1. Isavuconazole for the treatment of patients with invasive fungal diseases involving the central nervous system.
- Author
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Schwartz S, Cornely OA, Hamed K, Marty FM, Maertens J, Rahav G, Herbrecht R, and Heinz WJ
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Central Nervous System Fungal Infections microbiology, Child, Child, Preschool, Clinical Trials, Phase III as Topic, Drug Resistance, Fungal, Female, Fungi classification, Fungi drug effects, Humans, Invasive Fungal Infections microbiology, Male, Middle Aged, Retrospective Studies, Survival Analysis, Young Adult, Antifungal Agents therapeutic use, Central Nervous System Fungal Infections drug therapy, Invasive Fungal Infections drug therapy, Nitriles therapeutic use, Pyridines therapeutic use, Triazoles therapeutic use
- Abstract
The incidence of invasive fungal diseases (IFDs) with central nervous system (CNS) involvement is increasing due to the rising numbers of immunocompromised individuals, such as patients receiving chemotherapy, transplantation procedures, or immune-modulating therapies. CNS IFDs cause significant morbidity and mortality, and treatments are complicated by difficulties in identifying fungal pathogens and delivering antifungal agents to the CNS. Isavuconazole is a novel triazole with broad-spectrum activity that has shown good blood-brain barrier penetration in animal models. We present a retrospective analysis of isavuconazole in the treatment of patients with CNS IFDs and who either participated in the phase III VITAL or SECURE clinical trials, or were included in a named-patient program. A total of 36 patients were identified, including 27 patients from the clinical trials. Of these patients, 47.2% had hematologic malignancies, while 13.9% had no identifiable underlying conditions. Mucorales, Aspergillus species, and Cryptococcus species accounted for 30.6%, 22.2%, and 13.9% of infections, respectively. The overall survival rate was 80.6% at day 42 and 69.4% at day 84, and at the end of treatment, a complete or partial clinical response was achieved in 58.3% of patients. Isavuconazole exhibited clinical activity in a variety of CNS IFDs., (© The Author(s) 2019. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology.)
- Published
- 2020
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