Voriconazole versus itraconazole for antifungal prophylaxis following allogeneic haematopoietic stem-cell transplantation

• Verfasst von: Marks, David [VerfasserIn]
• Verfasst von: Pagliuca, Antonio [VerfasserIn]
• Verfasst von: Kibbler, Christopher C. [VerfasserIn]
• Verfasst von: Glasmacher, Axel [VerfasserIn]
• Verfasst von: Heußel, Claus Peter [VerfasserIn]
• Verfasst von: Kantecki, Michal [VerfasserIn]
• Verfasst von: Miller, Paul J.S. [VerfasserIn]
• Verfasst von: Ribaud, Patricia [VerfasserIn]
• Verfasst von: Schlamm, Haran T. [VerfasserIn]
• Verfasst von: Solano, Carlos [VerfasserIn]
• Verfasst von: Cook, Gordon [VerfasserIn]
• Titel: Voriconazole versus itraconazole for antifungal prophylaxis following allogeneic haematopoietic stem-cell transplantation
• Verf.angabe: David I. Marks, Antonio Pagliuca, Christopher C. Kibbler, Axel Glasmacher, Claus-Peter Heussel, Michal Kantecki, Paul J.S. Miller, Patricia Ribaud, Haran T. Schlamm, Carlos Solano and Gordon Cook for the IMPROVIT Study Group
• E-Jahr: 2011
• Jahr: 22 August 2011
• Umfang: 10 S.
• Fussnoten: Gesehen am 10.08.2022
• Titel Quelle: Enthalten in: British journal of haematology
• Ort Quelle: Oxford [u.a.] : Wiley-Blackwell, 1955
• Jahr Quelle: 2011
• Band/Heft Quelle: 155(2011), 3, Seite 318-327
• ISSN Quelle: 1365-2141
• DOI: doi:10.1111/j.1365-2141.2011.08838.x
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: azoles
• Sach-SW: invasive fungal disease
• Sach-SW: mould infections
• Sach-SW: stem-cell transplant
• Sach-SW: yeast infections
• K10plus-PPN: 1813995346

Abstract

Antifungal prophylaxis for allogeneic haematopoietic stem-cell transplant (alloHCT) recipients should prevent invasive mould and yeast infections (IFIs) and be well tolerated. This prospective, randomized, open-label, multicentre study compared the efficacy and safety of voriconazole (234 patients) versus itraconazole (255 patients) in alloHCT recipients. The primary composite endpoint, success of prophylaxis, incorporated ability to tolerate study drug for ≥100 d (with ≤14 d interruption) with survival to day 180 without proven/probable IFI. Success of prophylaxis was significantly higher with voriconazole than itraconazole (48·7% vs. 33·2%, P < 0·01); more voriconazole patients tolerated prophylaxis for 100 d (53·6% vs. 39·0%, P < 0·01; median total duration 96 vs. 68 d). The most common (>10%) treatment-related adverse events were vomiting (16·6%), nausea (15·8%) and diarrhoea (10·4%) for itraconazole, and hepatotoxicity/liver function abnormality (12·9%) for voriconazole. More itraconazole patients received other systemic antifungals (41·9% vs. 29·9%, P < 0·01). There was no difference in incidence of proven/probable IFI (1·3% vs. 2·1%) or survival to day 180 (81·9% vs. 80·9%) for voriconazole and itraconazole respectively. Voriconazole was superior to itraconazole as antifungal prophylaxis after alloHCT, based on differences in the primary composite endpoint. Voriconazole could be given for significantly longer durations, with less need for other systemic antifungals.