Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea.
Mycopathologia. 2020 Aug;185(4):653-664. doi: 10.1007/s11046-020-00471-8. Epub 2020 Jul 23.
Echinocandins are recommended for the treatment of invasive candidiasis and candidemia. However, there are few studies comparing anidulafungin and micafungin in terms of efficacy and safety. The objective of this study was to evaluate the clinical efficacy and safety between anidulafungin and micafungin treatment for adult patients with candidemia.
This retrospective cohort study performed on adult candidemia patients diagnosed from January 2006 through December 2018 at a tertiary medical center. The study subjects included adult patients ≥ 19 years with candidemia who were only treated with anidulafungin or micafungin for ≥ 3 days. Clinical characteristics were collected and analyzed. Hepatotoxicity was assessed according to the Common Terminology Criteria for Adverse Events Version 5.0.
A total of 98 patients with candidemia were treated with anidulafungin (n = 52, 53.1%) or micafungin (n = 46, 46.9%). There were no significant differences in age, sex, source of candidemia, and comorbidities between the anidulafungin and micafungin groups. Although there were more patients with abnormal baseline liver function test (LFT) in the anidulafungin group, the rate of clinical response (51.9% vs. 46.7%), mycological response (76.9% vs. 67.4%), and mortality (30-day mortality 26.9% vs. 21.7% and 90-day mortality 78.8% vs. 73.9%) was similar between the anidulafungin and micafungin groups. Also, there was no significant difference in terms of hepatotoxicity, even among the patients with abnormal baseline LFT between the two groups.
Our results suggest that clinical efficacy and safety may be similar between anidulafungin and micafungin treatment for adult patients with candidemia.
棘白菌素类药物被推荐用于侵袭性念珠菌病和念珠菌血症的治疗。然而，关于阿尼芬净和米卡芬净在疗效和安全性方面的比较研究较少。本研究旨在评估阿尼芬净和米卡芬净治疗成人念珠菌血症的临床疗效和安全性。
本回顾性队列研究纳入 2006 年 1 月至 2018 年 12 月在一家三级医疗中心诊断为成人念珠菌血症的患者。研究对象为接受阿尼芬净或米卡芬净治疗至少 3 天的≥19 岁成人念珠菌血症患者。收集并分析临床特征。采用不良事件常用术语标准 5.0 评估肝毒性。
共有 98 例念珠菌血症患者接受阿尼芬净（n=52，53.1%）或米卡芬净（n=46，46.9%）治疗。阿尼芬净组和米卡芬净组在年龄、性别、念珠菌血症来源和合并症方面无显著差异。尽管阿尼芬净组基线肝功能检查（LFT）异常的患者更多，但临床反应率（51.9% vs. 46.7%）、真菌学反应率（76.9% vs. 67.4%）和死亡率（30 天死亡率 26.9% vs. 21.7%和 90 天死亡率 78.8% vs. 73.9%）在两组间相似。此外，即使在两组基线 LFT 异常的患者中，肝毒性也无显著差异。
我们的研究结果表明，阿尼芬净和米卡芬净治疗成人念珠菌血症的临床疗效和安全性可能相似。
