Efficacy and safety of high-dose caspofungin in the treatment of invasive pulmonary aspergillosis
10.3760/cma.j.issn.1000-6680.2019.03.002
- VernacularTitle:高剂量卡泊芬净治疗侵袭性肺曲霉病的疗效与安全性
- Author:
Linghong ZHOU
1
;
Xuan WANG
;
Ruiying WANG
;
Huazhen ZHAO
;
Yingkui JIANG
;
Jiahui CHENG
;
Jingyun YE
;
Liping HUANG
;
Liping ZHU
Author Information
1. 复旦大学附属华山医院感染科
- Keywords:
Invasive pulmonary aspergillosis;
Caspofungin;
High-dose;
Efficacy;
Safety
- From:
Chinese Journal of Infectious Diseases
2019;37(3):139-143
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical efficacy and safety of high-dose caspofungin (70 mg/d)as initial or salvage treatment for invasive pulmonary aspergillosis.Methods Twenty-one patients with proven or probable invasive pulmonary aspergillosis from June 2014 to October 2017 in Huashan Hospital,Fudan University were retrospectively reviewed.According to the anti-fungal treatment before high-dose caspofungin application,patients were divided into initial treatment group and salvage treatment group.Patients' clinical data and laboratory data were collected.The characteristics,clinical efficacy,adverse reactions,one-year survival rate and the overall effective rate were evaluated.The prognosis of the two groups was compared by Kaplan-Meier analysis.Results Twenty of the 21 patients opportunistic acquired invasive pulmonary aspergillosis during the treatment of underlying diseases.Five patients were initially treated with high-dose caspofungin for 68 (62) days.At week 12,one patient achieved complete response,3 patients achieved partial response,and the overall effective rate was 80％ (4/5).Sixteen patients received caspofungin as salvage therapy for 66.50 (58) days,of which one patient got complete response at week 12,10 had partial response,and the overall effective rate was 68.75％ (11/16).One-year follow-up showed that no patient died in the initial treatment group,and the one-year survival rate was 100％ (5/5).In salvage treatment group,3 patients died of pulmonary bacterial infections and the one-year survival rate was 81.25％ (13/16).During treatment,one patient had elevated total bilirubin,which was possibly associated with high-dose caspofungin.Conclusions High-dose caspofungin regimen has good efficacy and safety,both for initial treatment and salvage therapy in patients with invasive pulmonary aspergillosis.
