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Posaconazole salvage therapy: The Posifi study.

Fortun, Jesús; Gioia, Francesca; Cardozo, Celia; Gudiol, Carlota; Diago, Elena; José Castón, Juan; Muñoz, Patricia; López, Javier; Puerta-Alcalde, Pedro; Enzenhofer, Matías; Ramos, Antonio; Frutos, Azahara; Machado, Marina; Garcia-Vidal, Carolina; Parody, Rocío; Martín-Dávila, Pilar.
Mycoses; 62(6): 526-533, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30864238

BACKGROUND:

Posaconazole (PCZ) is used mainly for the prevention of invasive fungal infection (IFI).

METHODS:

A multicentre retrospective, investigational study using a non-randomized, single-arm design carried out in six tertiary hospitals in Spain to evaluate the use of PCZ in different forms of administration in the (non-prophylactic) treatment of IFI.

RESULTS:

Over an eight-year-period, 67 patients were included in this study. PCZ was administered as salvage therapy (intolerant or refractory to a previous antifungal agent) in 65/67 (97%); of these, it was used against Aspergillosis (68.6%), Zygomycosis (13.4%), other moulds (8.9%) and yeast (10.5%). The median duration of PCZ therapy was 75 days. The oral solution was associated with low serum levels (<0.7 mg/L) in 63% of available patients. Clinical response at 3 and 12 months of PCZ therapy were for aspergillosis: 47.8% and 41.3%; for zygomycosis: 55.5% and 55.5%; and for other mycoses: 69.2% and 69.2%, respectively. Suspension by toxicity was only observed in 6% and 7.5% of patients at 3 and 12 months, respectively, mainly with grade III/IV elevations of liver function test (LFTs).

CONCLUSIONS:

Posaconazole salvage therapy, especially oral tablets, can be an effective alternative option for patients with IFI who cannot tolerate or do not respond to other antifungal therapies.
Selo DaSilva