Voriconazole versus itraconazole for antifungal prophylaxis following allogeneic haematopoietic stem‐cell transplantation
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Open Access
- 22 August 2011
- journal article
- research article
- Published by Wiley in British Journal of Haematology
- Vol. 155 (3), 318-327
- https://doi.org/10.1111/j.1365-2141.2011.08838.x
Abstract
Antifungal prophylaxis for allogeneic haematopoietic stem-cell transplant (alloHCT) recipients should prevent invasive mould and yeast infections (IFIs) and be well tolerated. This prospective, randomized, open-label, multicentre study compared the efficacy and safety of voriconazole (234 patients) versus itraconazole (255 patients) in alloHCT recipients. The primary composite endpoint, success of prophylaxis, incorporated ability to tolerate study drug for ≥100 d (with ≤14 d interruption) with survival to day 180 without proven/probable IFI. Success of prophylaxis was significantly higher with voriconazole than itraconazole (48·7% vs. 33·2%, P 10%) treatment-related adverse events were vomiting (16·6%), nausea (15·8%) and diarrhoea (10·4%) for itraconazole, and hepatotoxicity/liver function abnormality (12·9%) for voriconazole. More itraconazole patients received other systemic antifungals (41·9% vs. 29·9%, P<0·01). There was no difference in incidence of proven/probable IFI (1·3% vs. 2·1%) or survival to day 180 (81·9% vs. 80·9%) for voriconazole and itraconazole respectively. Voriconazole was superior to itraconazole as antifungal prophylaxis after alloHCT, based on differences in the primary composite endpoint. Voriconazole could be given for significantly longer durations, with less need for other systemic antifungals.This publication has 34 references indexed in Scilit:
- Randomized, double-blind trial of fluconazole versus voriconazole for prevention of invasive fungal infection after allogeneic hematopoietic cell transplantationBlood, 2010
- Voriconazole for secondary prophylaxis of invasive fungal infections in allogeneic stem cell transplant recipients: results of the VOSIFI studyHaematologica, 2010
- Voriconazole provides effective prophylaxis for invasive fungal infection in patients receiving glucocorticoid therapy for GVHDBone Marrow Transplantation, 2009
- Epidemiology of Invasive Mold Infections in Allogeneic Stem Cell Transplant Recipients: Biological Risk Factors for Infection According to Time after TransplantationClinical Infectious Diseases, 2008
- Pharmacokinetics and tolerability of voriconazole and a combination oral contraceptive co‐administered in healthy female subjectsBritish Journal of Clinical Pharmacology, 2008
- Posaconazole or Fluconazole for Prophylaxis in Severe Graft-versus-Host DiseaseThe New England Journal of Medicine, 2007
- Posaconazole vs. Fluconazole or Itraconazole Prophylaxis in Patients with NeutropeniaThe New England Journal of Medicine, 2007
- Itraconazole prophylaxis in pediatric cancer patients receiving conventional chemotherapy or autologous stem cell transplantsSupportive Care in Cancer, 2006
- Antifungal prophylaxis for severely neutropenic chemotherapy recipientsCancer, 2002
- A Controlled Trial of Fluconazole to Prevent Fungal Infections in Patients Undergoing Bone Marrow TransplantationThe New England Journal of Medicine, 1992