Application of the 2008 Definitions for Invasive Fungal Diseases to the Trial Comparing Voriconazole versus Amphotericin B for Therapy of Invasive Aspergillosis. A Collaborative Study of the Mycoses Study Group (MSG 05) and the EORTC Infectious Diseases
Fiche publication
Date publication
novembre 2014
Auteurs
Membres identifiés du Cancéropôle Est :
Pr HERBRECHT Raoul
Tous les auteurs :
Herbrecht R, Patterson TF, Slavin MA, Marchetti O, Maertens J, Johnson EM, Schlamm HT, Donnelly JP, Pappas PG
Lien Pubmed
Résumé
BACKGROUND: Strict definition of invasive aspergillosis (IA) cases is required to allow precise conclusions about the efficacy of antifungal therapy. The Global Comparative Aspergillus Study (CGAS) compared voriconazole to amphotericin B (AmB) deoxycholate for the primary therapy of IA. As predefined definitions used for this trial were substantially different from the consensus definitions proposed by the EORTC/MSG in 2008, we recategorized the 379 episodes of the CGAS according to the later definitions. METHODS: The objectives were to assess the impact of the current definitions on the classification of the episodes and to provide comparative efficacy for probable/proven and possible IA in patients treated with either voriconazole or AmB. In addition to original data, we integrated the results of baseline galactomannan serum levels obtained from 249 (65.7%) frozen samples. The original response assessment was accepted unchanged. RESULTS: Recategorization allowed 59 proven, 178 probable, and 106 possible IA to be identified. A higher favorable 12-week response rate was obtained with voriconazole (54.7%) than with AmB (29.9%; p
Référence
Clin Infect Dis. 2014 Nov 19. pii: ciu911.