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837. Isavuconazole in the Treatment of Chronic Forms of Coccidioidomycosis

BACKGROUND: Coccidioidomycosis is a fungal infection with a range of clinical manifestations. Currently used antifungal agents exhibit variable efficacy and toxicity profiles necessitating evaluation of additional therapeutic options. METHODS: Patients with coccidioidomycosis who received Isavuconaz...

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Autores principales: Heidari, Arash, Sharma, Rupam, Shakir, Qusai, Shah, Madiha, Donnelly, Monica, Reynolds, Trina, Trigg, Kate, Joliff, Jeff, Kuran, Rasha, Johnson, Royce H, Thompson, George R
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10678949/
http://dx.doi.org/10.1093/ofid/ofad500.882
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author Heidari, Arash
Sharma, Rupam
Shakir, Qusai
Shah, Madiha
Donnelly, Monica
Reynolds, Trina
Trigg, Kate
Joliff, Jeff
Kuran, Rasha
Johnson, Royce H
Thompson, George R
author_facet Heidari, Arash
Sharma, Rupam
Shakir, Qusai
Shah, Madiha
Donnelly, Monica
Reynolds, Trina
Trigg, Kate
Joliff, Jeff
Kuran, Rasha
Johnson, Royce H
Thompson, George R
author_sort Heidari, Arash
collection PubMed
description BACKGROUND: Coccidioidomycosis is a fungal infection with a range of clinical manifestations. Currently used antifungal agents exhibit variable efficacy and toxicity profiles necessitating evaluation of additional therapeutic options. METHODS: Patients with coccidioidomycosis who received Isavuconazole were identified by cross-indexing ICD-9 and ICD-10 codes from patients and data abstracted. Responses to Isavuconazole therapy were measured using a modified Mycoses Study Group Coccidioidomycosis Scoring system as described previously. RESULTS: 82 patients met the criteria for inclusion. Over half of the patient exhibited pulmonary involvement 45/82 (55%), although meningitis 32/82 (39%), bone and joint disease 14/82 (17%) and skin/soft tissue infection 7/82 (9%) were also seen. The majority of patients experienced a decrease in their MSG score following initiation of Isavuconazole therapy (median MSG score change across all patient groups 7 → 2, p< 0.0001). Overall improvement was noted in 58/82 (71%) patients, while no change was observed in 19/82 (23%) and 5/82 (6%) who were unresponsive to antifungal changes. CONCLUSION: Isavuconazole demonstrated efficacy in the majority of patients treated, with failures observed only in a subgroup of patients with coccidioidal meningitis. DISCLOSURES: Rupam Sharma, PGY-1/MD, Astellas: Grant/Research Support George R. Thompson, III, MD, Astellas: Advisor/Consultant|Astellas: Grant/Research Support|Cidara: Advisor/Consultant|Cidara: Grant/Research Support|F2G: Advisor/Consultant|F2G: Grant/Research Support|Mayne: Advisor/Consultant|Mayne: Grant/Research Support|Melinta: Advisor/Consultant|Melinta: Grant/Research Support|Mundipharma: Advisor/Consultant|Mundipharma: Grant/Research Support|Pfizer: Advisor/Consultant|Pfizer: Grant/Research Support
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spelling pubmed-106789492023-11-27 837. Isavuconazole in the Treatment of Chronic Forms of Coccidioidomycosis Heidari, Arash Sharma, Rupam Shakir, Qusai Shah, Madiha Donnelly, Monica Reynolds, Trina Trigg, Kate Joliff, Jeff Kuran, Rasha Johnson, Royce H Thompson, George R Open Forum Infect Dis Abstract BACKGROUND: Coccidioidomycosis is a fungal infection with a range of clinical manifestations. Currently used antifungal agents exhibit variable efficacy and toxicity profiles necessitating evaluation of additional therapeutic options. METHODS: Patients with coccidioidomycosis who received Isavuconazole were identified by cross-indexing ICD-9 and ICD-10 codes from patients and data abstracted. Responses to Isavuconazole therapy were measured using a modified Mycoses Study Group Coccidioidomycosis Scoring system as described previously. RESULTS: 82 patients met the criteria for inclusion. Over half of the patient exhibited pulmonary involvement 45/82 (55%), although meningitis 32/82 (39%), bone and joint disease 14/82 (17%) and skin/soft tissue infection 7/82 (9%) were also seen. The majority of patients experienced a decrease in their MSG score following initiation of Isavuconazole therapy (median MSG score change across all patient groups 7 → 2, p< 0.0001). Overall improvement was noted in 58/82 (71%) patients, while no change was observed in 19/82 (23%) and 5/82 (6%) who were unresponsive to antifungal changes. CONCLUSION: Isavuconazole demonstrated efficacy in the majority of patients treated, with failures observed only in a subgroup of patients with coccidioidal meningitis. DISCLOSURES: Rupam Sharma, PGY-1/MD, Astellas: Grant/Research Support George R. Thompson, III, MD, Astellas: Advisor/Consultant|Astellas: Grant/Research Support|Cidara: Advisor/Consultant|Cidara: Grant/Research Support|F2G: Advisor/Consultant|F2G: Grant/Research Support|Mayne: Advisor/Consultant|Mayne: Grant/Research Support|Melinta: Advisor/Consultant|Melinta: Grant/Research Support|Mundipharma: Advisor/Consultant|Mundipharma: Grant/Research Support|Pfizer: Advisor/Consultant|Pfizer: Grant/Research Support Oxford University Press 2023-11-27 /pmc/articles/PMC10678949/ http://dx.doi.org/10.1093/ofid/ofad500.882 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Abstract
Heidari, Arash
Sharma, Rupam
Shakir, Qusai
Shah, Madiha
Donnelly, Monica
Reynolds, Trina
Trigg, Kate
Joliff, Jeff
Kuran, Rasha
Johnson, Royce H
Thompson, George R
837. Isavuconazole in the Treatment of Chronic Forms of Coccidioidomycosis
title 837. Isavuconazole in the Treatment of Chronic Forms of Coccidioidomycosis
title_full 837. Isavuconazole in the Treatment of Chronic Forms of Coccidioidomycosis
title_fullStr 837. Isavuconazole in the Treatment of Chronic Forms of Coccidioidomycosis
title_full_unstemmed 837. Isavuconazole in the Treatment of Chronic Forms of Coccidioidomycosis
title_short 837. Isavuconazole in the Treatment of Chronic Forms of Coccidioidomycosis
title_sort 837. isavuconazole in the treatment of chronic forms of coccidioidomycosis
topic Abstract
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10678949/
http://dx.doi.org/10.1093/ofid/ofad500.882
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