Mould-active compared with fluconazole prophylaxis to prevent invasive fungal diseases in cancer patients receiving chemotherapy or haematopoietic stem-cell transplantation: a systematic review and meta-analysis of randomised controlled trials
Background: Objectives were to compare systemic mould-active vs fluconazole prophylaxis in cancer patients receiving chemotherapy or haematopoietic stem cell transplantation (HSCT). Methods: We searched OVID MEDLINE and the Cochrane Central Register of Controlled Trials (1948-August 2011) and EMBASE...
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| Veröffentlicht in: | British journal of cancer 2012-05, Vol.106 (10), p.1626-1637 |
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| creator | Ethier, M C Science, M Beyene, J Briel, M Lehrnbecher, T Sung, L |
| description | Background:
Objectives were to compare systemic mould-active
vs
fluconazole prophylaxis in cancer patients receiving chemotherapy or haematopoietic stem cell transplantation (HSCT).
Methods:
We searched OVID MEDLINE and the Cochrane Central Register of Controlled Trials (1948-August 2011) and EMBASE (1980-August 2011). Randomised controlled trials of mould-active
vs
fluconazole prophylaxis in cancer or HSCT patients were included. Primary outcome was proven/probable invasive fungal infections (IFI). Analysis was completed by computing relative risks (RRs) using a random-effects model and Mantel–Haenszel method.
Results:
From 984 reviewed articles, 20 were included in this review. Mould-active compared with fluconazole prophylaxis significantly reduced the number of proven/probable IFI (RR 0.71, 95% CI 0.52 to 0.98;
P
=0.03). Mould-active prophylaxis also decreased the risk of invasive aspergillosis (IA; RR 0.53, 95% confidence interval (CI) 0.37–0.75;
P
=0.0004) and IFI-related mortality (RR 0.67, 95% CI 0.47–0.96;
P
=0.03) but is also associated with an increased risk of adverse events (AEs) leading to antifungal discontinuation (RR 1.95, 95% CI 1.24–3.07;
P
=0.004). There was no decrease in overall mortality (RR 1.0; 95% CI 0.88–1.13;
P
=0.96).
Conclusion:
Mould-active compared with fluconazole prophylaxis significantly reduces proven/probable IFI, IA, and IFI-related mortality in cancer patients receiving chemotherapy or HSCT, but increases AE and does not affect overall mortality.(PROSPERO Registration: CRD420111174) |
| doi_str_mv | 10.1038/bjc.2012.147 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3349180</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1024209157</sourcerecordid><originalsourceid>FETCH-LOGICAL-c546t-539dd2f02c974f8e6efea8d0dc0d749875b450c1b2e6c3db82e23be4f35e50053</originalsourceid><addsrcrecordid>eNqNkk1v1DAQhiMEoqVw44wsISQOZLGdOB89IKGKL6mIC5yjiT3ZeOXYwXa2LH-bP4C3u5SCOHAaj-bx-J3xm2WPGV0xWjQv-41cccr4ipX1neyUiYLnrOH13eyUUlrntOX0JHsQwialLW3q-9kJ56Jq2rY9zX58dItROciot0ikm2bwqMiVjiMZzCKdhe_OIJm9m8edgW86kOhSilu0kWi7hbC_OSx2DYYoHRAChlQgEqxET2aIOqGBeJSot9quiRxxcnFED_OOOE9GwAmim53GqCUJEadcojEkerBhNmBjauLsOQESdvsy7LmkQeMVAavIhBFysGB2IQl0A0kXlZuSGpWGstE7Y9Ixeg0mPMzuDSngo2M8y768ffP54n1--endh4vXl7kUZRVzUbRK8YFy2dbl0GCFA0KjqJJU1WXb1KIvBZWs51jJQvUNR170WA6FQEGpKM6yV4e-89JPqGTaggfTzV5P4HedA939WbF67NZu2xVF2bKGpgbPjw28-7pgiF2aaL8YsOiW0DHKS05bJur_QFndVqVoy4Q-_QvduMWn3V1TTFSMXYt_caCkdyF4HG50M9rtjdcl43V743XJeAl_cnvWG_iX0xLw7AhAkGCG9EFSh9-caKq6YE3i8gMXUsmu0d9W94-HfwKwxvkt</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1011561105</pqid></control><display><type>article</type><title>Mould-active compared with fluconazole prophylaxis to prevent invasive fungal diseases in cancer patients receiving chemotherapy or haematopoietic stem-cell transplantation: a systematic review and meta-analysis of randomised controlled trials</title><source>MEDLINE</source><source>Nature</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>SpringerLink Journals - AutoHoldings</source><creator>Ethier, M C ; Science, M ; Beyene, J ; Briel, M ; Lehrnbecher, T ; Sung, L</creator><creatorcontrib>Ethier, M C ; Science, M ; Beyene, J ; Briel, M ; Lehrnbecher, T ; Sung, L</creatorcontrib><description>Background:
Objectives were to compare systemic mould-active
vs
fluconazole prophylaxis in cancer patients receiving chemotherapy or haematopoietic stem cell transplantation (HSCT).
