Posaconazole vs. fluconazole or itraconazole prophylaxis in patients with neutropenia.

@article{Cornely2007PosaconazoleVF,
  title={Posaconazole vs. fluconazole or itraconazole prophylaxis in patients with neutropenia.},
  author={Oliver A. Cornely and Johan Maertens and Drew J. Winston and John R. Perfect and Andrew J Ullmann and Thomas J. Walsh and David Helfgott and Jerzy Hołowiecki and Dick Stockelberg and Yeow Tee Goh and Mario Petrini and Catherine J. Hardalo and Rama Suresh and D. Angulo-Gonzalez},
  journal={The New England journal of medicine},
  year={2007},
  volume={356 4},
  pages={
          348-59
        }
}
BACKGROUND Patients with neutropenia resulting from chemotherapy for acute myelogenous leukemia or the myelodysplastic syndrome are at high risk for difficult-to-treat and often fatal invasive fungal infections. METHODS In this randomized, multicenter study involving evaluators who were unaware of treatment assignments, we compared the efficacy and safety of posaconazole with those of fluconazole or itraconazole as prophylaxis for patients with prolonged neutropenia. Patients received… 
Antifungal prophylaxis with posaconazole vs. fluconazole or itraconazole in pediatric patients with neutropenia
TLDR
Posaconazoles, fluconazole, and itraconazole are comparably effective in preventing invasive fungal infections in pediatric patients and defining dose recommendations in these patients requires larger studies.
Micafungin versus posaconazole prophylaxis in acute leukemia or myelodysplastic syndrome: A randomized study.
TLDR
The data support micafungin as alternative antifungal prophylaxis in patients with AL and MDS.
Posaconazole and fluconazole prophylaxis during induction therapy for pediatric acute lymphoblastic leukemia.
TLDR
Posaconazole prophylaxis reduced the odds of invasive fungal infections by > 60%, prolonged infection-free survival significantly, and did not increase the risk of hepatotoxicity, and the combination of age at diagnosis, clinically documented bacterial infection in the first 15 days of induction therapy, and absolute neutrophil count curve enabled significant prediction of the susceptibility to infections after receiving posaconazoles proPHylaxis.
Posaconazole versus voriconazole as antifungal prophylaxis during induction therapy for acute myelogenous leukemia or myelodysplastic syndrome
TLDR
Both posaconazole delayed-release tablets and oral voriconazole appear to be effective at preventing invasive fungal infection in acute myelogenous leukemia and myelodysplastic syndrome patients undergoing induction chemotherapy, although posaconzole may be more tolerable.
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TLDR
PP appears to be an effective and well‐tolerated protection against IFD for AML patients under natural clinical conditions.
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TLDR
In AML and MDS patients receiving HMAs, IFI risk may be high during the early cycles, especially when the underlying disease is not controlled, especially in patients who had neutropenia or did not respond to HMAs.
Posaconazole : a review of its use in the prophylaxis of invasive fungal infections.
TLDR
Posaconazole provided effective prophylaxis against invasive fungal infections and was generally well tolerated in two large, well designed trials in HSCT recipients with GVHD, or patients receiving induction-remission chemotherapy for acute myeloid leukaemia (AML) or myelodysplastic syndrome (MDS) that was expected to result in prolonged neutropenia.
Posaconazole versus fluconazole or itraconazole for prevention of invasive fungal infections in patients undergoing intensive cytotoxic therapy for acute myeloid leukemia or myelodysplasia: a cost effectiveness analysis
TLDR
Prophylaxis with posaconazole in cancer patients with prolonged neutropenia is not only cost effective but also cost saving, due to the drug’s ability to reduce the incidence of high cost fungal infections, particularly Aspergillus species.
Posaconazole vs. voriconazole in the prevention of invasive fungal diseases in patients with haematological malignancies: A retrospective study.
TLDR
Posaconazole and voriconazole have the same prophylactic effect against IFDs in high-risk neutropenic Chinese patients, while in terms of cost-effectiveness, voriconsazole has an advantage over posaconazoles.
