Overview of safety experience with caspofungin in clinical trials conducted over the first 15 years: a brief report

• Published in: International journal of antimicrobial agents Vol. 38; no. 6; pp. 540 - 544
• Main Authors: Ngai, Angela L, Bourque, Michael R, Lupinacci, Robert J, Strohmaier, Kim M, Kartsonis, Nicholas A
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier B.V 01-12-2011; Elsevier
• Subjects: Adolescent; Adult; adults; alanine transaminase; alkaline phosphatase; anti-infective agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antifungal Agents - adverse effects; Antifungal Agents - therapeutic use; aspartate transaminase; aspergillosis; Aspergillosis - drug therapy; Biological and medical sciences; candidiasis; Candidiasis - drug therapy; Caspofungin; Child; Child, Preschool; Clinical trials; Clinical Trials as Topic; Echinocandins - adverse effects; Echinocandins - therapeutic use; Empirical therapy; fever; Humans; Infant; Infectious Disease; Invasive mycoses; Lipopeptides; Medical sciences; neutropenia; patients; Pharmacology. Drug treatments; Safety; therapeutics; toxicity; Treatment Outcome; Young Adult; Clinical trials; Safety; Invasive mycoses; Empirical therapy; Caspofungin; Human; Mycosis; Report; Toxicity; Review; Echinocandine derivatives; Infection; Antifungal agent; Clinical trial
• ISSN: 0924-8579; 1872-7913
• DOI: 10.1016/j.ijantimicag.2011.07.008

Abstract Safety experience is available from 32 completed clinical studies (17 Phase I and 15 Phase II–III) of caspofungin (CAS) conducted between 1995 and 2010 in adult and paediatric patients. Clinical and laboratory adverse events (AEs) were collected from all enrolled subjects and patients. Investigators identified the seriousness, causality and result of all AEs noted during study therapy and for up to 28 days post therapy. Up to 31 December 2010, full safety data are available from 1951 individuals who have received at least one dose of CAS in Phase I–III clinical studies, including 171 paediatric patients, 394 volunteer adult subjects and 1386 adult patients (276 with oropharyngeal/oesophageal candidiasis, 366 with invasive candidiasis, 180 with invasive aspergillosis and 564 with persistent fever and neutropenia). CAS was administered for up to 196 days at daily doses ranging from 5 mg to 210 mg. Overall, 41.8% of CAS recipients had an AE that was classified as drug-related. The most frequently reported drug-related AEs were fever (9.3%), chills (5.2%), increased alanine aminotransferase (6.5%), increased aspartate aminotransferase (6.0%) and increased alkaline phosphatase (5.2%). Serious AEs were reported in 27.3% of CAS recipients overall but were attributed to CAS in only 0.8%, and discontinuation of CAS due to a drug-related AE was infrequent (2.7%). Dose-related CAS toxicity was not observed. In conclusion, CAS has demonstrated a favourable safety profile in 1951 adult and paediatric patients enrolled in clinical trials.