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  3. Isavuconazole Versus Voriconazole as the First-line Therapy for Solid Organ Transplant Recipients With Invasive Aspergillosis: Comparative Analysis of 2 Multicenter Cohort Studies.

Isavuconazole Versus Voriconazole as the First-line Therapy for Solid Organ Transplant Recipients With Invasive Aspergillosis: Comparative Analysis of 2 Multicenter Cohort Studies.

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Autores de IDIVAL

Autores ajenos al IDIVAL

  • Fernández-Ruiz M
  • Gioia F
  • Bodro M
  • Gutiérrez Martín I
  • Sabé N
  • Rodriguez-Álvarez R
  • Corbella L
  • López-Viñau T
  • Valerio M
  • Salto-Alejandre S
  • Cordero E
  • Fariñas MC
  • Vidal E
  • Carratalà J
  • Goikoetxea J
  • Ramos-Martínez A
  • Moreno A
  • Martín-Dávila P
  • Fortún J
  • Aguado JM
  • SOTIS and DiasperSOT Study Groups

Unidades

Abstract

BACKGROUND: Isavuconazole (ISA) and voriconazole (VORI) are recommended as the first-line treatment for invasive aspergillosis (IA). Despite theoretical advantages of ISA, both triazole agents have not been compared in solid organ transplant recipients. METHODS: We performed a post hoc analysis of 2 retrospective multicenter cohorts of solid organ transplant recipients with invasive fungal disease (the SOTIS [Solid Organ Transplantation and ISavuconazole] and DiasperSOT [DIagnosis of ASPERgillosis in Solid Organ Transplantation] studies). We selected adult patients with proven/probable IA that were treated for =48 h with ISA (n = 57) or VORI (n = 77) as first-line therapy, either in monotherapy or combination regimen. The primary outcome was the rate of clinical response at 12 wk from the initiation of therapy. Secondary outcomes comprised 12-wk all-cause and IA-attributable mortality and the rates of treatment-emergent adverse events and premature treatment discontinuation. RESULTS: Both groups were comparable in their demographics and major clinical and treatment-related variables. There were no differences in the rate of 12-wk clinical response between the ISA and VORI groups (59.6% versus 59.7%, respectively; odds ratio [OR], 0.99; 95% confidence interval [CI], 0.49-2.00). This result was confirmed after propensity score adjustment (OR, 0.81; 95% CI, 0.32-2.05) and matching (OR, 0.79; 95% CI, 0.31-2.04). All-cause and IA-attributable mortality were also similar. Patients in the ISA group were less likely to experience treatment-emergent adverse events (17.5% versus 37.7%; P = 0.011) and premature treatment discontinuation (8.8% versus 23.4%; P = 0.027). CONCLUSIONS: Front-line treatment with ISA for posttransplant IA led to similar clinical outcomes than VORI, with better tolerability and higher treatment completion.

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Datos de la publicación

ISSN/ISSNe:
0041-1337, 1534-6080

Transplantation  Lippincott Williams & Wilkins

Tipo:
Article
Páginas:
2260-2269
PubMed:
38773846

Citas Recibidas en Web of Science: 1

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