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128. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

03.05. - 06.05.2011, München

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Caspofungin for post solid organ transplant invasive fungal disease: results of a retrospective observational study

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  • Michael Winkler - Medizinische Hochschule Hannover, Allgemein-, Viszeral- und Transplantationschirurgie, Hannover
  • Johann Pratschke - Universitätsklinik Innsbruck, Univ.-Klinik f. Visceral-, Transplantations- u. Thoraxchirurgie, Innsbruck
  • Uwe Schulz - Herz- und Diabeteszentrum Nordrhein-Westfalen, Klinik für Thorax- und Kardiovaskularchirurgie, Bad Oeynhausen
  • Wolfgang Knitsch - Medizinische Hochschule Hannover, Klinik für Visceral- und Transplantationschirurgie, Hannover
  • Malathi Shivaprakash - Merck & Co. Inc, Outcomes Research, Whitehouse Station, New Jersey

Deutsche Gesellschaft für Chirurgie. 128. Kongress der Deutschen Gesellschaft für Chirurgie. München, 03.-06.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11dgch131

doi: 10.3205/11dgch131, urn:nbn:de:0183-11dgch1312

Published: May 20, 2011

© 2011 Winkler et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Introduction: This study was designed to determine clinical outcomes with caspofungin in patients with proven or probable invasive fungal infection (IFI) after a solid organ transplant (SOT) procedure.

Materials and methods: In this retrospective observational study, data were collected for a single episode of IFI in patients with an SOT between January 2004 and June 2007. Response was determined by the investigator as favorable (complete or partial) or unfavorable (stable disease or failure) at the end of caspofungin therapy (EOCT). The primary effectiveness population was the proportion of patients who received ≥5 doses of caspofungin (modified all-patients-treated population). Safety was assessed for patients who received ≥1 dose of caspofungin.

Results: A total 81 of patients from 13 sites in China, Germany, Italy, and the United Kingdom were enrolled, including 49 (60%) liver, 22 (27%) heart, 5 (6%) lung, 2 (2%) kidney, 2 (2%) liver and kidney, and 1 (1%) pancreas and kidney recipients. Candidiasis was diagnosed in 64/81 patients (79%) and aspergillosis in 22/81 patients (27%). Most patients received caspofungin monotherapy (75%). Caspofungin was given as first-line therapy to 59 (73%) patients. The overall favorable response at EOCT was 87% (58/67; 95% confidence interval [CI]: 76%, 94%), with favorable responses in 88% (43/49; 95% CI: 75%, 95%) of patients receiving caspofungin monotherapy and 83% (15/18; 95% CI: 59%, 96%) of patients receiving combination therapy with caspofungin (modified all-patients-treated population). Response by type of SOT was as follows: liver 87% (39/45), heart 93% (14/15), kidney 100% (5/5), and lung 50% (2/4). An overall survival rate (all-patients-treated) of 69% (56/81; 95% CI: 59%, 79%) was observed at 7 days post EOCT. No serious drug-related adverse events were reported.

Conclusion: In this study, caspofungin was effective and well tolerated in the treatment of IFIs involving SOT recipients.