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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...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2019
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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. |
format | Online Article Text |
id | pubmed-6809098 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
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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