TY - JOUR
T1 - Matched-paired analysis of patients treated for invasive mucormycosis
T2 - Standard treatment versus posaconazole new formulations (MoveOn)
AU - Salmanton-García, Jon
AU - Seidel, Danila
AU - Koehler, Philipp
AU - Mellinghoff, Sibylle C.
AU - Herbrecht, Raoul
AU - Klimko, Nikolai
AU - Ráčil, Zdeněk
AU - Falces-Romero, Iker
AU - Ingram, Paul
AU - Benítez-Peñuela, Miguel Ángel
AU - Rodríguez, José Yesid
AU - Desoubeaux, Guillaume
AU - Barać, Aleksandra
AU - García-Vidal, Carolina
AU - Hoenigl, Martin
AU - Mehta, Sanjay R.
AU - Cheng, Matthew P.
AU - Klyasova, Galina
AU - Heinz, Werner J.
AU - Iqbal, Nousheen
AU - Krause, Robert
AU - Ostermann, Helmut
AU - Penack, Olaf
AU - Schalk, Enrico
AU - Sheppard, Donald C.
AU - Willinger, Birgit
AU - Wisplinghoff, Hilmar
AU - Vehreschild, J. Janne
AU - Cornely, Oliver A.
AU - Vehreschild, Maria J.G.T.
N1 - Publisher Copyright:
© 2019 The Author(s).
PY - 2019/11/1
Y1 - 2019/11/1
N2 - Background: First-line antifungal treatment for invasive mucormycosis (IM) consists of liposomal amphotericin B. Salvage treatment options are limited and often based on posaconazole oral suspension. With the approval of posaconazole new formulations, patients could benefit from improved pharmacokinetics, safety and tolerability. Objectives: Our aim was to assess the effectiveness of posaconazole new formulations for IM treatment. Methods: We performed a case-matched analysis with proven or probable IM patients from the FungiScope® Registry. First-line posaconazole new formulations (1st-POSnew) and first-line amphotericin B plus posaconazole new formulations (1st-AMB+POSnew) cases were matched with first-line amphotericin B-based (1st-AMB) treatment controls. Salvage posaconazole new formulations (SAL-POSnew) cases were matched with salvage posaconazole oral suspension (SAL-POSsusp) controls. Each case was matched with up to three controls (based on severity, haematological/oncological malignancy, surgery and/or renal dysfunction). Results: Five patients receiving 1st-POSnew, 18 receiving 1st-AMB+POSnew and 22 receiving SAL-POSnew were identified. By day 42, a favourable response was reported for 80.0% (n=4/5) of patients receiving 1st-POSnew, for 27.8% (n=5/18) receiving 1st-AMB+POSnew and for 50.0% (n=11/22) receiving SAL-POSnew. Day 42 all-cause mortality of patients receiving posaconazole new formulations was lower compared with controls [20.0% (n=1/5) in 1st-POSnew versus 53.3% (n=8/15) in 1st-AMB; 33.3% (n=6/18) in 1st-AMB+POSnew versus 52.0% (n=26/50) in 1st-AMB; and 0.0% (n=0/22) in SAL-POSnew versus 4.4% (n=2/45) in SAL-POSsusp]. Conclusions: Posaconazole new formulations were effective in terms of treatment response and associated mortality of IM. While posaconazole new formulations may be an alternative for treatment of IM, the limited sample size of our study calls for a cautious interpretation of these observations.
AB - Background: First-line antifungal treatment for invasive mucormycosis (IM) consists of liposomal amphotericin B. Salvage treatment options are limited and often based on posaconazole oral suspension. With the approval of posaconazole new formulations, patients could benefit from improved pharmacokinetics, safety and tolerability. Objectives: Our aim was to assess the effectiveness of posaconazole new formulations for IM treatment. Methods: We performed a case-matched analysis with proven or probable IM patients from the FungiScope® Registry. First-line posaconazole new formulations (1st-POSnew) and first-line amphotericin B plus posaconazole new formulations (1st-AMB+POSnew) cases were matched with first-line amphotericin B-based (1st-AMB) treatment controls. Salvage posaconazole new formulations (SAL-POSnew) cases were matched with salvage posaconazole oral suspension (SAL-POSsusp) controls. Each case was matched with up to three controls (based on severity, haematological/oncological malignancy, surgery and/or renal dysfunction). Results: Five patients receiving 1st-POSnew, 18 receiving 1st-AMB+POSnew and 22 receiving SAL-POSnew were identified. By day 42, a favourable response was reported for 80.0% (n=4/5) of patients receiving 1st-POSnew, for 27.8% (n=5/18) receiving 1st-AMB+POSnew and for 50.0% (n=11/22) receiving SAL-POSnew. Day 42 all-cause mortality of patients receiving posaconazole new formulations was lower compared with controls [20.0% (n=1/5) in 1st-POSnew versus 53.3% (n=8/15) in 1st-AMB; 33.3% (n=6/18) in 1st-AMB+POSnew versus 52.0% (n=26/50) in 1st-AMB; and 0.0% (n=0/22) in SAL-POSnew versus 4.4% (n=2/45) in SAL-POSsusp]. Conclusions: Posaconazole new formulations were effective in terms of treatment response and associated mortality of IM. While posaconazole new formulations may be an alternative for treatment of IM, the limited sample size of our study calls for a cautious interpretation of these observations.
UR - https://www.scopus.com/pages/publications/85073576536
U2 - 10.1093/jac/dkz344
DO - 10.1093/jac/dkz344
M3 - Article
C2 - 31393591
AN - SCOPUS:85073576536
SN - 0305-7453
VL - 74
SP - 3315
EP - 3327
JO - Journal of Antimicrobial Chemotherapy
JF - Journal of Antimicrobial Chemotherapy
IS - 11
ER -
