Comparison of the Safety and Tolerance Profile of Micafungin with that of Other Echinocandins and Azoles in Patients with Pre-existing Child-Pugh B or C Liver Disease : A Case-Control Retrospective Study
Vena, Antonio (Hospital General Universitario Gregorio Marañón)
Bouza, Emilio (Hospital General Universitario Gregorio Marañón. Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM))
Bassetti, Matteo (University of Udine)
Menichetti, Francesco (Nuovo Santa Chiara University Hospital)
Merelli, Maria (University of Udine)
Grau, Santiago (Universitat Autònoma de Barcelona. Departament de Farmacologia, de Terapèutica i de Toxicologia)
Fortún, Jesús (Hospital Universitario Ramón y Cajal (Madrid))
Sánchez, María Isabel (Hospital Universitario Puerta de Hierro Majadahonda (Madrid))
Aguado, José María (Universidad Complutense de Madrid)
Merino, Paloma (Hospital Clínico San Carlos (Madrid))
Bonache, Francisco (Hospital General Universitario Gregorio Marañón)
Muñoz, Patricia (Hospital General Universitario Gregorio Marañón. Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM))

Data:	2020
Resum:	To assess the association between exposure to micafungin, other echinocandins, or azoles and the development of short-term liver injury (STLI) or long-term liver injury (LTLI) in patients with Child-Pugh B or C liver disease. Multicenter case-control study of patients with Child-Pugh B or C liver disease who received antifungals (AF) for ≥ 72 h (May 2009-May 2015) in six Spanish and Italian hospitals. All micafungin patients were randomly matched with one patient who received another echinocandin and with one patient who received azole treatment. Primary outcome was development of STLI or LTLI (development of any type of liver tumor during the follow-up period). Of 2335 patients with chronic liver disease admitted to the six centers, 20 (0. 85%) were found to have Child-Pugh B or C liver disease and received micafungin for ≥ 72 h. During AF treatment, the frequency of STLI was 10% in each group. Most cases of STLI were asymptomatic, and AFs had to be switched to another class of AF in only two patients (one micafungin and one azole). No patients developed acute liver insufficiency, were admitted to the ICU, or had to undergo transplantation. Follow-up data (median of 1. 3 years) were available for 30 patients. LTLI was observed in only one patient, who had previously received treatment with azoles. Our study suggests that the administration of micafungin to patients with end-stage liver disease does not imply a higher risk of developing STLI or LTLI. The online version of this article (10. 1007/s40121-020-00282-w) contains supplementary material, which is available to authorized users.
Ajuts:	Instituto de Salud Carlos III PI13-01148 Instituto de Salud Carlos III CM15-00181
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	End-stage liver disease ; Liver injury ; Micafungin ; Safety
Publicat a:	Infectious Diseases and Therapy, Vol. 9 (february 2020) , p. 151-163, ISSN 2193-6382

DOI: 10.1007/s40121-020-00282-w
PMID: 32086777

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