Matched-paired analysis of patients treated for invasive mucormycosis: Standard treatment versus posaconazole new formulations (MoveOn)

Salmanton-Garcia J, Seidel D, Koehler P, Mellinghoff SC, Herbrecht R, Klimko N, Racil Z, Falces-Romero I, Ingram P, Benitez-Penuela MA, Yesid Rodriguez J, Desoubeaux G, Barac A, Garcia-Vidal C, Hoenigl M, Mehta SR, Cheng MP, Klyasova G, Heinz WJ, Iqbal N, Krause R, Ostermann H, Penack O, Schalk E, Sheppard DC, Willinger B, Wisplinghoff H, Vehreschild JJ, Cornely OA, Vehreschild MJGT, Khedr RA, Arencibia-Nunez A, Aviles-Robles M, Banke I, Basher A, Benachinamardi K, Bertz H, Chakrabarti A, Drgona L, Garcia-Martinez J, Garcia-Rodriguez J, Graber S, Harter G, Klein M, Kouba M, Lee DG, Le Govic Y, Leo F, Maertens J, Maschmeyer G, Meintker L, Mo XD, Muller LK, Muller N, Nel JS, Novak J, Patel A, Pfafflin F, Pozo-Laderas JC, Puerta-Alcalde P, Rodriguez-Guardado A, Schroers R, Shekar V, Shenoi S, Silling G, Vinh D, Waizel-Haiat S, Yee Yee MY, Prakash PY, Zak P (2019)

Publication Type: Journal article

Publication year: 2019

Journal

Book Volume: 74

Pages Range: 3315-3327

Journal Issue: 11

DOI: 10.1093/jac/dkz344

Abstract

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.

Authors with CRIS profile

Involved external institutions

Julius-Maximilians-Universität Würzburg Germany (DE) Universität zu Köln Germany (DE) Otto-von-Guericke-Universität Magdeburg Germany (DE) Hospital Rosario Pumarejo de Lopez Colombia (CO) University of Belgrade / Универзитет у Београду Serbia (RS) Centre Hospitalier Régional Universitaire de Tours France (FR) University of California, San Diego United States (USA) (US) Charité - Universitätsmedizin Berlin Germany (DE) Royal Perth Hospital Australia (AU) McGill University Canada (CA) Universitat de Barcelona (UB) / University of Barcelona Spain (ES) Medizinische Universität Wien Austria (AT) Ludwig-Maximilians-Universität (LMU) Germany (DE) Aga Khan University Hospital Pakistan (PK) Masaryk University Czech Republic (CZ) Hospital Universitario La Paz Spain (ES) Hôpitaux universitaires de Strasbourg (HUS) / University Hospital Strasbourg France (FR) North-Western State Medical University named after I.I. Mechnikov / Санкт-Петербургская государственная медицинская академия (СЗГМУ) имени И. И. Мечникова Russian Federation (RU)

How to cite

APA:

Salmanton-Garcia, J., Seidel, D., Koehler, P., Mellinghoff, S.C., Herbrecht, R., Klimko, N.,... Zak, P. (2019). Matched-paired analysis of patients treated for invasive mucormycosis: Standard treatment versus posaconazole new formulations (MoveOn). Journal of Antimicrobial Chemotherapy, 74(11), 3315-3327. https://doi.org/10.1093/jac/dkz344

MLA:

Salmanton-Garcia, Jon, et al. "Matched-paired analysis of patients treated for invasive mucormycosis: Standard treatment versus posaconazole new formulations (MoveOn)." Journal of Antimicrobial Chemotherapy 74.11 (2019): 3315-3327.

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