Elajez Reem Hasan, Bakdach Dana, Al Balushi Sara, Zaqout Ahmed, Alattar Rand, Abdallah Tasneem, Awouda Waleed, Wilson Godwin, Al-Wali Walid, Ibrahim Emad, Alsoub Hussam
Pharmacy Department, Hamad General Hospital, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar.
Pharmacy Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
Ther Adv Infect Dis. 2025 Aug 2;12:20499361251344777. doi: 10.1177/20499361251344777. eCollection 2025 Jan-Dec.
Echinocandins are recommended as an initial treatment for invasive candidiasis. Although safety and efficacy profiles of both anidulafungin and caspofungin are well established, direct head-to-head comparisons have not been reported before.
Compare efficacy and safety of anidulafungin versus caspofungin among patients with invasive candidiasis.
Retrospective observational study.
Adult patients with invasive candidiasis who were treated with either anidulafungin or caspofungin for ⩾5 days were retrospectively reviewed over a period of 6 years. The primary endpoint was global response, defined as clinical and microbiological success at the end of treatment duration.
A total of 223 patients who received either anidulafungin ( = 176) or caspofungin ( = 47) were initially included. Propensity score matching (based on age, malignancy, level of care, presence of candidemia, and other factors) was performed to improve comparability of the two groups. As a result, 32 patients in the caspofungin arm and 79 patients in the anidulafungin arm were included in the final analysis. Around three-quarters of the cohort had candidemia, and the most common isolated species were and . Response rates were comparable between both groups, with the primary outcome of global response showing no significant difference (56.3% for the caspofungin group vs 63.3% for anidulafungin, = 0.490). Similarly, no differences between the two groups were observed in terms of 90-day all-cause mortality ( = 0.672) or any other secondary endpoints.
Our data suggest that anidulafungin and caspofungin have comparable global response among patients with invasive candidiasis. Additionally, both studied echinocandins showed no significant difference in 90-day all-cause mortality. However, due to the limited sample size, larger studies are needed to confirm these results.
棘白菌素类药物被推荐作为侵袭性念珠菌病的初始治疗药物。虽然阿尼芬净和卡泊芬净的安全性和有效性已得到充分证实，但此前尚未有直接的头对头比较报道。
比较阿尼芬净与卡泊芬净治疗侵袭性念珠菌病患者的疗效和安全性。
回顾性观察研究。
对6年间接受阿尼芬净或卡泊芬净治疗≥5天的成年侵袭性念珠菌病患者进行回顾性分析。主要终点为总体反应，定义为治疗结束时临床和微生物学治愈。
最初纳入了223例接受阿尼芬净（n = 176）或卡泊芬净（n = 47）治疗的患者。进行倾向评分匹配（基于年龄、恶性肿瘤、护理级别、念珠菌血症的存在及其他因素）以提高两组的可比性。结果，卡泊芬净组32例患者和阿尼芬净组79例患者纳入最终分析。队列中约四分之三的患者患有念珠菌血症，最常见的分离菌种为 和 。两组的反应率相当，总体反应的主要结局无显著差异（卡泊芬净组为56.3%，阿尼芬净组为63.3%，P = 0.490）。同样，两组在90天全因死亡率（P = 0.672）或任何其他次要终点方面均未观察到差异。
我们的数据表明，阿尼芬净和卡泊芬净在侵袭性念珠菌病患者中的总体反应相当。此外，两种研究的棘白菌素类药物在90天全因死亡率方面均无显著差异。然而，由于样本量有限，需要更大规模的研究来证实这些结果。
