Isavuconazole and voriconazole for the treatment of chronic pulmonary aspergillosis: A retrospective comparison of rates of adverse events
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Date
2018-12-13
Journal Title
Journal ISSN
Volume Title
Publisher
Mycoses
Abstract
Background: Long-term oral triazole antifungal therapy is the cornerstone of man agement for patients with chronic pulmonary aspergillosis (CPA). Itraconazole is the
first-line choice of treatment. Voriconazole, posaconazole or isavuconazole can be
used as alternative treatments in case of resistance or intolerance. All of these can
cause significant adverse drug reactions.
Objectives: To evaluate how CPA patients tolerate voriconazole and isavuconazole
after prior triazole therapy.
Methods: We performed a retrospective observational study at the UK National
Aspergillosis Centre. Medical records for all consecutive CPA patients started on isa vuconazole and voriconazole during an observation period of 12 and 6 months re spectively were analysed.
Results: During this study period, 20 patients were started on isavuconazole and 21
patients on voriconazole. Adverse events were seen in 18 of 21 (86%) the patients in
the voriconazole group and 12 of 20 (60%) in the isavuconazole group (P = 0.02). For
those who developed adverse events to these agents, the rates of discontinuation of
therapy were comparable (ie 10/18 [56%], voriconazole vs 8/12 [67%], isavucona zole; P = 0.54). Five (25%) patients in the isavuconazole group who were intolerant to
other triazoles tolerated the standard dose of isavuconazole.
Conclusions: Compared with isavuconazole, adverse events were significantly higher
in CPA patients commenced on voriconazole. Isavuconazole may be an option for
those patients who are intolerant to other triazoles.
Description
Keywords
adverse events,, chronic pulmonary aspergillosis,, isavuconazole,, voriconazole
Citation
Bongomin, F., Maguire, N., Moore, C. B., Felton, T., & Rautemaa‐Richardson, R. (2019). Isavuconazole and voriconazole for the treatment of chronic pulmonary aspergillosis: A retrospective comparison of rates of adverse events. Mycoses, 62(3), 217-222.