Review
Immunology
Tingting Zhang, Yuyan Shen, Sizhou Feng
Summary: Invasive fungal diseases (IFD) are a major public health concern globally. Isavuconazole (ISA) has shown promising efficacy in the treatment and prevention of IFD, making it a potential new choice due to its tolerability, bioavailability, and few drug interactions.
FRONTIERS IN CELLULAR AND INFECTION MICROBIOLOGY
(2022)
Article
Immunology
Marlene L. Durand, Therese M. Kitt, Yi Song, Francisco M. Marty
Summary: This post hoc analysis of international phase III isavuconazole trials found that overall survival rates for patients with invasive fungal sinusitis treated with isavuconazole were 82% at day 42 and 70% at day 84.
CLINICAL INFECTIOUS DISEASES
(2021)
Article
Infectious Diseases
Lisa Kriegl, Stefan Hatzl, Christoph Zurl, Alexander Christian Reisinger, Gernot Schilcher, Philipp Eller, Yvonne Gringschl, Tina Muhr, Andreas Meinitzer, Juergen Prattes, Martin Hoenigl, Robert Krause
Summary: This study found that ECMO therapy may influence isavuconazole plasma concentrations, but not altered by the ECMO oxygenator. Patients achieved median plasma concentrations >1 μg/mL 24 hours after the first loading dose.
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY
(2022)
Article
Microbiology
Chris Kosmidis, Akan Otu, Caroline B. Moore, Malcolm D. Richardson, Riina Rautemaa-Richardson
Summary: Isavuconazole shows promising pharmacokinetic and safety profiles in patients with chronic pulmonary aspergillosis. Lower daily doses may be sufficient to maintain adequate drug levels and lead to better tolerability, enabling long-term therapy continuation.
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY
(2021)
Review
Microbiology
Nadir Ullah, Chiara Sepulcri, Malgorzata Mikulska
Summary: This review discusses the use of isavuconazole for COVID-19-associated aspergillosis and mucormycosis. The findings show that isavuconazole is commonly used for the treatment of these diseases and has shown high efficacy and safety. However, the challenge of achieving adequate drug exposure in COVID-19 patients needs to be addressed.
Article
Microbiology
Siobhan O'Regan, Brendan O'Kelly, Paul Reidy, Aoibhlinn O'Toole, John Caird, Cora McNally, Samuel McConkey, Eoghan de Barra
Summary: This case describes the successful treatment of a cervical spinal cord Aspergillus fumigatus infection in an immunocompromised patient using (1,3)-beta-D glucan guidance. The patient, who was immunocompromised due to steroid and anti-TNF therapy as well as underlying conditions, underwent neurosurgical intervention and received prolonged antifungal therapy, resulting in clinical cure.
Article
Dermatology
Jose Ramon Azanza, Santiago Grau, Lourdes Vazquez, Pablo Rebollo, Carmen Peral, Alejandra Lopez-Ibanez de Aldecoa, Vanessa Lopez-Gomez
Summary: The study evaluated the cost-effectiveness of isavuconazole vs voriconazole for adult patients with possible IA. Results showed that isavuconazole had higher costs compared to voriconazole, but also showed better effectiveness per patient, making it a cost-effective treatment for patients with a willingness to pay threshold of 25,000 euros per additional QALY.
Article
Immunology
Mario Fernandez-Ruiz, Marta Bodro, Isabel Gutierrez Martin, Regino Rodriguez-Alvarez, Maria Ruiz-Ruigomez, Nuria Sabe, Teresa Lopez-Vinau, Maricela Valerio, Aitziber Illaro, Jesus Fortun, Sonsoles Salto-Alejandre, Elisa Cordero, Maria del Carmen Farinas, Patricia Munoz, Elisa Vidal, Jordi Carratala, Josune Goikoetxea, Antonio Ramos-Martinez, Asuncion Moreno, Jose Maria Aguado
Summary: Retrospective study shows that isavuconazole is a safe and effective treatment option for invasive mold disease in solid organ transplantation recipients. Clinical response was achieved in over 50% of patients by weeks 6 and 12, and adverse events were relatively low.
