Retrospective cohort study comparing the risk of severe hepatotoxicity in hospitalized patients treated with echinocandins for invasive candidiasis in the presence of confounding by indication

BMC Infectious Diseases
Francis VekemanMei Sheng Duh

Abstract

To compare the risk of severe hepatotoxicity with anidulafungin versus caspofungin and micafungin in hospitalized adults. This retrospective cohort study combined data from two large US- based hospital electronic medical record databases. Severe hepatotoxicity was a Grade ≥ 3 liver function test (LFT) post-echinocandin initiation. Adjusted incidence rate ratios (IRRs) were estimated for anidulafungin versus caspofungin and micafungin, overall and in patients with normal baseline LFT (Grade 0). Treatments included anidulafungin (n = 1700), caspofungin (n = 4431), or micafungin (n = 6547). The proportions with LFT Grade ≥ 3 pre-echinocandin initiation were: anidulafungin 40.4% versus caspofungin 25.9% (p <  0.001) and micafungin 25.6% (p <  0.001). Rates of severe underlying diseases or comorbidities were: critical care admissions: 75.3% versus 52.6 and 48.6%; and organ failures: 69.4% versus 46.7 and 51.5%. Adjusted IRRs of severe hepatotoxicity for anidulafungin versus caspofungin and micafungin were 1.43 (p = 0.002) and 1.19 (p = 0.183) overall, and 0.88 (P = 0.773) and 0.97 (P = 0.945) for normal baseline LFT, respectively. Accounting for confounders, severe hepatotoxicity risk was not significantly different across echinocan...Continue Reading

References

Apr 1, 1983·Statistics in Medicine·O S Miettinen
Aug 13, 2004·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Hilmar WisplinghoffMichael B Edmond
Jan 11, 2007·Archives of Internal Medicine·Philippe Gabriel StegUNKNOWN GRACE Investigators
May 18, 2010·Medical Care·M Alan BrookhartSebastian Schneeweiss
Aug 26, 2010·JAMA : the Journal of the American Medical Association·Bruce M Psaty, David S Siscovick
Sep 9, 2010·Expert Opinion on Drug Metabolism & Toxicology·Effie L Kuti, Joseph L Kuti
Feb 15, 2011·Infectious Disease Clinics of North America·George J Alangaden
Jun 1, 2011·Drug Discovery Today·Minjun ChenWeida Tong
Feb 14, 2012·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·J M AguadoUNKNOWN TOSCANA Study Group
Dec 21, 2012·Science Translational Medicine·Gordon D BrownTheodore C White
Jan 27, 2016·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Peter G PappasJack D Sobel
Jun 9, 2016·Expert Review of Anti-infective Therapy·Frank P TverdekDimitrios P Kontoyiannis
Jul 14, 2016·The Journal of Antimicrobial Chemotherapy·Sebastian SchneeweissAlexander M Walker
Sep 17, 2016·BMC Infectious Diseases·Patrick J van der GeestA B Johan Groeneveld
Apr 23, 2017·Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy·Yuichi ShibataHiroshige Mikamo
Aug 12, 2017·Clinics in Chest Medicine·Eva M Carmona, Andrew H Limper

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