUSIONS
  Micafungin has a good safety and tolerability profile, with an efficacy at least comparable to the other antifungal agents. Micafungin offers advantages over other agents for antifungal prophylaxis. Micafungin offers an appropriate alternative for antifungal prophylaxis rather than the treatment of invasive candida infections.
authors.affiliation: Department of Clinical Pharmacology, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Chen
authors.forename: Mao-Hu
authors.initials: MH
authors.lastname: Lin
authors.forename: Meng-Li
authors.initials: ML
authors.lastname: Chen
authors.forename: Zhe-Yuan
authors.initials: ZY
authors.lastname: Liu
authors.forename: Dong
authors.initials: D
authors.lastname: Chai
authors.forename: Rui
authors.initials: R
authors.lastname: Wang
mesh_terms: D000935:Antifungal Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D058365:Candidiasis, Invasive / Q000188:drug therapy*; D054714:Echinocandins / Q000009:adverse effects* / Q000627:therapeutic use*; D006801:Humans; D055666:Lipopeptides / Q000009:adverse effects* / Q000627:therapeutic use*; D000077551:Micafungin; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D000077551:Micafungin