Posaconazole Shows Success in Difficult-to-Treat Fungal Infections

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Posaconazole Shows Success in Difficult-to-Treat Fungal Infections:

Presented at ICAAC

http://main.pslgroup.com/news/content.nsf/MedicalNews/8525697700573E1

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By W. A. son, PhD

CHICAGO, IL -- October 7, 2003 -- Several open-label studies

presented at this year's Interscience Conference on Antimicrobial

Agents and Chemotherapy (ICAAC) support the usefulness of

posaconazole in disease states that are normally considered

difficult to treat.

Among these was a report on use of posaconazole -- a broad-spectrum

antifungal currently in the late stages of clinical development --

in fungal central nervous system (CNS) infections that are

refractory to other therapies, presented here September 15th by

Punnee Pitisuttithum, MD, Vaccine Trial Center, Bangkok, Thailand,

and colleagues from other institutions around the world.

The study included 39 AIDS patients with cryptococcal meningitis and

10 patients infected with other fungi -- Aspergillus (3),

Pseudallescheria (2), Coccidioides, Histoplasma, Ramichloridium,

Phaeohyphomycetes, and Apophysomyces. All patients either had failed

to respond to previous therapy, had experienced unacceptable

toxicity, or were for other reasons not candidates for standard

therapy.

Of the AIDS patients, 23 were successfully treated with

posaconazole, achieving microbiological eradication and at least

partial improvement of clinical symptoms. Twelve had persistent

disease and 4 relapsed after apparent microbiological eradication.

Among the 9 patients with non-cryptococcal infections, 4 were

successfully treated and 1 had stable disease over a 12-month

period. Particularly notable, the authors pointed out, was

successful treatment of a Ramichloridium infection -- previous

reports of this rare disease had suggested a fatality rate

approaching 100%.

Other papers presented at ICAAC detailed successful treatment of

refractory invasive zygomycosis, pulmonary histoplasmosis,

filamentous fungal infections in patients with chronic granulomatous

disease, mycetoma, and chromoblastomycosis. The paper on invasive

zygomycosis noted that posaconazole was well tolerated, while

tolerability was not discussed in the other papers. All papers

except the one on chronic granulomatous disease were sponsored by

Schering-Plough.

[study title: Efficacy of Posaconazole (POS) in Treatment of Central

Nervous System (CNS) Fungal Infections: Results of an Open-Label

Study]