Micafungin versus caspofungin for treatment of candidemia and other forms of invasive candidiasis

Peter G. Pappas, Coleman M.F. Rotstein, Robert F. Betts, Marcio Nucci, Deepak Talwar, Jan J. De Waele, Jose Antonio Vazquez, Bertrand F. Dupont, David L. Horn, Luis Ostrosky-Zeichner, Annette C. Reboli, Byungse Suh, Raghunadharao Digumarti, Chunzhang Wu, Laura L. Kovanda, Leah J. Arnold, Donald N. Buell

Research output: Contribution to journalArticle

492 Citations (Scopus)

Abstract

Background. Invasive candidiasis is an important cause of morbidity and mortality among patients with health care-associated infection. The echinocandins have potent fungicidal activity against most Candida species, but there are few data comparing the safety and efficacy of echinocandins in the treatment of invasive candidiasis. Methods. This was an international, randomized, double-blind trial comparing micafungin (100 mg daily) and micafungin (150 mg daily) with a standard dosage of caspofungin (70 mg followed by 50 mg daily) in adults with candidemia and other forms of invasive candidiasis. The primary end point was treatment success, defined as clinical and mycological success at the end of blinded intravenous therapy. Results. A total of 595 patients were randomized to one the treatment groups and received at least 1 dose of study drug. In the modified intent-to-treat population, 191 patients were assigned to the micafungin 100 mg group, 199 to the micafungin 150 mg group, and 188 to the caspofungin group. Demographic characteristics and underlying disorders were comparable across the groups. Approximately 85% of patients had candidemia; the remainder had noncandidemic invasive candidiasis. At the end of blinded intravenous therapy, treatment was considered successful for 76.4% of patients in the micafungin 100 mg group, 71.4% in the micafungin 150 mg group, and 72.3% in the caspofungin group. The median time to culture negativity was 2 days in the micafungin 100 mg group and the caspofungin group, compared with 3 days in the micafungin 150 mg groups. There were no significant differences in mortality, relapsing and emergent infections, or adverse events between the study arms. Conclusions. Dosages of micafungin 100 mg daily and 150 mg daily were noninferior to a standard dosage of caspofungin for the treatment of candidemia and other forms of invasive candidiasis.

Original languageEnglish (US)
Pages (from-to)883-893
Number of pages11
JournalClinical Infectious Diseases
Volume45
Issue number7
DOIs
StatePublished - Oct 22 2007
Externally publishedYes

Fingerprint

caspofungin
Invasive Candidiasis
Candidemia
Echinocandins
Therapeutics
micafungin
Mortality
Cross Infection
Candida

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Pappas, P. G., Rotstein, C. M. F., Betts, R. F., Nucci, M., Talwar, D., De Waele, J. J., ... Buell, D. N. (2007). Micafungin versus caspofungin for treatment of candidemia and other forms of invasive candidiasis. Clinical Infectious Diseases, 45(7), 883-893. https://doi.org/10.1086/520980

Micafungin versus caspofungin for treatment of candidemia and other forms of invasive candidiasis. / Pappas, Peter G.; Rotstein, Coleman M.F.; Betts, Robert F.; Nucci, Marcio; Talwar, Deepak; De Waele, Jan J.; Vazquez, Jose Antonio; Dupont, Bertrand F.; Horn, David L.; Ostrosky-Zeichner, Luis; Reboli, Annette C.; Suh, Byungse; Digumarti, Raghunadharao; Wu, Chunzhang; Kovanda, Laura L.; Arnold, Leah J.; Buell, Donald N.

In: Clinical Infectious Diseases, Vol. 45, No. 7, 22.10.2007, p. 883-893.

