Real-World Effectiveness and Safety of Isavuconazole Versus Amphotericin B for Patients with Invasive Mucormycosis
Background: Invasive mucormycosis (IM) poses a substantial morbidity and mortality burden among immunocompromised patients. Objectives: We aim to compare the real-world effectiveness and safety of isavuconazole with those of amphotericin B in patients with IM. Patients and methods: In this observati...
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2025-01-01
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| author | Jiayuan Qin Hongxia Bi Guangmin Tang Xinyao Liu Junyan Qu Xiaoju Lv Yanbin Liu |
| author_facet | Jiayuan Qin Hongxia Bi Guangmin Tang Xinyao Liu Junyan Qu Xiaoju Lv Yanbin Liu |
| author_sort | Jiayuan Qin |
| collection | DOAJ |
| description | Background: Invasive mucormycosis (IM) poses a substantial morbidity and mortality burden among immunocompromised patients. Objectives: We aim to compare the real-world effectiveness and safety of isavuconazole with those of amphotericin B in patients with IM. Patients and methods: In this observational cohort study, we enrolled patients who were diagnosed with IM and treated with either isavuconazole or amphotericin B. Results: A total of 106 patients met the study criteria. Of these, 47 received isavuconazole, and 59 received amphotericin B as the primary treatment. The two cohorts had similar baseline characteristics, including a history of malignancy, use of immunosuppressants, infection sites, and pathogens. The amphotericin B group demonstrated a significantly greater incidence of renal disorders (<i>p</i> < 0.001) and hypokalemia (<i>p</i> < 0.001) than the isavuconazole group. The proportion of patients who received salvage therapy was greater in the amphotericin B group than in the isavuconazole group (42% vs. 6%, <i>p</i> < 0.001). Eighteen patients in the amphotericin B group discontinued treatment because of adverse events, whereas no patients in the isavuconazole group discontinued treatment because of adverse events. A significant difference in the primary therapeutic response between the isavuconazole and amphotericin B groups was noted (<i>p</i> = 0.013), with a higher treatment failure rate in the amphotericin B group (68% vs. 36%, <i>p</i> = 0.001). However, there were no significant differences in all-cause mortality or mucormycosis-attributable mortality rates between the two groups. Conclusions: Isavuconazole outperformed amphotericin B as a first-line treatment option for IM in terms of its clinical effectiveness and safety. |
| format | Article |
| id | doaj-art-fcaa3c482eb742efbfc8d3dd0195f754 |
| institution | Kabale University |
| issn | 2076-2607 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Microorganisms |
| spelling | doaj-art-fcaa3c482eb742efbfc8d3dd0195f7542025-01-24T13:42:27ZengMDPI AGMicroorganisms2076-26072025-01-011315510.3390/microorganisms13010055Real-World Effectiveness and Safety of Isavuconazole Versus Amphotericin B for Patients with Invasive MucormycosisJiayuan Qin0Hongxia Bi1Guangmin Tang2Xinyao Liu3Junyan Qu4Xiaoju Lv5Yanbin Liu6Center of Infectious Diseases, West China Hospital, Sichuan University, Guoxuexiang 37, Chengdu 610041, ChinaCenter of Infectious Diseases, West China Hospital, Sichuan University, Guoxuexiang 37, Chengdu 610041, ChinaCenter of Infectious Diseases, West China Hospital, Sichuan University, Guoxuexiang 37, Chengdu 610041, ChinaCenter for Pathogen Research, West China Hospital, Sichuan University, Chengdu 610041, ChinaCenter of Infectious Diseases, West China Hospital, Sichuan University, Guoxuexiang 37, Chengdu 610041, ChinaCenter of Infectious Diseases, West China Hospital, Sichuan University, Guoxuexiang 37, Chengdu 610041, ChinaCenter of Infectious Diseases, West China Hospital, Sichuan University, Guoxuexiang 37, Chengdu 610041, ChinaBackground: Invasive mucormycosis (IM) poses a substantial morbidity and mortality burden among immunocompromised patients. Objectives: We aim to compare the real-world effectiveness and safety of isavuconazole with those of amphotericin B in patients with IM. Patients and methods: In this observational cohort study, we enrolled patients who were diagnosed with IM and treated with either isavuconazole or amphotericin B. Results: A total of 106 patients met the study criteria. Of these, 47 received isavuconazole, and 59 received amphotericin B as the primary treatment. The two cohorts had similar baseline characteristics, including a history of malignancy, use of immunosuppressants, infection sites, and pathogens. The amphotericin B group demonstrated a significantly greater incidence of renal disorders (<i>p</i> < 0.001) and hypokalemia (<i>p</i> < 0.001) than the isavuconazole group. The proportion of patients who received salvage therapy was greater in the amphotericin B group than in the isavuconazole group (42% vs. 6%, <i>p</i> < 0.001). Eighteen patients in the amphotericin B group discontinued treatment because of adverse events, whereas no patients in the isavuconazole group discontinued treatment because of adverse events. A significant difference in the primary therapeutic response between the isavuconazole and amphotericin B groups was noted (<i>p</i> = 0.013), with a higher treatment failure rate in the amphotericin B group (68% vs. 36%, <i>p</i> = 0.001). However, there were no significant differences in all-cause mortality or mucormycosis-attributable mortality rates between the two groups. Conclusions: Isavuconazole outperformed amphotericin B as a first-line treatment option for IM in terms of its clinical effectiveness and safety.https://www.mdpi.com/2076-2607/13/1/55isavuconazoleamphotericin Binvasive mucormycosiseffectivenesssafetyreal-world |
| spellingShingle | Jiayuan Qin Hongxia Bi Guangmin Tang Xinyao Liu Junyan Qu Xiaoju Lv Yanbin Liu Real-World Effectiveness and Safety of Isavuconazole Versus Amphotericin B for Patients with Invasive Mucormycosis Microorganisms isavuconazole amphotericin B invasive mucormycosis effectiveness safety real-world |
| title | Real-World Effectiveness and Safety of Isavuconazole Versus Amphotericin B for Patients with Invasive Mucormycosis |
| title_full | Real-World Effectiveness and Safety of Isavuconazole Versus Amphotericin B for Patients with Invasive Mucormycosis |
| title_fullStr | Real-World Effectiveness and Safety of Isavuconazole Versus Amphotericin B for Patients with Invasive Mucormycosis |
| title_full_unstemmed | Real-World Effectiveness and Safety of Isavuconazole Versus Amphotericin B for Patients with Invasive Mucormycosis |
| title_short | Real-World Effectiveness and Safety of Isavuconazole Versus Amphotericin B for Patients with Invasive Mucormycosis |
| title_sort | real world effectiveness and safety of isavuconazole versus amphotericin b for patients with invasive mucormycosis |
| topic | isavuconazole amphotericin B invasive mucormycosis effectiveness safety real-world |
| url | https://www.mdpi.com/2076-2607/13/1/55 |
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