Universität zu Köln

Wingen-Heimann, Sebastian M., Cornely, Oliver A., Vehreschild, Maria J. G. T., Wisplinghoff, Hilmar, Franke, Bernd, Schons, Max, von Bergwelt-Baildon, Michael, Scheid, Christof and Vehreschild, Joerg Janne (2021). Clinical and pharmacoeconomic evaluation of antifungal prophylaxis with continuous micafungin in patients undergoing allogeneic stem cell transplantation: A six-year cohort analysis. Mycoses, 64 (4). S. 437 - 445. HOBOKEN: WILEY. ISSN 1439-0507

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Abstract

Background Patients undergoing allogeneic stem cell transplantation (aSCT) are at high risk to develop an invasive fungal disease (IFD). Optimisation of antifungal prophylaxis strategies may improve patient outcomes and reduce treatment costs. Objectives To analyse the clinical and economical impact of using continuous micafungin as antifungal prophylaxis. Patients/Methods We performed a single-centre evaluation comparing patients who received either oral posaconazole with micafungin as intravenous bridging as required (POS-MIC) to patients who received only micafungin (MIC) as antifungal prophylaxis after aSCT. Epidemiological, clinical and direct treatment cost data extracted from the Cologne Cohort of Neutropenic Patients (CoCoNut) were analysed. Results Three hundred and thirteen patients (97 and 216 patients in the POS-MIC and MIC groups, respectively) were included into the analysis. In the POS-MIC and MIC groups, median overall length of stay was 42 days (IQR: 35-52 days) vs 40 days (IQR: 35-49 days; p = .296), resulting in median overall costs of euro42,964 (IQR: euro35,040-euro56,348) vs euro43,291 (IQR: euro37,281 vs euro51,848; p = .993), respectively. Probable/proven IFD in the POS-MIC and MIC groups occurred in 5 patients (5%) vs 3 patients (1%; p = .051), respectively. The Kaplan-Meier analysis showed improved outcome of patients in the MIC group at day 100 (p = .037) and day 365 (p < .001) following aSCT. Conclusions Our study results demonstrate improved outcomes in the MIC group compared with the POS-MIC group, which can in part be explained by a tendency towards less probable/proven IFD. Higher drug acquisition costs of micafungin did not translate into higher overall costs.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Wingen-Heimann, Sebastian M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Cornely, Oliver A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Vehreschild, Maria J. G. T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wisplinghoff, Hilmar UNSPECIFIED UNSPECIFIED UNSPECIFIED Franke, Bernd UNSPECIFIED UNSPECIFIED UNSPECIFIED Schons, Max UNSPECIFIED UNSPECIFIED UNSPECIFIED von Bergwelt-Baildon, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Scheid, Christof UNSPECIFIED UNSPECIFIED UNSPECIFIED Vehreschild, Joerg Janne UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-593625
DOI:	10.1111/myc.13232
Journal or Publication Title:	Mycoses
Volume:	64
Number:	4
Page Range:	S. 437 - 445
Date:	2021
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1439-0507
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language INVASIVE FUNGAL-INFECTIONS; HIGH-RISK PATIENTS; ACUTE MYELOGENOUS LEUKEMIA; EPIDEMIOLOGY; VORICONAZOLE; FLUCONAZOLE; COMBINATION; RECIPIENTS; DISEASES; THERAPY Multiple languages Dermatology; Mycology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/59362