Research output: Contribution to journalArticle

Pappas, PG, Rotstein, CMF, Betts, RF, Nucci, M, Talwar, D, De Waele, JJ, Vazquez, JA, Dupont, BF, Horn, DL, Ostrosky-Zeichner, L, Reboli, AC, Suh, B, Digumarti, R, Wu, C, Kovanda, LL, Arnold, LJ & Buell, DN 2007, 'Micafungin versus caspofungin for treatment of candidemia and other forms of invasive candidiasis', Clinical Infectious Diseases, vol. 45, no. 7, pp. 883-893. https://doi.org/10.1086/520980
Pappas PG, Rotstein CMF, Betts RF, Nucci M, Talwar D, De Waele JJ et al. Micafungin versus caspofungin for treatment of candidemia and other forms of invasive candidiasis. Clinical Infectious Diseases. 2007 Oct 22;45(7):883-893. https://doi.org/10.1086/520980
Pappas, Peter G. ; Rotstein, Coleman M.F. ; Betts, Robert F. ; Nucci, Marcio ; Talwar, Deepak ; De Waele, Jan J. ; Vazquez, Jose Antonio ; Dupont, Bertrand F. ; Horn, David L. ; Ostrosky-Zeichner, Luis ; Reboli, Annette C. ; Suh, Byungse ; Digumarti, Raghunadharao ; Wu, Chunzhang ; Kovanda, Laura L. ; Arnold, Leah J. ; Buell, Donald N. / Micafungin versus caspofungin for treatment of candidemia and other forms of invasive candidiasis. In: Clinical Infectious Diseases. 2007 ; Vol. 45, No. 7. pp. 883-893.
@article{049d623b13a84919b6c1923b9597b2b3,
title = "Micafungin versus caspofungin for treatment of candidemia and other forms of invasive candidiasis",
abstract = "Background. Invasive candidiasis is an important cause of morbidity and mortality among patients with health care-associated infection. The echinocandins have potent fungicidal activity against most Candida species, but there are few data comparing the safety and efficacy of echinocandins in the treatment of invasive candidiasis. Methods. This was an international, randomized, double-blind trial comparing micafungin (100 mg daily) and micafungin (150 mg daily) with a standard dosage of caspofungin (70 mg followed by 50 mg daily) in adults with candidemia and other forms of invasive candidiasis. The primary end point was treatment success, defined as clinical and mycological success at the end of blinded intravenous therapy. Results. A total of 595 patients were randomized to one the treatment groups and received at least 1 dose of study drug. In the modified intent-to-treat population, 191 patients were assigned to the micafungin 100 mg group, 199 to the micafungin 150 mg group, and 188 to the caspofungin group. Demographic characteristics and underlying disorders were comparable across the groups. Approximately 85{\%} of patients had candidemia; the remainder had noncandidemic invasive candidiasis. At the end of blinded intravenous therapy, treatment was considered successful for 76.4{\%} of patients in the micafungin 100 mg group, 71.4{\%} in the micafungin 150 mg group, and 72.3{\%} in the caspofungin group. The median time to culture negativity was 2 days in the micafungin 100 mg group and the caspofungin group, compared with 3 days in the micafungin 150 mg groups. There were no significant differences in mortality, relapsing and emergent infections, or adverse events between the study arms. Conclusions. Dosages of micafungin 100 mg daily and 150 mg daily were noninferior to a standard dosage of caspofungin for the treatment of candidemia and other forms of invasive candidiasis.",
author = "Pappas, {Peter G.} and Rotstein, {Coleman M.F.} and Betts, {Robert F.} and Marcio Nucci and Deepak Talwar and {De Waele}, {Jan J.} and Vazquez, {Jose Antonio} and Dupont, {Bertrand F.} and Horn, {David L.} and Luis Ostrosky-Zeichner and Reboli, {Annette C.} and Byungse Suh and Raghunadharao Digumarti and Chunzhang Wu and Kovanda, {Laura L.} and Arnold, {Leah J.} and Buell, {Donald N.}",
year = "2007",
month = "10",
day = "22",
doi = "10.1086/520980",
language = "English (US)",
volume = "45",
pages = "883--893",
journal = "Clinical Infectious Diseases",
issn = "1058-4838",
publisher = "Oxford University Press",
number = "7",

}

TY - JOUR

T1 - Micafungin versus caspofungin for treatment of candidemia and other forms of invasive candidiasis

AU - Pappas, Peter G.

AU - Rotstein, Coleman M.F.

AU - Betts, Robert F.

