ANIDULAFUNGIN IN COMPARISON TO FLUCONAZOLE, AMPHOTERICIN B DEOXYCHOLATE, AMPHOTERICIN B LIPOSOMAL, CASPOFUNGIN AND MICAFUNGIN FOR THE TREATMENT OF INVASIVE CANDIDIASIS AMONG NON-NEUTROPENICPATIENTS ABOVE 16 YEARS- BAYESIAN MIXED TREATMENT C ...

Author(s)

Diaz JA1, Huerfano C1, Niño CP1, Alzate JP1, Urrego-Novoa JR1, Moreno JA2, Prieto VA3
1Universidad Nacional de Colombia, Bogota, Colombia, 2Salud Total EPS, Bogotá D.C., Colombia, 3Pfizer SAS, Bogota, Colombia

OBJECTIVES: Invasive candidiasis is an important cause of complication and mortality of inpatient. Anidulafungin as others echinocandins are drugs that have shown clinical relevance in the treatment of invasive candidiasis. This research sought to evaluate the effectiveness and safety of anidulafungin in comparison to fluconazole, amphotericin B deoxycholate, amphotericin B liposomal, caspofungin and micafungin for the treatment of invasive candidiasis among non-neutropenicpatients above 16 years. METHODS: We performed a systematic review in which were included randomized clinical trials (RCT) evaluating the different drugs to treatment of invasive candidiasis in non-neutropenic patients. It involved in MEDLINE, EMBASE, Cochrane, DARE and LILACS. The quality of evidence and risk of bias of clinical trials were assessed with GRADE tool and Cochrane methodology respectively. We performed a meta-analysis and Bayesian mixed treatment comparison (MTC) to compare the effectiveness and safety of the different considered treatment. The outcomes of effectiveness and safetywere global response rate, mortality and occurrence serious event adverse (SEA). RESULTS: We included 11 RCT and clinical evidence provided was of moderate quality according to the GRADE system. For global response rate, the MTC displayed that anidulafungin was more effective than fluconazole (OR 2.07 IC95% 1.20- 2.59). In comparison with others drugs, anidulafungin presented similar effectiveness (non-significant statistically differences). In mortality, it presented less proportion of events (29,5% IC95% 18,8-42,0) than other interventions, but it was not statistically different of them. Anidulafungin showed better safety profile than amphotericin B deoxycholate regarding to occurrence of SEA (OR 0.15 IC95% 0.02-0.97). However, there were not significantly statistical differences with amphotericin B liposomal, caspofungin and fluconazole. CONCLUSIONS: The MTC found that anidulafungin is more effective than fluconazole and exhibited similar effectiveness than others interventions. With respect to safety profile, anidulafungin was superior to amphotericin B deoxycolate and similar to the others.

Conference/Value in Health Info

2015-05, ISPOR 2015, Philadelphia, PA, USA

Value in Health, Vol. 18, No. 3 (May 2015)

Code

PIN3

Topic

Clinical Outcomes, Epidemiology & Public Health

Topic Subcategory

Comparative Effectiveness or Efficacy, Safety & Pharmacoepidemiology

Disease

Infectious Disease (non-vaccine)

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