Intravenous micafungin versus voriconazole for chronic pulmonary aspergillosis: A multicenter trial in Japan

Kohno, Shigeru; Izumikawa, Koichi; Ogawa, Kenji; Kurashima, Atsuyuki; Okimoto, Niro; Amitani, Ryoichi; Kakeya, Hiroshi; Niki, Yoshihito; Miyazaki, Yoshitsugu

doi:10.1016/j.jinf.2010.08.005

Cited by 108 publications

(151 citation statements)

References 22 publications

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“…antifungal agents [14], the other oral azole therapy randomised against no antifungal therapy [83]. Most of the cohort studies do not clearly separate out the various subsets of CPA.…”

Section: Treatment and Follow-upmentioning

confidence: 99%

“…micafungin in comparison with i.v. voriconazole in CPA patients [14]. Within the echinocandin class, a small double-blinded randomised controlled trial has shown caspofungin to be as effective as micafungin in improving health status in the CPA subset [97].…”

Section: Duration Of Antifungal Therapy For Cpamentioning

confidence: 99%

“…Subsequently criteria for the diagnosis and categorisation of patients were proposed in 2003 [10], and later refinements to the criteria and classification of the disease were proposed [12,13]. Several prospective treatment studies were undertaken [14][15][16]. The global burden of CPA following pulmonary TB ( prevalence of 1.74 million), complicating allergic bronchopulmonary aspergillosis (ABPA) (CPA prevalence of 411 000) and sarcoidosis (CPA prevalence of 72 000) have been estimated [17][18][19], showing the extent of the problem internationally.…”

Section: Introductionmentioning

confidence: 99%

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Chronic pulmonary aspergillosis: rationale and clinical guidelines for diagnosis and management

Denning¹,

Cadranel²,

et al. 2015

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Chronic pulmonary aspergillosis (CPA) is an uncommon and problematic pulmonary disease, complicating many other respiratory disorders, thought to affect ∼240 000 people in Europe. The most common form of CPA is chronic cavitary pulmonary aspergillosis (CCPA), which untreated may progress to chronic fibrosing pulmonary aspergillosis. Less common manifestations include: Aspergillus nodule and single aspergilloma. All these entities are found in non-immunocompromised patients with prior or current lung disease. Subacute invasive pulmonary aspergillosis (formerly called chronic necrotising pulmonary aspergillosis) is a more rapidly progressive infection (<3 months) usually found in moderately immunocompromised patients, which should be managed as invasive aspergillosis. Few clinical guidelines have been previously proposed for either diagnosis or management of CPA. A group of experts convened to develop clinical, radiological and microbiological guidelines. The diagnosis of CPA requires a combination of characteristics: one or more cavities with or without a fungal ball present or nodules on thoracic imaging, direct evidence of Aspergillus infection (microscopy or culture from biopsy) or an immunological response to Aspergillus spp. and exclusion of alternative diagnoses, all present for at least 3 months. Aspergillus antibody (precipitins) is elevated in over 90% of patients. Surgical excision of simple aspergilloma is recommended, if technically possible, and preferably via video-assisted thoracic surgery technique. Long-term oral antifungal therapy is recommended for CCPA to improve overall health status and respiratory symptoms, arrest haemoptysis and prevent progression. Careful monitoring of azole serum concentrations, drug interactions and possible toxicities is recommended. Haemoptysis may be controlled with tranexamic acid and bronchial artery embolisation, rarely surgical resection, and may be a sign of therapeutic failure and/or antifungal resistance. Patients with single Aspergillus nodules only need antifungal therapy if not fully resected, but if multiple they may benefit from antifungal treatment, and require careful follow-up. @ERSpublications ERS and ESCMID guideline for the management of chronic pulmonary aspergillosis released

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“…antifungal agents [14], the other oral azole therapy randomised against no antifungal therapy [83]. Most of the cohort studies do not clearly separate out the various subsets of CPA.…”

Section: Treatment and Follow-upmentioning

confidence: 99%

Section: Duration Of Antifungal Therapy For Cpamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Chronic pulmonary aspergillosis: rationale and clinical guidelines for diagnosis and management

Denning¹,

Cadranel²,

et al. 2015

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“…Antifungal therapy is very beneficial in CPA patients, as it reduces both morbidity and mortality. [6][7][8]30,[43][44][45][46] Little data exist on the development of CPA after PTB. Prospective clinical and epidemiological studies using the best diagnostic tools available are needed to ascertain its frequency in different places and among different ethnic groups.…”

Section: Future Directionsmentioning

confidence: 99%

Global burden of chronic pulmonary aspergillosis as a sequel to pulmonary tuberculosis

Denning¹,

Pleuvry²,

Cole³

2011

Bull World Health Org

360

366

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“…Antifungal therapy is effective in ameliorating symptoms and reducing recurrence of haemoptysis in .60% of patients [4][5][6][7][8][9][10], and may reduce progressive lung fibrosis. Overall, treated CPA has a 20-33% short-term mortality and a 50% mortality over 5 yrs [6,11], but one small cohort showed that almost all patients with sarcoidosis and CPA had died within 2 yrs [12].…”

mentioning

confidence: 99%

Global burden of chronic pulmonary aspergillosis complicating sarcoidosis

Pleuvry²,

2012

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Chronic pulmonary aspergillosis (CPA) may complicate pulmonary sarcoidosis. We re-estimated the global burden of sarcoidosis and the burden of CPA complicating sarcoidosis.We searched the literature and reference lists of retrieved papers to identify all published sarcoidosis incidence and prevalence data. We estimated the frequency of CPA from 11 papers relating to .3,000 patients with sarcoidosis to derive CPA patient numbers. We applied an annual attrition rate of 15% (range 10-25%) to estimate the global burden of CPA.We estimate that the annual incidence of sarcoidosis is 344,000 patients worldwide and the prevalence is ,1,238,000 cases, distributed as follows: 165,979 in Europe, 224,000 in the Americas, 492,892 in Africa, 80,023 in the Eastern Mediterranean, 41,660 in the West Pacific and 234,010 in Southeast Asia. CPA complicates sarcoidosis in 3-12% of cases. Using a 6% frequency, we estimate a global burden of 71,907 (range 35,954-143,815 (3-12%)) CPA cases complicating sarcoidosis, with 24% and 37% of cases estimated to be present in the Americas and Africa, because of the higher incidence of sarcoidosis in black people.As CPA responds to long-term antifungal therapy, which may prevent life-threatening haemoptysis, screening periodically for CPA in those with pulmonary sarcoidosis may be important, especially in patients requiring corticosteroid therapy.

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Intravenous micafungin versus voriconazole for chronic pulmonary aspergillosis: A multicenter trial in Japan

Cited by 108 publications

References 22 publications

Chronic pulmonary aspergillosis: rationale and clinical guidelines for diagnosis and management

Chronic pulmonary aspergillosis: rationale and clinical guidelines for diagnosis and management

Global burden of chronic pulmonary aspergillosis as a sequel to pulmonary tuberculosis

Global burden of chronic pulmonary aspergillosis complicating sarcoidosis

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