Efficacy and safety of caspofungin for the treatment of invasive pulmonary aspergillosis in patients with chronic obstructive pulmonary disease

• Published in: Journal of international medical research Vol. 52; no. 3; p. 3000605241237878
• Main Authors: Li, Shaoqiang, Li, Zhengtu, Wang, Penglei, Zhan, Yangqing, Xie, Jiaxing, Ye, Feng
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.03.2024; Sage Publications Ltd; SAGE Publishing
• Subjects: Antifungal Agents - adverse effects; Aspergillosis; Caspofungin - therapeutic use; Chronic obstructive pulmonary disease; Echinocandins - adverse effects; Fungal infections; Humans; Invasive Pulmonary Aspergillosis - chemically induced; Invasive Pulmonary Aspergillosis - complications; Invasive Pulmonary Aspergillosis - drug therapy; Lipopeptides - therapeutic use; Pulmonary Disease, Chronic Obstructive - complications; Pulmonary Disease, Chronic Obstructive - drug therapy; Randomised Clinical Trial; Success; Aspergillus; safety; Caspofungin; efficacy study; salvage therapy; invasive pulmonary aspergillosis; chronic obstructive pulmonary disease
• DOI: 10.1177/03000605241237878
• ISSN: 0300-0605

Objectives We assessed the efficacy of a 3-week primary or salvage caspofungin regimen in patients with chronic obstructive pulmonary disease (COPD) and concomitant proven or suspected invasive pulmonary aspergillosis (IPA). Methods Forty-four patients were treated with an initial loading caspofungin dose of 70 mg, followed by a daily dose of 50 mg for 20 days. The main efficacy endpoint was clinical effectiveness. Secondary endpoints included the clinical efficacy of caspofungin after 1 week, therapeutic efficacy based on the European Organization for Research and Treatment of Cancer and Mycoses Study Group Education and Research Consortium (EORTC/MSG) criteria, the sensitivity of different Aspergillus strains to caspofungin in vitro, and the safety of caspofungin. Results An assessment of 42 patients in the intention-to-treat group revealed efficacy rates of 33.33% within 1 week and 38.10% within 3 weeks. According to the EORTC/MSG criteria, the treatment success rate was 38.10%. The success rate of first-line treatment was 54.76%, whereas salvage treatment had a success rate of 45.24%. No adverse events were reported among the participants. Conclusions Caspofungin is effective and safe as an initial or salvage treatment for patients with IPA and COPD.