Methods:
We searched OVID MEDLINE and the Cochrane Central Register of Controlled Trials (1948-August 2011) and EMBASE (1980-August 2011). Randomised controlled trials of mould-active
vs
fluconazole prophylaxis in cancer or HSCT patients were included. Primary outcome was proven/probable invasive fungal infections (IFI). Analysis was completed by computing relative risks (RRs) using a random-effects model and Mantel–Haenszel method.
Results:
From 984 reviewed articles, 20 were included in this review. Mould-active compared with fluconazole prophylaxis significantly reduced the number of proven/probable IFI (RR 0.71, 95% CI 0.52 to 0.98;
P
=0.03). Mould-active prophylaxis also decreased the risk of invasive aspergillosis (IA; RR 0.53, 95% confidence interval (CI) 0.37–0.75;
P
=0.0004) and IFI-related mortality (RR 0.67, 95% CI 0.47–0.96;
P
=0.03) but is also associated with an increased risk of adverse events (AEs) leading to antifungal discontinuation (RR 1.95, 95% CI 1.24–3.07;
P
=0.004). There was no decrease in overall mortality (RR 1.0; 95% CI 0.88–1.13;
P
=0.96).
Conclusion:
Mould-active compared with fluconazole prophylaxis significantly reduces proven/probable IFI, IA, and IFI-related mortality in cancer patients receiving chemotherapy or HSCT, but increases AE and does not affect overall mortality.(PROSPERO Registration: CRD420111174)</description><identifier>ISSN: 0007-0920</identifier><identifier>EISSN: 1532-1827</identifier><identifier>DOI: 10.1038/bjc.2012.147</identifier><identifier>PMID: 22568999</identifier><identifier>CODEN: BJCAAI</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>631/326/22/1292 ; 692/699/255/1672 ; 692/699/67/1059/99 ; 692/700/565/545/576/1955 ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antifungal Agents - therapeutic use ; Antineoplastic Agents - adverse effects ; Aspergillus ; Biological and medical sciences ; Biomedical and Life Sciences ; Biomedicine ; Cancer Research ; Cancer therapies ; Chemotherapy ; Child ; Child, Preschool ; Clinical Study ; Disease prevention ; Drug Resistance ; Epidemiology ; Fluconazole - therapeutic use ; Fungal infections ; Hematology ; Hematopoietic Stem Cell Transplantation - adverse effects ; Humans ; Infant ; Medical research ; Medical sciences ; Meta-analysis ; Middle Aged ; Molecular Medicine ; Mortality ; Mycoses - prevention & control ; Neoplasms - therapy ; Oncology ; Randomized Controlled Trials as Topic ; Stem cell transplantation ; Systematic review ; Tumors</subject><ispartof>British journal of cancer, 2012-05, Vol.106 (10), p.1626-1637</ispartof><rights>The Author(s) 2012</rights><rights>2015 INIST-CNRS</rights><rights>Copyright Nature Publishing Group May 8, 2012</rights><rights>Copyright © 2012 Cancer Research UK 2012 Cancer Research UK</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c546t-539dd2f02c974f8e6efea8d0dc0d749875b450c1b2e6c3db82e23be4f35e50053</citedby><cites>FETCH-LOGICAL-c546t-539dd2f02c974f8e6efea8d0dc0d749875b450c1b2e6c3db82e23be4f35e50053</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3349180/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3349180/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,882,27905,27906,41469,42538,51300,53772,53774</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25867318$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22568999$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ethier, M C</creatorcontrib><creatorcontrib>Science, M</creatorcontrib><creatorcontrib>Beyene, J</creatorcontrib><creatorcontrib>Briel, M</creatorcontrib><creatorcontrib>Lehrnbecher, T</creatorcontrib><creatorcontrib>Sung, L</creatorcontrib><title>Mould-active compared with fluconazole prophylaxis to prevent invasive fungal diseases in cancer patients receiving chemotherapy or haematopoietic stem-cell transplantation: a systematic review and meta-analysis of randomised controlled trials</title><title>British journal of cancer</title><addtitle>Br J Cancer</addtitle><addtitle>Br J Cancer</addtitle><description>Background:
Objectives were to compare systemic mould-active
vs
fluconazole prophylaxis in cancer patients receiving chemotherapy or haematopoietic stem cell transplantation (HSCT).
