Antifungal Treatment for Japanese Patients with Chronic Pulmonary Aspergillosis
Abstract Introduction Despite the ongoing efforts to refine treatment durations and methods for patients with chronic pulmonary aspergillosis, the clinical use of antifungal agents remains unclear. This study aimed to describe the treatment practices, trajectories, and prognoses of newly diagnosed p...
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| Format: | Article |
| Language: | English |
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Adis, Springer Healthcare
2024-12-01
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| Series: | Infectious Diseases and Therapy |
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| Online Access: | https://doi.org/10.1007/s40121-024-01094-y |
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| _version_ | 1832571454982455296 |
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| author | Takahiro Takazono Yoshiyuki Saito Masato Tashiro Masataka Yoshida Kazuaki Takeda Shotaro Ide Naoki Iwanaga Naoki Hosogaya Noriho Sakamoto Hiroshi Mukae Koichi Izumikawa |
| author_facet | Takahiro Takazono Yoshiyuki Saito Masato Tashiro Masataka Yoshida Kazuaki Takeda Shotaro Ide Naoki Iwanaga Naoki Hosogaya Noriho Sakamoto Hiroshi Mukae Koichi Izumikawa |
| author_sort | Takahiro Takazono |
| collection | DOAJ |
| description | Abstract Introduction Despite the ongoing efforts to refine treatment durations and methods for patients with chronic pulmonary aspergillosis, the clinical use of antifungal agents remains unclear. This study aimed to describe the treatment practices, trajectories, and prognoses of newly diagnosed patients with chronic pulmonary aspergillosis. Methods Data from a longitudinal database from hospitals in Japan was used. The target population included patients who started antifungal treatment following their initial diagnosis of pulmonary aspergillosis, pulmonary aspergilloma, or chronic necrotizing pulmonary aspergillosis between October 2015 and September 2017. We described patient characteristics and treatment practices. Results Of the 680 patients analyzed, 253 (37.2%), 231 (34.0%), 155 (22.8%), 31 (4.6%), and 10 (1.5%) patients received the initial treatment with voriconazole, itraconazole, micafungin, caspofungin, and liposomal amphotericin B, respectively. Over 50% of the patients initially treated with micafungin or caspofungin switched to azoles within a month. Of the patients treated with antifungal agents, only 46.8% continued treatment for 6 months, indicating a lower retention rate. The overall mortality rate at 1 year was 24.7%. The median treatment duration of initial treatment until switching was 83 days (interquartile range [IQR], 159) for voriconazole and 162 days (IQR, 310) for itraconazole, indicating a significant variation in treatment duration. Notably, 15.7% (76/484) of the patients underwent a treatment switch between voriconazole and itraconazole in the initial azole treatment group. Conclusions Our findings highlight the challenges associated with sustaining long-term antifungal treatment. |
| format | Article |
| id | doaj-art-808c2346ad734ddc863df1c831a6bcf0 |
| institution | Kabale University |
| issn | 2193-8229 2193-6382 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Adis, Springer Healthcare |
| record_format | Article |
| series | Infectious Diseases and Therapy |
| spelling | doaj-art-808c2346ad734ddc863df1c831a6bcf02025-02-02T12:35:12ZengAdis, Springer HealthcareInfectious Diseases and Therapy2193-82292193-63822024-12-0114124525910.1007/s40121-024-01094-yAntifungal Treatment for Japanese Patients with Chronic Pulmonary AspergillosisTakahiro Takazono0Yoshiyuki Saito1Masato Tashiro2Masataka Yoshida3Kazuaki Takeda4Shotaro Ide5Naoki Iwanaga6Naoki Hosogaya7Noriho Sakamoto8Hiroshi Mukae9Koichi Izumikawa10Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical SciencesDatack Inc.Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical SciencesDepartment of Respiratory Medicine, Nagasaki University Graduate School of Biomedical SciencesDepartment of Respiratory Medicine, Nagasaki University Graduate School of Biomedical SciencesInfectious Diseases Experts Training Center, Nagasaki University HospitalDepartment of Respiratory Medicine, Nagasaki University Graduate School of Biomedical SciencesClinical Research Center, Nagasaki University HospitalDepartment of Respiratory Medicine, Nagasaki University Graduate School of Biomedical SciencesDepartment of Respiratory Medicine, Nagasaki University Graduate School of Biomedical SciencesDepartment of Infectious Diseases, Nagasaki University Graduate School of Biomedical SciencesAbstract Introduction Despite the ongoing efforts to refine treatment durations and methods for patients with chronic pulmonary aspergillosis, the clinical use of antifungal agents remains unclear. This study aimed to describe the treatment practices, trajectories, and prognoses of newly diagnosed patients with chronic pulmonary aspergillosis. Methods Data from a longitudinal database from hospitals in Japan was used. The target population included patients who started antifungal treatment following their initial diagnosis of pulmonary aspergillosis, pulmonary aspergilloma, or chronic necrotizing pulmonary aspergillosis between October 2015 and September 2017. We described patient characteristics and treatment practices. Results Of the 680 patients analyzed, 253 (37.2%), 231 (34.0%), 155 (22.8%), 31 (4.6%), and 10 (1.5%) patients received the initial treatment with voriconazole, itraconazole, micafungin, caspofungin, and liposomal amphotericin B, respectively. Over 50% of the patients initially treated with micafungin or caspofungin switched to azoles within a month. Of the patients treated with antifungal agents, only 46.8% continued treatment for 6 months, indicating a lower retention rate. The overall mortality rate at 1 year was 24.7%. The median treatment duration of initial treatment until switching was 83 days (interquartile range [IQR], 159) for voriconazole and 162 days (IQR, 310) for itraconazole, indicating a significant variation in treatment duration. Notably, 15.7% (76/484) of the patients underwent a treatment switch between voriconazole and itraconazole in the initial azole treatment group. Conclusions Our findings highlight the challenges associated with sustaining long-term antifungal treatment.https://doi.org/10.1007/s40121-024-01094-yAntifungal agentsChronic pulmonary aspergillosisItraconazoleVoriconazole |
| spellingShingle | Takahiro Takazono Yoshiyuki Saito Masato Tashiro Masataka Yoshida Kazuaki Takeda Shotaro Ide Naoki Iwanaga Naoki Hosogaya Noriho Sakamoto Hiroshi Mukae Koichi Izumikawa Antifungal Treatment for Japanese Patients with Chronic Pulmonary Aspergillosis Infectious Diseases and Therapy Antifungal agents Chronic pulmonary aspergillosis Itraconazole Voriconazole |
| title | Antifungal Treatment for Japanese Patients with Chronic Pulmonary Aspergillosis |
| title_full | Antifungal Treatment for Japanese Patients with Chronic Pulmonary Aspergillosis |
| title_fullStr | Antifungal Treatment for Japanese Patients with Chronic Pulmonary Aspergillosis |
| title_full_unstemmed | Antifungal Treatment for Japanese Patients with Chronic Pulmonary Aspergillosis |
| title_short | Antifungal Treatment for Japanese Patients with Chronic Pulmonary Aspergillosis |
| title_sort | antifungal treatment for japanese patients with chronic pulmonary aspergillosis |
| topic | Antifungal agents Chronic pulmonary aspergillosis Itraconazole Voriconazole |
| url | https://doi.org/10.1007/s40121-024-01094-y |
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