Voriconazole Treatment for Less‐Common, Emerging, or Refractory Fungal Infections

TLDR

Treatments for invasive fungal infections remain unsatisfactory. The study evaluated the efficacy, tolerability, and safety of voriconazole as salvage therapy for 273 refractory or intolerant fungal infection patients and as primary therapy for 28 patients with infections lacking approved treatments. The authors assessed voriconazole outcomes in these 301 patients, measuring global responses, tolerability, and safety. Voriconazole achieved satisfactory global responses in 50% of the cohort, with 47% response in salvage patients and 68% in patients lacking approved therapy, and was well tolerated with <10% treatment‑related discontinuations or dose reductions.

Abstract

Treatments for invasive fungal infections remain unsatisfactory. We evaluated the efficacy, tolerability, and safety of voriconazole as salvage treatment for 273 patients with refractory and intolerant-to-treatment fungal infections and as primary treatment for 28 patients with infections for which there is no approved therapy. Voriconazole was associated with satisfactory global responses in 50% of the overall cohort; specifically, successful outcomes were observed in 47% of patients whose infections failed to respond to previous antifungal therapy and in 68% of patients whose infections have no approved antifungal therapy. In this population at high risk for treatment failure, the efficacy rates for voriconazole were 43.7% for aspergillosis, 57.5% for candidiasis, 38.9% for cryptococcosis, 45.5% for fusariosis, and 30% for scedosporiosis. Voriconazole was well tolerated, and treatment-related discontinuations of therapy or dose reductions occurred for <10% of patients. Voriconazole is an effective and well-tolerated treatment for refractory or less-common invasive fungal infections.