Article
Chemistry, Medicinal
Philippe Zimmermann, Benoit Brethon, Julie Roupret-Serzec, Marion Caseris, Lauriane Goldwirt, Andre Baruchel, Marie de Tersant
Summary: The objective of this study was to evaluate the safety of isavuconazole as a treatment or prophylaxis for invasive fungal infections in immunocompromised children. The results showed that isavuconazole was effective and safe in both treatment and prophylactic use. Monitoring plasma drug levels is recommended during isavuconazole administration.
Article
Multidisciplinary Sciences
Kamal Hamed, Marc Engelhardt, Laura L. Kovanda, Jin Ju Huang, Jean Yan, Jalal A. Aram
Summary: Isavuconazole was found to have a higher rate of adverse events and lower efficacy in patients aged 65 and above with invasive fungal diseases.
SCIENTIFIC REPORTS
(2023)
Article
Immunology
Qian He, Min Li, Jiaqi Cao, Ming Zhang, Chunlai Feng
Summary: The study found that plasma Dectin-1 and IL-17 levels are significantly elevated in bronchiectasis patients with IPA, and the sensitivity of Dectin-1 and IL-17 in plasma is superior to GM for diagnosing IPA in patients with bronchiectasis.
FRONTIERS IN CELLULAR AND INFECTION MICROBIOLOGY
(2022)
Article
Pharmacology & Pharmacy
Geetha Sivasubramanian, Pranatharthi H. Chandrasekar
Summary: Isavuconazole is a safe and effective option for the treatment of invasive aspergillosis, with advantages over other antifungal agents in terms of adverse event profile and pharmacokinetic properties.
EXPERT OPINION ON PHARMACOTHERAPY
(2022)
Article
Microbiology
Hiba Dagher, Ray Hachem, Anne-Marie Chaftari, Ying Jiang, Shahnoor Ali, Rita Deeba, Shivan Shah, Issam Raad
Summary: Isavuconazole shows promising clinical response and good safety profile in high-risk cancer patients with hematologic malignancies, whether used as first-line therapy or after the failure of other therapies. Additionally, combination therapy did not provide additional benefit compared to Isavuconazole therapy.
Article
Medicine, General & Internal
Johan A. Maertens, Galia Rahav, Dong-Gun Lee, Alfredo Ponce-de-Leon, Isabel Cristina Ramirez Sanchez, Nikolay Klimko, Anne Sonet, Shariq Haider, Juan Diego Velez, Issam Raad, Liang-Piu Koh, Meinolf Karthaus, Jianying Zhou, Ronen Ben-Ami, Mary R. Motyl, Seongah Han, Anjana Grandhi, Hetty Waskin
Summary: Posaconazole was non-inferior to voriconazole in terms of all-cause mortality up to day 42 in patients with invasive aspergillosis. Posaconazole was well tolerated with fewer treatment-related adverse events compared to voriconazole in the study, supporting its use as a first-line treatment for the condition.
Article
Dermatology
Jing Zhang, Yingyuan Zhang, Depei Wu, Guoying Cao, Kamal Hamed, Amit Desai, Jalal A. Aram, Xuan Guo, Rana Fayyad, Oliver A. Cornely
Summary: The study showed that there were no clinically relevant PK differences between Chinese and Western participants, although Chinese volunteers had higher exposure. In Chinese patients, the efficacy and safety of isavuconazole were similar to the global population.
Article
Health Policy & Services
Martin Hoenigl, Megan Lo, Christopher J. Coyne, Gabriel A. Wagner, Jill Blumenthal, Kushagra Mathur, Lucy E. Horton, Thomas C. S. Martin, Gary M. Vilke, Susan J. Little
Summary: The objective of this study was to determine the hospital costs and revenue of universal opt-out HIV emergency department (ED) screening. The study found that implementing universal screening resulted in a net profit for the hospital.
