Efficacy and safety of micafungin for treatment of serious Candida infections in patients with or without malignant disease

Academic Article

Abstract

  • The aim of this study was to evaluate micafungin efficacy for treatment of invasive candidiasis/candidaemia in patients with cancer. Modified intent-to-treat populations were analysed from two trials: one, in adults and children with confirmed Candida infection, compared micafungin (adults 100mgday -1; children 2mgkg -1day -1) with liposomal amphotericin B (L-AmB 3mgkg -1day -1); and the other, in adults only, compared micafungin (100 or 150mgday -1) with caspofungin (50mgday -1; 70mg loading dose). Primary efficacy endpoint in both trials was treatment success, defined as both clinical and mycological response at end of therapy. In the micafungin/L-AmB trial, 183/489 patients had malignancy (37% neutropenic). In the micafungin/caspofungin trial, 176/572 patients had malignancy (26% neutropenic). Micafungin treatment success rates were generally similar in patients with/without malignancy and to rates observed with L-AmB and caspofungin. Most patients with malignancy and neutropenia were successfully treated by all three drugs. For all drugs, incidence of discontinuations because of treatment-related adverse events was similar for patients with malignancy (≤7.7%) vs. no malignancy (≤8.0%). These results suggest that compared with L-AmB and caspofungin, micafungin was effective and well tolerated in patients with candidiasis/candidaemia with/without malignancy. Further prospective trials are recommended to evaluate comparative outcomes with a primary focus on patients with malignancies and invasive candidiasis. © 2011 Blackwell Verlag GmbH.
  • Digital Object Identifier (doi)

    Author List

  • Cornely OA; Marty FM; Stucker F; Pappas PG; Ullmann AJ
  • Volume

  • 54
  • Issue

  • 6