Clinical effectiveness of posaconazole versus fluconazole as antifungal prophylaxis in hematology–oncology patients: a retrospective cohort study
TLDR
This study demonstrates superior effectiveness of posaconazole over fluconazole as prophylaxis of IFD in AML and MDS patients, but such superiority did not translate to reductions in 100‐day all‐cause mortality.
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References

SHOWING 1-10 OF 33 REFERENCES
Posaconazole as salvage treatment for invasive fusariosis in patients with underlying hematologic malignancy and other conditions.
  • I. Raad, R. Hachem, +4 authors D. Kontoyiannis
  • Medicine
    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
  • 2006
TLDR
It is suggested that posaconazole is useful for the treatment of invasive fusariosis after a retrospective analysis of patients from 3 open-label clinical trials.
Itraconazole versus fluconazole for prevention of fungal infections in patients receiving allogeneic stem cell transplants.
TLDR
Itraconazole appears to prevent invasive mold infections (IMIs) in the subset of patients who tolerate the drug; however, toxicities and poor tolerability limit its success as prophylactic therapy.
A controlled trial of fluconazole to prevent fungal infections in patients undergoing bone marrow transplantation.
TLDR
Prophylactic administration of fluconazole to recipients of bone marrow transplants reduces the incidence of both systemic and superficial fungal infections.
Pharmacokinetics, Safety, and Efficacy of Posaconazole in Patients with Persistent Febrile Neutropenia or Refractory Invasive Fungal Infection
ABSTRACT The pharmacokinetic profiles, safety, and efficacies of different dosing schedules of posaconazole oral suspension in patients with possible, probable, and proven refractory invasive fungal
Randomized Placebo-Controlled Trial of Fluconazole Prophylaxis for Neutropenic Cancer Patients: Benefit Based on Purpose and Intensity of Cytotoxic Therapy
TLDR
Fluconazole prophylaxis reduces the incidence of superficial fungal infection and invasive fungal infections andFungal infection-related mortality among patients who are receiving intensive cytotoxic chemotherapy for remission induction.
Fluconazole Prophylaxis of Fungal Infections in Patients with Acute Leukemia: Results of a Randomized Placebo-Controlled, Double-Blind, Multicenter Trial
TLDR
There is currently no uniformly accepted or proven approach for prevention of fungal infections in neutropenic patients with acute leukemia and fluconazole is a new triazole antifungal agent with activity against many common fungal pathogens causing infection in patients with severe liver disease.
An open-label randomized trial comparing itraconazole oral solution with fluconazole oral solution for primary prophylaxis of fungal infections in patients with haematological malignancy and profound neutropenia.
TLDR
There were no differences in the efficacy and safety of itraconazole and fluconazole prophylaxis in neutropenic patients with haematological malignancies and no differences were detected between treatment groups in proven or suspected invasive fungal infections or other endpoints.
Evidence-based assessment of primary antifungal prophylaxis in patients with hematologic malignancies.
TLDR
An objective of this review of 50 studies accumulating more than 9000 patients is to assess evidence-based criteria with regard to the efficacy of antifungal prophylaxis in neutropenic cancer patients.
Itraconazole prevents invasive fungal infections in neutropenic patients treated for hematologic malignancies: evidence from a meta-analysis of 3,597 patients.
TLDR
Antifungal prophylaxis with itraconazole effectively prevents proven invasive fungal infections and is shown for the first time for antifungals-reduces mortality from these infections and the rate of invasive Aspergillus infections in neutropenic patients with hematologic malignancies.
Antifungal Activity and Pharmacokinetics of Posaconazole (SCH 56592) in Treatment and Prevention of Experimental Invasive Pulmonary Aspergillosis: Correlation with Galactomannan Antigenemia
TLDR
In summary, POC at ≥6 mg/kg/day per os generated sustained concentrations in plasma of ≥1 μg/ml that were as effective in the treatment and prevention of invasive pulmonary aspergillosis as AMB at 1 mg/ kg/day and more effective than cyclodextrin ITC at ≥ 6 mg/kerpine per os in persistently neutropenic rabbits.
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