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Live Imaging of Antifungal Activity by Human Primary Neutrophils and Monocytes in Response to A. fumigatus
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Posaconazole

Gillian M Keating1

  • 1Adis International Limited, Auckland, New Zealand. demail@adis.co.nz

Drugs
|July 22, 2005
PubMed

Insights

Posaconazole shows significant efficacy in treating invasive fungal infections, particularly in patients refractory to other antifungals. This triazole antifungal agent demonstrated high success rates across various mycoses, including aspergillosis and zygomycosis.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Pharmacology

Background:

  • Invasive fungal infections (IFIs) pose a significant threat, especially in immunocompromised patients.
  • Limited treatment options exist for patients with IFIs refractory to or intolerant of standard antifungal therapies.
  • Posaconazole, a triazole antifungal, offers broad-spectrum activity against various fungi.

Purpose of the Study:

  • To evaluate the clinical efficacy and safety of posaconazole in patients with IFIs refractory to or intolerant of other antifungal agents.
  • To assess posaconazole's effectiveness across a spectrum of fungal infections, including aspergillosis, zygomycosis, and candidiasis.

Main Methods:

  • An open-label, multicentre, phase III study involving 330 patients receiving posaconazole and 279 external controls.
  • Phase II study in febrile neutropenia and a phase III study in HIV-infected patients with candidiasis were also referenced.
  • Data collected included global response success rates at end-of-therapy and clinical response rates.

Main Results:

  • Significantly higher success rates for posaconazole in aspergillosis (42% vs. 26%) compared to external controls.
  • High success rates observed for posaconazole in zygomycosis (54%), fusariosis (46%), Pseudallescheria infection (43%), phaeohyphomycosis (80%), and histoplasmosis (100%).
  • Effective in refractory infections: candidiasis (48%), coccidioidomycosis (69%), cryptococcal infection (48%), chromoblastomycosis/mycetoma (82%); 81% success in febrile neutropenia; 75% clinical response in HIV-associated candidiasis.

Conclusions:

  • Posaconazole demonstrates clinically relevant activity and is generally well-tolerated in patients with invasive fungal infections, including those refractory to other treatments.
  • The drug shows promise for various mycoses and in specific patient populations like febrile neutropenia and advanced HIV.
  • Oral posaconazole suspension is a viable treatment option, even for long-term use (>1 year).

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