AIDS CARE-PSYCHOLOGICAL AND SOCIO-MEDICAL ASPECTS OF AIDS/HIV
(2023)
Article
Hematology
Francesco Marchesi, Jon Salmanton-Garcia, Ziad Emarah, Klara Piukovics, Marcio Nucci, Alberto Lopez-Garcia, Zdenek Racil, Francesca Farina, Marina Popova, Sofia Zompi, Ernesta Audisio, Marie-Pierre Ledoux, Luisa Verga, Barbora Weinbergerova, Tomas Szotkovski, Maria Gomes Da Silva, Nicola Fracchiolla, Nick De Jonge, Graham Collins, Monia Marchetti, Gabriele Magliano, Carolina Garcfa-Vidal, Monika M. Biernat, Jaap Van Doesum, Marina Machado, Fatih Demirkan, Murtadha Al-Khabori, Pavel Zak, Benjamfn Vfsek, Igor Stoma, Gustavo-Adolfo Mendez, Johan Maertens, Nina Khanna, Ildefonso Espigado, Giulia Dragonetti, Luana Fianchi, Maria Ilaria Del Principe, Alba Cabirta, Irati Ormazabal-Velez, Ozren Jaksic, Caterina Buquicchio, Valentina Bonuomo, Josip Batinic, Ali S. Omrani, Sylvain Lamure, Olimpia Finizio, Noemf Fernandez, Iker Falces-Romero, Ola Blennow, Rui Bergantim, Natasha Ali, Sein Win, Jens Van Praet, Maria Chiara Tisi, Ayten Shirinova, Martin Schoenlein, Juergen Prattes, Monica Piedimonte, Verena Petzer, Milan Navratil, Austin Kulasekararaj, Pavel Jindra, Jiff Sramek, Andreas Glenthoj, Rita Fazzi, Cristina De Ramon-Sanchez, Chiara Cattaneo, Maria Calbacho, Nathan C. Bahr, Shaimaa El-Ashwah, Raul Cordoba, Michaela Hanakova, Giovanni Paolo Maria Zambrotta, Giovanni Zambrotta, Mariarita Sciume, Stephen Booth, Raquel Nunes Rodrigues, Maria Vittoria Sacchi, Nicole Garcia-Pouton, Juan-Alberto Martin-Gonzalez, Sofya Khostelidi, Stefanie Graefe, Laman Rahimli, Emanuele Ammatuna, Alessandro Busca, Paolo Corradini, Martin Hoenigl, Nikolai Klimko, Philipp Koehler, Antonio Pagliuca, Francesco Passamonti, Oliver A. Cornely, Livio Pagano
Summary: Patients with acute myeloid leukemia (AML) who are diagnosed with COVID-19 are at high risk of death. The management of AML patients with COVID-19 has not been established. In our study, a significant number of AML patients receiving or having received AML treatment had severe or critical COVID-19. Chemotherapy was modified or discontinued in a substantial portion of patients. The mortality rate was high, and survival was better when AML treatment could be delayed.
Editorial Material
Biochemistry & Molecular Biology
Jean-Pierre Gangneux, Martin Hoenigl, Nicolas Papon
Summary: By unraveling the mechanistic link between predisposing conditions and deadly infections by Aspergillus fumigatus (Af) in ICU patients, Sarden et al. have discovered a shared B1a lymphocyte-natural antibody-neutrophil defense pathway to Af, bringing new perspectives in diagnostics and therapeutics.
TRENDS IN MICROBIOLOGY
(2023)
Article
Infectious Diseases
Jon Salmanton-Garcia, Wing-Yan Au, Martin Hoenigl, Louis Yi Ann Chai, Hamid Badali, Ariful Basher, Ronja A. Brockhoff, Sharon C. -A. Chen, Ariya Chindamporn, Anuradha Chowdhary, Christopher H. Heath, Kausar Jabeen, Jaehyeon Lee, Madonna Matar, Saad Jaber Taj-Aldeen, Ban Hock Tan, Kenji Uno, Retno Wahyuningsih, Liping Zhu, Arunaloke Chakrabarti, Oliver A. Cornely
Summary: Invasive fungal infections pose a significant threat to patients in Asia/Pacific with malignancies, uncontrolled diabetes mellitus, undiagnosed/untreated HIV/AIDS. Adequate access to diagnostic tools and antifungals is essential for IFI management and patient survival.
INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS
(2023)
Review
Infectious Diseases
Jannik Stemler, Sibylle C. Mellinghoff, Yascha Khodamoradi, Rosanne Sprute, Annika Y. Classen, Sonja E. Zapke, Martin Hoenigl, Robert Krause, Martin Schmidt-Hieber, Werner J. Heinz, Michael Klein, Philipp Koehler, Blasius Liss, Michael Koldehoff, Christoph Buhl, Olaf Penack, Georg Maschmeyer, Enrico Schalk, Cornelia Lass-Floerl, Meinolf Karthaus, Markus Ruhnke, Oliver A. Cornely, Daniel Teschner
Summary: Patients with haematological malignancies are at high risk of invasive fungal disease. The German Society of Haematology and Medical Oncology has updated their antifungal prophylaxis recommendations, recommending continued antifungal prophylaxis for patients with long-lasting neutropenia and posaconazole as the drug of choice. There is insufficient data to give general recommendations for antifungal prophylaxis in patients receiving novel treatments for HM, such as CAR-T-cell therapy or novel targeted therapies for AML.
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY
(2023)
Article
Microbiology
Martin Hoenigl, Matthias Egger, Jessica Price, Robert Krause, Juergen Prattes, P. Lewis White
Summary: Timely diagnosis remains an unmet need in non-neutropenic patients at risk for aspergillosis, including those with COVID-19-associated pulmonary aspergillosis (CAPA). Currently available mycological tests show limited sensitivity when testing blood specimens. Metagenomic next-generation sequencing (mNGS) to detect microbial cell-free DNA (mcfDNA) in plasma might overcome some of the limitations of conventional diagnostics.
JOURNAL OF CLINICAL MICROBIOLOGY
(2023)
Article
Infectious Diseases
Martin Hoenigl, Jon Salmanton-Garcia, Matthias Egger, Jean-Pierre Gangneux, Tihana Bicanic, Sevtap Arikan-Akdagli, Ana Alastruey-Izquierdo, Nikolai Klimko, Aleksandra Barac, Volkan Ozenci, Eelco F. J. Meijer, Nina Khanna, Matteo Bassetti, Riina Rautemaa-Richardson, Katrien Lagrou, Kai -Manuel Adam, Emin Halis Akalin, Murat Akova, Valentina Arsic Arsenijevic, Avinash Aujayeb, Ola Blennow, Stephane Bretagne, Francois Danion, Blandine Denis, Nick Alexander de Jonge, Guillaume Desoubeaux, Lubos Drgona, Nurettin Erben, Andrea Gori, Julio Garcia Rodriguez, Carolina Garcia-Vidal, Daniele Roberto Giacobbe, Anna L. Goodman, Petr Hamal, Helena Hammarstrom, Cristina Toscano, Fanny Lanternier, Cornelia Lass-Floerl, Deborah E. A. Lockhart, Thomas Longval, Laura Loughlin, Tadeja Matos, Malgorzata Mikulska, Manjusha Narayanan, Sonia Martin-Perez, Juergen Prattes, Benedict Rogers, Laman Rahimli, Maite Ruiz, Emmanuel Roilides, Michael Samarkos, Ulrike Scharmann, Uluhan Sili, Oguz Resat Sipahi, Alena Sivakova, Joerg Steinmann, Janina Trauth, Ozge Turhan, Jens Van Praet, Antonio Vena, P. Lewis White, Birgit Willinger, Anna Maria Tortorano, Maiken C. Arendrup, Philipp Koehler, Oliver A. Cornely
Summary: The European Confederation of Medical Mycology (ECMM) collected data on candidaemia patients in Europe to assess the association between adherence to guideline recommendations and outcomes. The study found that following the recommendations can improve the survival rate of patients.
LANCET INFECTIOUS DISEASES
(2023)
Article
Gastroenterology & Hepatology
Matthias Egger, Angela Horvath, Florian Prueller, Peter Fickert, Malcolm Finkelman, Lisa Kriegl, Henning Gronbaek, Holger Jon Moller, Juergen Prattes, Robert Krause, Martin Hoenigl, Vanessa Stadlbauer
Summary: Liver cirrhosis, a systemic disease causing 1 million deaths per year, is associated with fungal translocation and its effects on gut integrity, inflammation, and liver disease severity/outcome. This study found a correlation between fungal translocation and markers of gut inflammation, as well as a significant difference in mortality between patients with positive versus negative fungal translocation. Further research is needed to understand the complex interactions and potential therapeutic interventions.
