Efficacy and safety of micafungin, an echinocandin antifungal agent, on invasive fungal infections in patients with hematological disorders

• Published in: Leukemia & lymphoma Vol. 50; no. 1; pp. 92 - 100
• Main Authors: Tamura, Kazuo, Urabe, Akio, Yoshida, Minoru, Kanamaru, Akihisa, Kodera, Yoshihisa, Okamoto, Shinichiro, Maesaki, Shigefumi, Masaoka, Tohru
• Format: Journal Article
• Language: English
• Published: United States Informa UK Ltd 2009; Taylor & Francis
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Algorithms; Antifungal Agents - adverse effects; Antifungal Agents - therapeutic use; echinocandin; Echinocandins - adverse effects; Echinocandins - therapeutic use; empirical therapy; febrile neutropenia; Female; fungal infection; Hematologic Diseases - complications; hematological disorders; Humans; Leukocyte Count; Lipopeptides - adverse effects; Lipopeptides - therapeutic use; Male; Micafungin; Middle Aged; Mycoses - complications; Mycoses - diagnosis; Mycoses - drug therapy; Neutrophils - cytology; Neutrophils - drug effects
• ISSN: 1042-8194; 1029-2403
• DOI: 10.1080/10428190802635500

The study was conducted as a prospective multicenter trial to evaluate the efficacy and safety of micafungin in patients with invasive fungal infections (IFIs) in hematological disorders. A total of 277 patients was registered, and 197 were assessed for clinical efficacy. The mean dosage and duration of micafungin were 170.7 mg day and 22.0 days, respectively. The efficacy rates were 87.5% (7 8) for patients with candidiasis, 44.7% (17 38) for probable IFIs, 61.9% (39 63) for possible IFIs and 80.7% (71 88) for those who failed to respond to antibacterials. In patients with febrile neutropenia (below 500 µL), despite broad-spectrum antibacterial treatment over 2 days, 86.3% (44 51) of patients had a favourable response to micafungin. The incidence of adverse events related to micafungin was 14.1% (39 277), but most of them were mild and reversible. These data indicate the usefulness of micafungin as a novel therapeutic drug for both empirical and targeted therapy for IFIs.