AU - Nucci, Marcio

AU - Talwar, Deepak

AU - De Waele, Jan J.

AU - Vazquez, Jose Antonio

AU - Dupont, Bertrand F.

AU - Horn, David L.

AU - Ostrosky-Zeichner, Luis

AU - Reboli, Annette C.

AU - Suh, Byungse

AU - Digumarti, Raghunadharao

AU - Wu, Chunzhang

AU - Kovanda, Laura L.

AU - Arnold, Leah J.

AU - Buell, Donald N.

PY - 2007/10/22

Y1 - 2007/10/22

N2 - Background. Invasive candidiasis is an important cause of morbidity and mortality among patients with health care-associated infection. The echinocandins have potent fungicidal activity against most Candida species, but there are few data comparing the safety and efficacy of echinocandins in the treatment of invasive candidiasis. Methods. This was an international, randomized, double-blind trial comparing micafungin (100 mg daily) and micafungin (150 mg daily) with a standard dosage of caspofungin (70 mg followed by 50 mg daily) in adults with candidemia and other forms of invasive candidiasis. The primary end point was treatment success, defined as clinical and mycological success at the end of blinded intravenous therapy. Results. A total of 595 patients were randomized to one the treatment groups and received at least 1 dose of study drug. In the modified intent-to-treat population, 191 patients were assigned to the micafungin 100 mg group, 199 to the micafungin 150 mg group, and 188 to the caspofungin group. Demographic characteristics and underlying disorders were comparable across the groups. Approximately 85% of patients had candidemia; the remainder had noncandidemic invasive candidiasis. At the end of blinded intravenous therapy, treatment was considered successful for 76.4% of patients in the micafungin 100 mg group, 71.4% in the micafungin 150 mg group, and 72.3% in the caspofungin group. The median time to culture negativity was 2 days in the micafungin 100 mg group and the caspofungin group, compared with 3 days in the micafungin 150 mg groups. There were no significant differences in mortality, relapsing and emergent infections, or adverse events between the study arms. Conclusions. Dosages of micafungin 100 mg daily and 150 mg daily were noninferior to a standard dosage of caspofungin for the treatment of candidemia and other forms of invasive candidiasis.

AB - Background. Invasive candidiasis is an important cause of morbidity and mortality among patients with health care-associated infection. The echinocandins have potent fungicidal activity against most Candida species, but there are few data comparing the safety and efficacy of echinocandins in the treatment of invasive candidiasis. Methods. This was an international, randomized, double-blind trial comparing micafungin (100 mg daily) and micafungin (150 mg daily) with a standard dosage of caspofungin (70 mg followed by 50 mg daily) in adults with candidemia and other forms of invasive candidiasis. The primary end point was treatment success, defined as clinical and mycological success at the end of blinded intravenous therapy. Results. A total of 595 patients were randomized to one the treatment groups and received at least 1 dose of study drug. In the modified intent-to-treat population, 191 patients were assigned to the micafungin 100 mg group, 199 to the micafungin 150 mg group, and 188 to the caspofungin group. Demographic characteristics and underlying disorders were comparable across the groups. Approximately 85% of patients had candidemia; the remainder had noncandidemic invasive candidiasis. At the end of blinded intravenous therapy, treatment was considered successful for 76.4% of patients in the micafungin 100 mg group, 71.4% in the micafungin 150 mg group, and 72.3% in the caspofungin group. The median time to culture negativity was 2 days in the micafungin 100 mg group and the caspofungin group, compared with 3 days in the micafungin 150 mg groups. There were no significant differences in mortality, relapsing and emergent infections, or adverse events between the study arms. Conclusions. Dosages of micafungin 100 mg daily and 150 mg daily were noninferior to a standard dosage of caspofungin for the treatment of candidemia and other forms of invasive candidiasis.

UR - http://www.scopus.com/inward/record.url?scp=34848928703&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34848928703&partnerID=8YFLogxK

U2 - 10.1086/520980

DO - 10.1086/520980

M3 - Article

VL - 45

SP - 883

EP - 893

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

SN - 1058-4838

IS - 7

ER -