A Retrospective Case Control Review Evaluating the Safety and Efficacy of Anidulafungin versus Caspofungin in Individuals with Hepatic Dysfunction Including Liver Transplant Recipients

Ref ID: 19258

Author:

M. A. Barron, K. Richardson, A. E. Hilts, M. E. Levi

Author address:

Univ. of Colorado Denver, Aurora, CO

Full conference title:

53rd Interscience Conference on Antimicrobial Agents and Chemotherapy

Date: 10 September 2014

Abstract:

Background: Anidulafungin levels may be more predictable compared to caspofungin in patients with liver dysfunction and may be better tolerated; however, this has not been formally evaluated. We evaluated the safety and efficacy of anidulafungin compared to caspofungin as empiric or directed treatment of invasive fungal infections (IFI) in patients with hepatic insufficiency and/or liver transplantation. Methods: A retrospective chart review of 142 matched patients with hepatic dysfunction (Child’s Class B or C) or liver transplantation that received either anidulafungin or caspofungin from July 1, 2006 through January 31, 2010. Results: Thirty three subjects in each group were liver transplant recipients. The mean MELD score was similar in the anidulafungin versus caspofungin groups – 23 versus 24. Hepatitis C and alcohol were the most common causes of liver dysfunction. Risk factors for IFI and duration of antifungal therapy (7 days) were similar in both groups.C. albicans and C. glabrata were the most common yeast species isolated. Ten patients that were receiving caspofungin were changed to anidulafungin during treatment because of concerns about toxicity. Overall, 10 patients in the anidulafungin arm (14%) and 7
patients in the caspofungin arm (10%) had at least a fivefold
increase in their liver function tests compared to
baseline but these normalized by the completion of therapy
and were not thought to be due to antifungal therapy. The
median hospital stay was 27 days versus 32 days for
anidulafungin compared to caspofungin
respectively. Conclusions: Anidulafungin was well
tolerated in patients with liver dysfunction and/or liver
transplantation.

Abstract Number: NULL

Conference Year: 2013

Link to conference website: NULL

New link: NULL

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