Methods:
We searched OVID MEDLINE and the Cochrane Central Register of Controlled Trials (1948-August 2011) and EMBASE (1980-August 2011). Randomised controlled trials of mould-active
vs
fluconazole prophylaxis in cancer or HSCT patients were included. Primary outcome was proven/probable invasive fungal infections (IFI). Analysis was completed by computing relative risks (RRs) using a random-effects model and Mantel–Haenszel method.
Results:
From 984 reviewed articles, 20 were included in this review. Mould-active compared with fluconazole prophylaxis significantly reduced the number of proven/probable IFI (RR 0.71, 95% CI 0.52 to 0.98;
P
=0.03). Mould-active prophylaxis also decreased the risk of invasive aspergillosis (IA; RR 0.53, 95% confidence interval (CI) 0.37–0.75;
P
=0.0004) and IFI-related mortality (RR 0.67, 95% CI 0.47–0.96;
P
=0.03) but is also associated with an increased risk of adverse events (AEs) leading to antifungal discontinuation (RR 1.95, 95% CI 1.24–3.07;
P
=0.004). There was no decrease in overall mortality (RR 1.0; 95% CI 0.88–1.13;
P
=0.96).
Conclusion:
Mould-active compared with fluconazole prophylaxis significantly reduces proven/probable IFI, IA, and IFI-related mortality in cancer patients receiving chemotherapy or HSCT, but increases AE and does not affect overall mortality.(PROSPERO Registration: CRD420111174)</description><subject>631/326/22/1292</subject><subject>692/699/255/1672</subject><subject>692/699/67/1059/99</subject><subject>692/700/565/545/576/1955</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antifungal Agents - therapeutic use</subject><subject>Antineoplastic Agents - adverse effects</subject><subject>Aspergillus</subject><subject>Biological and medical sciences</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Cancer Research</subject><subject>Cancer therapies</subject><subject>Chemotherapy</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Clinical Study</subject><subject>Disease prevention</subject><subject>Drug Resistance</subject><subject>Epidemiology</subject><subject>Fluconazole - therapeutic use</subject><subject>Fungal infections</subject><subject>Hematology</subject><subject>Hematopoietic Stem Cell Transplantation - adverse effects</subject><subject>Humans</subject><subject>Infant</subject><subject>Medical research</subject><subject>Medical sciences</subject><subject>Meta-analysis</subject><subject>Middle Aged</subject><subject>Molecular Medicine</subject><subject>Mortality</subject><subject>Mycoses - prevention & control</subject><subject>Neoplasms - therapy</subject><subject>Oncology</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Stem cell transplantation</subject><subject>Systematic review</subject><subject>Tumors</subject><issn>0007-0920</issn><issn>1532-1827</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqNkk1v1DAQhiMEoqVw44wsISQOZLGdOB89IKGKL6mIC5yjiT3ZeOXYwXa2LH-bP4C3u5SCOHAaj-bx-J3xm2WPGV0xWjQv-41cccr4ipX1neyUiYLnrOH13eyUUlrntOX0JHsQwialLW3q-9kJ56Jq2rY9zX58dItROciot0ikm2bwqMiVjiMZzCKdhe_OIJm9m8edgW86kOhSilu0kWi7hbC_OSx2DYYoHRAChlQgEqxET2aIOqGBeJSot9quiRxxcnFED_OOOE9GwAmim53GqCUJEadcojEkerBhNmBjauLsOQESdvsy7LmkQeMVAavIhBFysGB2IQl0A0kXlZuSGpWGstE7Y9Ixeg0mPMzuDSngo2M8y768ffP54n1--endh4vXl7kUZRVzUbRK8YFy2dbl0GCFA0KjqJJU1WXb1KIvBZWs51jJQvUNR170WA6FQEGpKM6yV4e-89JPqGTaggfTzV5P4HedA939WbF67NZu2xVF2bKGpgbPjw28-7pgiF2aaL8YsOiW0DHKS05bJur_QFndVqVoy4Q-_QvduMWn3V1TTFSMXYt_caCkdyF4HG50M9rtjdcl43V743XJeAl_cnvWG_iX0xLw7AhAkGCG9EFSh9-caKq6YE3i8gMXUsmu0d9W94-HfwKwxvkt</recordid><startdate>20120508</startdate><enddate>20120508</enddate><creator>Ethier, M C</creator><creator>Science, M</creator><creator>Beyene, J</creator><creator>Briel, M</creator><creator>Lehrnbecher, T</creator><creator>Sung, L</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</general><scope>C6C</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TO</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7U1</scope><scope>7U2</scope><scope>C1K</scope><scope>M7N</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>5PM</scope></search><sort><creationdate>20120508</creationdate><title>Mould-active compared with fluconazole prophylaxis to prevent invasive fungal diseases in cancer patients receiving chemotherapy or haematopoietic stem-cell transplantation: a systematic