Comparison of the Safety and Tolerance Profile of Micafungin with that of Other Echinocandins and Azoles in Patients with Pre-existing Child–Pugh B or C Liver Disease: A Case–Control Retrospective Study
Abstract Introduction To assess the association between exposure to micafungin, other echinocandins, or azoles and the development of short-term liver injury (STLI) or long-term liver injury (LTLI) in patients with Child–Pugh B or C liver disease. Methods Multicenter case–control study of patients w...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Adis, Springer Healthcare
2020-02-01
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| Series: | Infectious Diseases and Therapy |
| Subjects: | |
| Online Access: | https://doi.org/10.1007/s40121-020-00282-w |
| _version_ | 1818965688448974848 |
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| author | Antonio Vena Emilio Bouza Matteo Bassetti Francesco Menichetti Maria Merelli Santiago Grau Jesús Fortun María Isabel Sánchez José María Aguado Paloma Merino Francisco Bonache Patricia Muñoz |
| author_facet | Antonio Vena Emilio Bouza Matteo Bassetti Francesco Menichetti Maria Merelli Santiago Grau Jesús Fortun María Isabel Sánchez José María Aguado Paloma Merino Francisco Bonache Patricia Muñoz |
| author_sort | Antonio Vena |
| collection | DOAJ |
| description | Abstract Introduction To assess the association between exposure to micafungin, other echinocandins, or azoles and the development of short-term liver injury (STLI) or long-term liver injury (LTLI) in patients with Child–Pugh B or C liver disease. Methods Multicenter case–control study of patients with Child–Pugh B or C liver disease who received antifungals (AF) for ≥ 72 h (May 2009–May 2015) in six Spanish and Italian hospitals. All micafungin patients were randomly matched with one patient who received another echinocandin and with one patient who received azole treatment. Primary outcome was development of STLI or LTLI (development of any type of liver tumor during the follow-up period). Results Of 2335 patients with chronic liver disease admitted to the six centers, 20 (0.85%) were found to have Child–Pugh B or C liver disease and received micafungin for ≥ 72 h. During AF treatment, the frequency of STLI was 10% in each group. Most cases of STLI were asymptomatic, and AFs had to be switched to another class of AF in only two patients (one micafungin and one azole). No patients developed acute liver insufficiency, were admitted to the ICU, or had to undergo transplantation. Follow-up data (median of 1.3 years) were available for 30 patients. LTLI was observed in only one patient, who had previously received treatment with azoles. Conclusions Our study suggests that the administration of micafungin to patients with end-stage liver disease does not imply a higher risk of developing STLI or LTLI. |
| first_indexed | 2024-12-20T13:20:59Z |
| format | Article |
| id | doaj.art-77df09677966459f8343385f39edbef1 |
| institution | Directory Open Access Journal |
| issn | 2193-8229 2193-6382 |
| language | English |
| last_indexed | 2024-12-20T13:20:59Z |
| publishDate | 2020-02-01 |
| publisher | Adis, Springer Healthcare |
| record_format | Article |
| series | Infectious Diseases and Therapy |
| spelling | doaj.art-77df09677966459f8343385f39edbef12022-12-21T19:39:24ZengAdis, Springer HealthcareInfectious Diseases and Therapy2193-82292193-63822020-02-019115116310.1007/s40121-020-00282-wComparison of the Safety and Tolerance Profile of Micafungin with that of Other Echinocandins and Azoles in Patients with Pre-existing Child–Pugh B or C Liver Disease: A Case–Control Retrospective StudyAntonio Vena0Emilio Bouza1Matteo Bassetti2Francesco Menichetti3Maria Merelli4Santiago Grau5Jesús Fortun6María Isabel Sánchez7José María Aguado8Paloma Merino9Francisco Bonache10Patricia Muñoz11Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio MarañónClinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio MarañónInfectious Diseases Clinic, Department of Medicine, University of Udine and Azienda Sanitaria Universitaria IntegrataInfectious Diseases Clinic, Nuovo Santa Chiara University Hospital, Azienda Ospedaliera Universitaria PisanaInfectious Diseases