Efficacy and Safety of Caspofungin in Hematological Patients with Invasive Aspergillosis

Abstract

Invasive aspergillosis remains as a frequent cause of lethality in hematological patients. The authors retrospectively analyzed the experience of caspofungin usage in 20 hematological patients with invasive aspergillosis in different medical centers in Russia and also made a literature review. The pulmonary invasive aspergillosis was registered in 75% of patients, a combined affection of lungs and ENT-structures – in 20%, the affection of sinuses of nose with maxillary osteomyelitis – in 5%. The clinicalmicrobiological efficacy and safety profile of caspofungin in invasive aspergillosis were studied. Also a clinical-economical analysis was made. Caspofungin more often was used after non-efficacy of other antimycotics (90%). The preparation was used as monotherapy (55%), also as a combination with other antifungals (45%). The efficacy of monotherapy was 91%, combined therapy – 100%. Attributive lethality in patients with invasive aspergillosis treated with caspofungin was 5%. The overall 30-days probability of survival was 85±8%. The study has showed that the duration of efficacious treatment of invasive aspergillosis with caspofungin should be no less than two weeks. There were no serious adverse events; also there were no cases of treatment discontinuation. During the caspofungin usage the majority of expenses were related to antimycotic.