title: The clinical efficacy and safety of micafungin-itraconazole combination therapy in patients with pulmonary aspergilloma.
abstract: In spite of recent advances in chemotherapy, the treatment of pulmonary aspergilloma remains unsatisfactory. To evaluate the clinical efficacy and safety of combination therapy for pulmonary aspergilloma, we conducted a multi-institutional prospective study using micafungin (MCFG) and itraconazole (ITCZ). Adult patients who fulfilled the criteria for pulmonary aspergilloma were enrolled in this study. After patient consent had been obtained, intravenous MCFG 150 mg/day and an oral capsule of ITCZ 200 mg/day were administered for at least 1 month. The primary endpoint was the response assessed using an algorithm that incorporated the levels of improvement by evaluating clinical symptoms and signs, mycological and serological tests, and diagnostic imaging. A total of 17 patients were enrolled from three facilities. The response rate to the combination therapy was 58.8% (10/17). The long-term control in the group of patients who responded to treatment was better than that in the group of patients who did not respond. Adverse events occurred in 6 of the 17 patients (35.3%), but there were no severe adverse events. MCFG-ITCZ combination therapy appeared to be relatively safe and effective in patients with pulmonary aspergilloma.
authors.affiliation: Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan. mfujita@fukuoka-u.ac.jp
authors.forename: Masaki
authors.initials: M
authors.lastname: Fujita
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Tao
authors.forename: Akira
authors.initials: A
authors.lastname: Kajiki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ouchi
authors.forename: Eiji
authors.initials: E
authors.lastname: Harada
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ikegame
authors.forename: Takemasa
authors.initials: T
authors.lastname: Matsumoto
authors.forename: Junji
authors.initials: J
authors.lastname: Uchino
authors.forename: Kentaro
authors.initials: K
authors.lastname: Watanabe
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Nakanishi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D001232:Aspergillus fumigatus / Q000302:isolation & purification; D004359:Drug Therapy, Combination; D054714:Echinocandins / Q000009:adverse effects* / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D017964:Itraconazole / Q000009:adverse effects* / Q000627:therapeutic use*; D055666:Lipopeptides / Q000009:adverse effects* / Q000627:therapeutic use*; D008297:Male; D000077551:Micafungin; D008875:Middle Aged; D011446:Prospective Studies; D055732:Pulmonary Aspergillosis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D013902:Radiography, Thoracic; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D017964:Itraconazole; D000077551:Micafungin