Clinic, Department of Medicine, University of Udine and Azienda Sanitaria Universitaria IntegrataDepartment of Pharmacy, Hospital del Mar, Universitat Autònoma de BarcelonaInfectious Diseases Department, Hospital Universitario Ramón y CajalClinical Microbiology and Infectious Diseases Department, Hospital Puerta de HierroMedicine Department, School of Medicine, Universidad Complutense de MadridClinical Microbiology Department, Hospital Universitario Clinico San CarlosClinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio MarañónClinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio MarañónAbstract Introduction To assess the association between exposure to micafungin, other echinocandins, or azoles and the development of short-term liver injury (STLI) or long-term liver injury (LTLI) in patients with Child–Pugh B or C liver disease. Methods Multicenter case–control study of patients with Child–Pugh B or C liver disease who received antifungals (AF) for ≥ 72 h (May 2009–May 2015) in six Spanish and Italian hospitals. All micafungin patients were randomly matched with one patient who received another echinocandin and with one patient who received azole treatment. Primary outcome was development of STLI or LTLI (development of any type of liver tumor during the follow-up period). Results Of 2335 patients with chronic liver disease admitted to the six centers, 20 (0.85%) were found to have Child–Pugh B or C liver disease and received micafungin for ≥ 72 h. During AF treatment, the frequency of STLI was 10% in each group. Most cases of STLI were asymptomatic, and AFs had to be switched to another class of AF in only two patients (one micafungin and one azole). No patients developed acute liver insufficiency, were admitted to the ICU, or had to undergo transplantation. Follow-up data (median of 1.3 years) were available for 30 patients. LTLI was observed in only one patient, who had previously received treatment with azoles. Conclusions Our study suggests that the administration of micafungin to patients with end-stage liver disease does not imply a higher risk of developing STLI or LTLI.https://doi.org/10.1007/s40121-020-00282-wEnd-stage liver diseaseLiver injuryMicafunginSafety |
| spellingShingle | Antonio Vena Emilio Bouza Matteo Bassetti Francesco Menichetti Maria Merelli Santiago Grau Jesús Fortun María Isabel Sánchez José María Aguado Paloma Merino Francisco Bonache Patricia Muñoz Comparison of the Safety and Tolerance Profile of Micafungin with that of Other Echinocandins and Azoles in Patients with Pre-existing Child–Pugh B or C Liver Disease: A Case–Control Retrospective Study Infectious Diseases and Therapy End-stage liver disease Liver injury Micafungin Safety |
| title | Comparison of the Safety and Tolerance Profile of Micafungin with that of Other Echinocandins and Azoles in Patients with Pre-existing Child–Pugh B or C Liver Disease: A Case–Control Retrospective Study |
| title_full | Comparison of the Safety and Tolerance Profile of Micafungin with that of Other Echinocandins and Azoles in Patients with Pre-existing Child–Pugh B or C Liver Disease: A Case–Control Retrospective Study |
| title_fullStr | Comparison of the Safety and Tolerance Profile of Micafungin with that of Other Echinocandins and Azoles in Patients with Pre-existing Child–Pugh B or C Liver Disease: A Case–Control Retrospective Study |
| title_full_unstemmed | Comparison of the Safety and Tolerance Profile of Micafungin with that of Other Echinocandins and Azoles in Patients with Pre-existing Child–Pugh B or C Liver Disease: A Case–Control Retrospective Study |
| title_short | Comparison of the Safety and Tolerance Profile of Micafungin with that of Other Echinocandins and Azoles in Patients with Pre-existing Child–Pugh B or C Liver Disease: A Case–Control Retrospective Study |
| title_sort | comparison of the safety and tolerance profile of micafungin with that of other echinocandins and azoles in patients with pre existing child pugh b or c liver disease a case control retrospective study |
| topic | End-stage liver disease Liver injury Micafungin Safety |
| url | https://doi.org/10.1007/s40121-020-00282-w |
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