Efficacy and safety of anidulafungin in elderly, critically ill patients with invasive Candida infections: a post hoc analysis

• Type: Article in International Scientific Journal
• Date: 2012

Authors

Dimopoulos, G (Author) Other; Paiva, J-A (Author) FMUP; Meersseman, W (Author) Other; Pachl, J (Author) Other; Grigoras, I (Author) Other; Sganga, G (Author) Other; Montravers, P (Author) Other; Auzinger, G (Author) Other; Borges Sa, MB (Author) Other; Miller, PJ (Author) Other; Marcek, T (Author) Other; Kantecki, M (Author) Other; Ruhnke, M (Author) Other

Journal

Title: International Journal of Antimicrobial Agents

Vol. 40

Pages: 521-526

ISSN: 0924-8579

Publisher: Elsevier

Indexing

ISI Web of Knowledge - 11 Citations

Scopus - 13 Citations

Other information

Authenticus ID: P-002-305

DOI: 10.1016/j.ijantimicag.2012.07.018

Abstract (EN): Post hoc analysis of a non-comparative, prospective, multicentre, phase IIIb study was performed to compare efficacy and safety of anidulafungin in elderly (>= 65 years) versus non-elderly (<65 years) Intensive Care Unit (ICU) patients with candidaemia/invasive candidiasis (C/IC). Adult ICU patients with confirmed C/IC meeting >= 1 of the following criteria were enrolled: post-abdominal surgery; solid tumour; renal/hepatic insufficiency; solid organ transplantation; neutropenia; age >= 65 years. Patients received anidulafungin (200 mg on Day 1, 100 mg/day thereafter) for >= 10 days followed by optional azole step-down therapy for a total treatment duration of 14-56 days. The primary efficacy endpoint was global (clinical and microbiological) response at the end of all therapy (EOT). Primary efficacy analysis was performed in the modified intent-to-treat (mITT) population (n = 170), excluding unknown and missing responses. In total, 80 patients (47.1%) were aged >= 65 years and 90 (52.9%) were aged <65 years; the mean age difference between the two groups was 21.9 years. Global success at EOT in mITT patients was similar in elderly (68.1%) and non-elderly (70.7%) patients (P = 0.719). However, global success rates were significantly lower in elderly versus non-elderly patients at 2 and 6 weeks after EOT (P = 0.045 and P = 0.016, respectively). Ninety-day survival was significantly lower (P = 0.006) for elderly (42.8%) versus non-elderly patients (63.3%). The incidence and profile of adverse events were similar in elderly and non-elderly patients. Anidulafungin was effective and safe for treatment of C/IC in elderly ICU patients, despite higher baseline severity of illness scores.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 6