Voriconazole versus itraconazole for antifungal prophylaxis following allogeneic haematopoietic stem-cell transplantation

David I. Marks; Tony Pagliuca; Christopher C. Kibbler; Axel Glasmacher; Claus-Peter Heussel; Michal Kantecki; Paul J. S. Miller; Patricia Ribaud; Haran T. Schlamm; Carlos Solano; Gordon Cook; IMPROVIT Study Grp

doi:10.1111/j.1365-2141.2011.08838.x

Voriconazole versus itraconazole for antifungal prophylaxis following allogeneic haematopoietic stem-cell transplantation

David I. Marks^*, Tony Pagliuca, Christopher C. Kibbler, Axel Glasmacher, Claus-Peter Heussel, Michal Kantecki, Paul J. S. Miller, Patricia Ribaud, Haran T. Schlamm, Carlos Solano, Gordon Cook, IMPROVIT Study Grp

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

198 Citations (Scopus)

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 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.

Original language	English
Pages (from-to)	318-327
Number of pages	10
Journal	British Journal of Haematology
Volume	155
Issue number	3
DOIs	https://doi.org/10.1111/j.1365-2141.2011.08838.x
Publication status	Published - Nov 2011

Keywords

stem-cell transplant
azoles
invasive fungal disease
mould infections
yeast infections
INVASIVE FUNGAL-INFECTIONS
NEUTROPENIC PATIENTS
RISK-FACTORS
MARROW-TRANSPLANTATION
AMPHOTERICIN-B
FLUCONAZOLE
RECIPIENTS
ASPERGILLOSIS
TRIAL
METAANALYSIS

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1111/j.1365-2141.2011.08838.x

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Marks, D. I., Pagliuca, T., Kibbler, C. C., Glasmacher, A., Heussel, C.-P., Kantecki, M., Miller, P. J. S., Ribaud, P., Schlamm, H. T., Solano, C., Cook, G., & IMPROVIT Study Grp (2011). Voriconazole versus itraconazole for antifungal prophylaxis following allogeneic haematopoietic stem-cell transplantation. British Journal of Haematology, 155(3), 318-327. https://doi.org/10.1111/j.1365-2141.2011.08838.x

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title = "Voriconazole versus itraconazole for antifungal prophylaxis following allogeneic haematopoietic stem-cell transplantation",

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 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.",

keywords = "stem-cell transplant, azoles, invasive fungal disease, mould infections, yeast infections, INVASIVE FUNGAL-INFECTIONS, NEUTROPENIC PATIENTS, RISK-FACTORS, MARROW-TRANSPLANTATION, AMPHOTERICIN-B, FLUCONAZOLE, RECIPIENTS, ASPERGILLOSIS, TRIAL, METAANALYSIS",

author = "Marks, {David I.} and Tony Pagliuca and Kibbler, {Christopher C.} and Axel Glasmacher and Claus-Peter Heussel and Michal Kantecki and Miller, {Paul J. S.} and Patricia Ribaud and Schlamm, {Haran T.} and Carlos Solano and Gordon Cook and {IMPROVIT Study Grp}",

year = "2011",

month = nov,

doi = "10.1111/j.1365-2141.2011.08838.x",

language = "English",

volume = "155",

pages = "318--327",

journal = "British Journal of Haematology",

issn = "0007-1048",

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Marks, DI, Pagliuca, T, Kibbler, CC, Glasmacher, A, Heussel, C-P, Kantecki, M, Miller, PJS, Ribaud, P, Schlamm, HT, Solano, C, Cook, G & IMPROVIT Study Grp 2011, 'Voriconazole versus itraconazole for antifungal prophylaxis following allogeneic haematopoietic stem-cell transplantation', British Journal of Haematology, vol. 155, no. 3, pp. 318-327. https://doi.org/10.1111/j.1365-2141.2011.08838.x

TY - JOUR

T1 - Voriconazole versus itraconazole for antifungal prophylaxis following allogeneic haematopoietic stem-cell transplantation

AU - Marks, David I.

AU - Pagliuca, Tony

AU - Kibbler, Christopher C.

AU - Glasmacher, Axel

AU - Heussel, Claus-Peter

AU - Kantecki, Michal

AU - Miller, Paul J. S.

AU - Ribaud, Patricia

AU - Schlamm, Haran T.

AU - Solano, Carlos

AU - Cook, Gordon

AU - IMPROVIT Study Grp

PY - 2011/11

Y1 - 2011/11

N2 - 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 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.

AB - 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 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.

KW - stem-cell transplant

KW - azoles

KW - invasive fungal disease

KW - mould infections

KW - yeast infections

KW - INVASIVE FUNGAL-INFECTIONS

KW - NEUTROPENIC PATIENTS

KW - RISK-FACTORS

KW - MARROW-TRANSPLANTATION

KW - AMPHOTERICIN-B

KW - FLUCONAZOLE

KW - RECIPIENTS

KW - ASPERGILLOSIS

KW - TRIAL

KW - METAANALYSIS

U2 - 10.1111/j.1365-2141.2011.08838.x

DO - 10.1111/j.1365-2141.2011.08838.x

M3 - Article

SN - 0007-1048

VL - 155

SP - 318

EP - 327

JO - British Journal of Haematology

JF - British Journal of Haematology

IS - 3

ER -

Voriconazole versus itraconazole for antifungal prophylaxis following allogeneic haematopoietic stem-cell transplantation

Abstract

Keywords

UN SDGs

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