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2119. Matched-Paired Analysis of Patients Treated for Invasive Mucormycosis—Standard Treatment vs. Posaconazole New Formulations (MoveOn)

BACKGROUND: Current first-line (first) antifungal treatment for invasive mucormycosis (IM) consists of liposomal amphotericin B (AMB). Salvage (SAL) treatment options are limited and often based on posaconazole oral suspension (POSsusp). However, with the approval of posaconazole new formulations (P...

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Autores principales: Salmanton-Garcia, Jon, Seidel, Danila, Koehler, Philipp, Mellinghoff, Sibylle, Wisplinghoff, Hilmar, Vehreschild, Jörg, Cornely, Oliver, Vehreschild, Maria
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6809098/
http://dx.doi.org/10.1093/ofid/ofz360.1799
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author Salmanton-Garcia, Jon
Seidel, Danila
Koehler, Philipp
Mellinghoff, Sibylle
Wisplinghoff, Hilmar
Vehreschild, Jörg
Cornely, Oliver
Vehreschild, Maria
author_facet Salmanton-Garcia, Jon
Seidel, Danila
Koehler, Philipp
Mellinghoff, Sibylle
Wisplinghoff, Hilmar
Vehreschild, Jörg
Cornely, Oliver
Vehreschild, Maria
author_sort Salmanton-Garcia, Jon
collection PubMed
description BACKGROUND: Current first-line (first) antifungal treatment for invasive mucormycosis (IM) consists of liposomal amphotericin B (AMB). Salvage (SAL) treatment options are limited and often based on posaconazole oral suspension (POSsusp). However, with the approval of posaconazole new formulations (POSnew), patients could benefit from improved pharmacokinetics, safety and tolerability. Our aim was to assess the effectiveness of POSnew as first-line and SAL treatments for IM. METHODS: We performed a case-matched analysis with proven or probable IM patients from the FungiScope® Registry. 1st-POSnew and 1st-AMB+POSnew cases were matched with 1st-AMB-based treatment controls, and SAL-POSnew cases were matched with SAL-POSsusp controls. Each case was matched with up to three controls based on severity, hematological/oncological malignancy, surgery and/or renal dysfunction. RESULTS: Five patients receiving first-line POSnew alone, 18 receiving first-line POSnew combined with AMB, and 22 receiving salvage POSnew were identified. By day 42, favorable response was reported for 80.0% (n = 4/5) of patients receiving first-line POSnew, for 27.8% (n = 5/18) receiving first-line POSnew plus AMB, and for 50.0% (n = 11/22) receiving salvage POSnew. Day-42 all-cause mortality of patients receiving POSnew was lower compared with mortality in their respective controls (20.0% (n = 1/5) in 1st-POSnew vs. 53.3% (n = 8/15) in 1st-AMB; 33.3% (n = 6/18) in 1st-AMB+POSnew vs. 52.0% (n = 26/50) in 1st-AMB; 0.0% (n = 0/22) in SAL-POSnew vs. 4.4% (n = 2/45) in SAL-POSsusp). CONCLUSION: In the observed patients, POSnew was effective in terms of treatment response and-associated mortality of IM. POSnew may be an alternative for the treatment of IM. DISCLOSURES: All authors: No reported disclosures.
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spelling pubmed-68090982019-10-28 2119. Matched-Paired Analysis of Patients Treated for Invasive Mucormycosis—Standard Treatment vs. Posaconazole New Formulations (MoveOn) Salmanton-Garcia, Jon Seidel, Danila Koehler, Philipp Mellinghoff, Sibylle Wisplinghoff, Hilmar Vehreschild, Jörg Cornely, Oliver Vehreschild, Maria Open Forum Infect Dis Abstracts BACKGROUND: Current first-line (first) antifungal treatment for invasive mucormycosis (IM) consists of liposomal amphotericin B (AMB). Salvage (SAL) treatment options are limited and often based on posaconazole oral suspension (POSsusp). However, with the approval of posaconazole new formulations (POSnew), patients could benefit from improved pharmacokinetics, safety and tolerability. Our aim was to assess the effectiveness of POSnew as first-line and SAL treatments for IM. METHODS: We performed a case-matched analysis with proven or probable IM patients from the FungiScope® Registry. 1st-POSnew and 1st-AMB+POSnew cases were matched with 1st-AMB-based treatment controls, and SAL-POSnew cases were matched with SAL-POSsusp controls. Each case was matched with up to three controls based on severity, hematological/oncological malignancy, surgery and/or renal dysfunction. RESULTS: Five patients receiving first-line POSnew alone, 18 receiving first-line POSnew combined with AMB, and 22 receiving salvage POSnew were identified. By day 42, favorable response was reported for 80.0% (n = 4/5) of patients receiving first-line POSnew, for 27.8% (n = 5/18) receiving first-line POSnew plus AMB, and for 50.0% (n = 11/22) receiving salvage POSnew. Day-42 all-cause mortality of patients receiving POSnew was lower compared with mortality in their respective controls (20.0% (n = 1/5) in 1st-POSnew vs. 53.3% (n = 8/15) in 1st-AMB; 33.3% (n = 6/18) in 1st-AMB+POSnew vs. 52.0% (n = 26/50) in 1st-AMB; 0.0% (n = 0/22) in SAL-POSnew vs. 4.4% (n = 2/45) in SAL-POSsusp). CONCLUSION: In the observed patients, POSnew was effective in terms of treatment response and-associated mortality of IM. POSnew may be an alternative for the treatment of IM. DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2019-10-23 /pmc/articles/PMC6809098/ http://dx.doi.org/10.1093/ofid/ofz360.1799 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
Salmanton-Garcia, Jon
Seidel, Danila
Koehler, Philipp
Mellinghoff, Sibylle
Wisplinghoff, Hilmar
Vehreschild, Jörg
Cornely, Oliver
Vehreschild, Maria
2119. Matched-Paired Analysis of Patients Treated for Invasive Mucormycosis—Standard Treatment vs. Posaconazole New Formulations (MoveOn)
title 2119. Matched-Paired Analysis of Patients Treated for Invasive Mucormycosis—Standard Treatment vs. Posaconazole New Formulations (MoveOn)
title_full 2119. Matched-Paired Analysis of Patients Treated for Invasive Mucormycosis—Standard Treatment vs. Posaconazole New Formulations (MoveOn)
title_fullStr 2119. Matched-Paired Analysis of Patients Treated for Invasive Mucormycosis—Standard Treatment vs. Posaconazole New Formulations (MoveOn)
title_full_unstemmed 2119. Matched-Paired Analysis of Patients Treated for Invasive Mucormycosis—Standard Treatment vs. Posaconazole New Formulations (MoveOn)
title_short 2119. Matched-Paired Analysis of Patients Treated for Invasive Mucormycosis—Standard Treatment vs. Posaconazole New Formulations (MoveOn)
title_sort 2119. matched-paired analysis of patients treated for invasive mucormycosis—standard treatment vs. posaconazole new formulations (moveon)
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6809098/
http://dx.doi.org/10.1093/ofid/ofz360.1799
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