title: Caspofungin for treatment of invasive aspergillosis in Germany: results of a pre-planned subanalysis of an international registry.
abstract: BACKGROUND
  This study is a pre-planned country-specific subanalysis of results in Germany from a multinational multicenter registry to prospectively assess real-world experience with caspofungin administered for treatment of proven or probable invasive aspergillosis (IA).
  
  
  METHODS
  Data from patients treated with caspofungin for a single episode of IA were collected. Effectiveness was determined by the local investigator as favorable (complete or partial response) or unfavorable (stable disease, failure or death) at the end of caspofungin therapy. Descriptive statistics with binomial exact confidence intervals were employed.
  
  
  RESULTS
  Forty-two consecutive patients were identified in three German centers. Three patients (7%) had proven IA and 39/42 (93%) had probable IA (modified European Organization for Research and Treatment of Cancer/Mycosis Study Group (EORTC/MSG) criteria). Forty-one patients had pulmonary IA and one had tracheal IA. Caspofungin monotherapy was received by 36/42 patients (86%); of these, 26/36 (72%) received salvage therapy. A favorable response was observed in 29/42 patients (69%; 95% CI 53 to 82%); of these, 21/29 (72%) had a complete and 8/29 (28%) a partial response. Favorable response rate was 69% in patients with monotherapy (95% CI 52% to 84%; 25/36 patients), and 67% in patients receiving combination therapy (95% CI 22% to 96%; 4/6 patients). Favorable response rate in patients with first line therapy was 64% (95% CI 31% to 89%; 7/11 patients), and 73% in patients with second line therapy (95% CI 54% to 88%; 20/30 patients). No adverse events were reported. In total, 35/42 patients (83%; 95% CI 69 to 93%) survived seven days after completion of caspofungin therapy.
  
  
  CONCLUSIONS
  These real-life findings in Germany are consistent with the international findings from this registry and with findings from randomized studies.
authors.affiliation: Ruprecht-Karls-Universität Heidelberg, Universitaetsklinikum, Medizinische Klinik Abteilung V, Heidelberg, Germany. gerlinde.egerer@med.uni-heidelberg.de
authors.forename: Gerlinde
authors.initials: G
authors.lastname: Egerer
authors.forename: Dietmar
authors.initials: D
authors.lastname: Reichert
authors.forename: Mathias W
authors.initials: MW
authors.lastname: Pletz
authors.forename: Peter
authors.initials: P
authors.lastname: Kaskel
authors.forename: Karl J
authors.initials: KJ
authors.lastname: Krobot
authors.forename: Johan
authors.initials: J
authors.lastname: Maertens
mesh_terms: D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000008:administration & dosage*; D001230:Aspergillus / Q000472:pathogenicity; D000077336:Caspofungin; D054714:Echinocandins / Q000008:administration & dosage* / Q000009:adverse effects; D005858:Germany; D006801:Humans; D055744:Invasive Pulmonary Aspergillosis / Q000188:drug therapy* / Q000473:pathology; D055666:Lipopeptides; D008875:Middle Aged
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D000077336:Caspofungin