LIVER INTERNATIONAL
(2023)
Review
Mycology
Johannes Boyer, Simon Feys, Isabella Zsifkovits, Martin Hoenigl, Matthias Egger
Summary: Despite improvements in treatment and diagnostics, invasive aspergillosis (IA) remains a devastating fungal disease with increasing cases around the world. The emergence of azole-resistant strains poses a new challenge for therapy. New drugs like olorofim, fosmanogepix, ibrexafungerp, opelconazole, and rezafungin are in late-stage development and offer potential new treatment options. Immunotherapy is also being explored as an additional therapy for IA. This review discusses current treatment strategies, potential new pharmaceutical options, and ongoing research in immunotherapy.
Review
Infectious Diseases
Matthias Egger, Romuald Bellmann, Robert Krause, Johannes Boyer, Daniela Jaksic, Martin Hoenigl
Summary: Invasive mold diseases require careful selection, dosing, and monitoring of antifungal drugs. Failure of initial antifungal therapy may necessitate treatment adaption, such as switching drug class or adding another drug for combination therapy. Currently, options for antifungal drug classes are limited, but novel antifungals with innovative mechanisms of action show promising results. These may expand options for salvage therapy in the future. This article outlines current recommendations for salvage therapy and future treatment options for invasive aspergillosis and mucormycosis.
INFECTION AND DRUG RESISTANCE
(2023)
Article
Microbiology
Matthew E. Mead, Patricia Alves L. de Castro, Jacob L. Steenwyk, Jean-Pierre Gangneux, Martin Hoenigl, Juergen Prattes, Riina Rautemaa-Richardson, Helene B. Guegan, Caroline B. Moore, Cornelia Lass-Floerl, Florian Reizine, Clara Valero, Norman J. Van Rhijn, Michael J. Bromley, Antonis H. Rokas, Gustavo H. Goldman, Sara Gago, ECMM CAPA Study Grp
Summary: Secondary infections caused by Aspergillus fumigatus are a major cause of death in severe COVID-19 patients. Genomic analysis of 11 A. fumigatus isolates from CAPA patients in Europe revealed that CAPA isolates do not cluster based on geographic origin. Phenotypically, CAPA isolates are more similar to the A1160 reference strain, but differ from the Af293 strain in infection-relevant stresses. Further research is needed to understand the molecular epidemiology of CAPA and identify genetic factors contributing to copathogenicity and antifungal resistance in COVID-19 patients.
MICROBIOLOGY SPECTRUM
(2023)
Article
Infectious Diseases
Stefan Hatzl, Lisa Kriegl, Florian Posch, Gernot Schilcher, Philipp Eller, Alexander Reisinger, Yvonne Grinschgl, Tina Muhr, Andreas Meinitzer, Martin Hoenigl, Robert Krause
Summary: Increasing the first loading dose of isavuconazole in critically ill patients with ECMO can result in higher plasma concentrations during the initial 24 hours of treatment. However, regardless of the loading dose regimen, all patient groups reached similar plasma concentrations in the subsequent treatment period.
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY
(2023)
Review
Dermatology
Jon Salmanton-Garcia, Ilana Reinhold, Juergen Prattes, Nico Bekaan, Philipp Koehler, Oliver A. Cornely
Summary: The growing threat of antimicrobial resistance is a global concern, particularly in the treatment of candidemia. The current recommendation of a minimum treatment duration of 14 days for candidemia is being questioned, and further research and clinical trials are needed to establish evidence-based guidelines.
Review
Infectious Diseases
Jon Salmanton-Garcia, Martin Hoenigl, Jean-Pierre Gangneux, Esther Segal, Ana Alastruey-Izquierdo, Sevtap Arikan Akdagli, Katrien Lagrou, Volkan oezenci, Antonio Vena, Oliver A. Cornely
Summary: The diagnostic capacity for invasive fungal infections in Europe is generally good, but there are limitations in access to certain diagnostic tools and antifungal drugs. These limitations need to be addressed to ensure optimal diagnosis and treatment for all patients.