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Isavuconazole Treatment of Cryptococcosis and Dimorphic Mycoses

George R Thompson1, Adrian Rendon2, Rodrigo Ribeiro Dos Santos3

  • 1Department of Medicine/Division of Infectious Diseases, University of California-Davis Medical Center, Sacramento.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|May 13, 2016
PubMed
Abstract

Insights

Isavuconazole (ISAV) demonstrated clinical activity and was well tolerated in patients with invasive fungal diseases (IFD) caused by Cryptococcus and dimorphic fungi. This broad-spectrum antifungal agent offers a valuable treatment option for these serious infections.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Pharmacology

Background:

  • Invasive fungal diseases (IFD) caused by Cryptococcus and dimorphic fungi lead to significant morbidity and mortality.
  • Isavuconazole (ISAV) is a novel, broad-spectrum triazole antifungal agent available intravenously and orally.
  • ISAV exhibits potent in vitro activity against these challenging fungal pathogens.

Purpose of the Study:

  • To evaluate the efficacy and safety of ISAV in treating patients with cryptococcosis or dimorphic fungal infections.
  • To assess the clinical outcomes, including response rates, disease progression, and mortality, in patients treated with ISAV.
  • To determine the safety profile of ISAV in this patient population.

Main Methods:

  • The VITAL study was an open-label, nonrandomized phase 3 trial.
  • Patients received ISAV (200 mg TID for 2 days, then 200 mg QD) via IV or oral routes.
  • Outcomes were assessed by an independent data-review committee, including overall response at end of treatment, mortality, and safety.

Main Results:

  • Thirty-eight patients with IFD caused by various fungi (Cryptococcus, Paracoccidioides, Coccidioides, Histoplasma, Blastomyces) were treated.
  • A successful overall response was observed in 63% (24/38) of patients at the end of treatment.
  • Adverse events were reported in 87% (33/38) of patients, with ISAV generally well tolerated.

Conclusions:

  • Isavuconazole (ISAV) demonstrated clinical activity against endemic fungi, supporting its broad-spectrum efficacy.
  • The safety profile of ISAV was consistent with larger studies, indicating good tolerability.
  • ISAV represents a potentially valuable alternative treatment for invasive fungal diseases caused by these pathogens.
Keywords:
blastomycosiscoccidioidomycosiscryptococcosishistoplasmosisparacoccidioidomycosis

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