[Background] Micafungin (MCFG), the first echinocandin antifungal agent available in Japan, has excellent in vitro antifungal activity with a low minimum inhibitory concentration (MIC) against Aspergillus spp. [Purpose] We assessed the utility and safety of MCFG for the treatment of Chronic necrotizing pulmonary aspergillosis (CNPA). [Methods] MCFG was administered to the patients with CNPA (n=30) who were admitted to five hospitals in Saitama Prefecture, Japan. We prospectively examined the efficacy and adverse effects of MCFG by improvements of clinical scores (findings and/or symptoms), inflammation, radiological signs, nutritional status, and eradication of fungi. [Results] Of the 30 patients with CNPA, 16 (53%) improved significantly (not cured). Of the 14 unresponsive patients, the conditions of 7 were unchanged, 3 became worse, and 4 died. Among the patients who worsened or died, bad performance status (PS) and extreme tabescence were observed. Adverse events occurred in 9 of 30 patients (30%), including rash or eruption, phlebitis or digestive symptoms. All adverse events were not serious. [Conclusions] In more than half of the patients with CNPA, MCFG led to significant responses, but these patients were not cured. MCFG was less effective in patients with malnutrition. This study suggests that MCFG is a valuable new treatment option for CNPA.
Full conference title:
15th European Respiratory Society annual conference
- ERS 15th (2005)