review and meta-analysis of randomised controlled trials</title><author>Ethier, M C ; Science, M ; Beyene, J ; Briel, M ; Lehrnbecher, T ; Sung, L</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c546t-539dd2f02c974f8e6efea8d0dc0d749875b450c1b2e6c3db82e23be4f35e50053</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>631/326/22/1292</topic><topic>692/699/255/1672</topic><topic>692/699/67/1059/99</topic><topic>692/700/565/545/576/1955</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antifungal Agents - therapeutic use</topic><topic>Antineoplastic Agents - adverse effects</topic><topic>Aspergillus</topic><topic>Biological and medical sciences</topic><topic>Biomedical and Life Sciences</topic><topic>Biomedicine</topic><topic>Cancer Research</topic><topic>Cancer therapies</topic><topic>Chemotherapy</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Clinical Study</topic><topic>Disease prevention</topic><topic>Drug Resistance</topic><topic>Epidemiology</topic><topic>Fluconazole - therapeutic use</topic><topic>Fungal infections</topic><topic>Hematology</topic><topic>Hematopoietic Stem Cell Transplantation - adverse effects</topic><topic>Humans</topic><topic>Infant</topic><topic>Medical research</topic><topic>Medical sciences</topic><topic>Meta-analysis</topic><topic>Middle Aged</topic><topic>Molecular Medicine</topic><topic>Mortality</topic><topic>Mycoses - prevention & control</topic><topic>Neoplasms - therapy</topic><topic>Oncology</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Stem cell transplantation</topic><topic>Systematic review</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ethier, M C</creatorcontrib><creatorcontrib>Science, M</creatorcontrib><creatorcontrib>Beyene, J</creatorcontrib><creatorcontrib>Briel, M</creatorcontrib><creatorcontrib>Lehrnbecher, T</creatorcontrib><creatorcontrib>Sung, L</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Risk Abstracts</collection><collection>Safety Science and Risk</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>British journal of cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ethier, M C</au><au>Science, M</au><au>Beyene, J</au><au>Briel, M</au><au>Lehrnbecher, T</au><au>Sung, L</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Mould-active compared with fluconazole prophylaxis to prevent invasive fungal diseases in cancer patients receiving chemotherapy or haematopoietic stem-cell transplantation: a systematic review and meta-analysis of randomised controlled trials</atitle><jtitle>British journal of cancer</jtitle><stitle>Br J Cancer</stitle><addtitle>Br J Cancer</addtitle><date>2012-05-08</date><risdate>2012</risdate><volume>106</volume><issue>10</issue><spage>1626</spage><epage>1637</epage><pages>1626-1637</pages><issn>0007-0920</issn><eissn>1532-1827</eissn><coden>BJCAAI</coden><abstract>Background:
Objectives were to compare systemic mould-active
vs
fluconazole prophylaxis in cancer patients receiving chemotherapy or haematopoietic stem cell transplantation (HSCT).
Methods:
We searched OVID MEDLINE and the Cochrane Central Register of Controlled Trials (1948-August 2011) and EMBASE (1980-August 2011). Randomised controlled trials of mould-active
vs
fluconazole prophylaxis in cancer or HSCT patients were included. Primary outcome was proven/probable invasive fungal infections (IFI). Analysis was completed by computing relative risks (RRs) using a random-effects model and Mantel–Haenszel method.
Results:
From 984 reviewed articles, 20 were included in this review. Mould-active compared with fluconazole prophylaxis significantly reduced the number of proven/probable IFI (RR 0.71, 95% CI 0.52 to 0.98;
P
=0.03). Mould-active prophylaxis also decreased the risk of invasive aspergillosis (IA; RR 0.53, 95% confidence interval (CI) 0.37–0.75;
P
=0.0004) and IFI-related mortality (RR 0.67, 95% CI 0.47–0.96;
P
=0.03) but is also associated with an increased risk of adverse events (AEs) leading to antifungal discontinuation (RR 1.95, 95% CI 1.24–3.07;
P
=0.004). There was no decrease in overall mortality (RR 1.0; 95% CI 0.88–1.13;
P
=0.96).
Conclusion:
Mould-active compared with fluconazole prophylaxis significantly reduces proven/probable IFI, IA, and IFI-related mortality in cancer patients receiving chemotherapy or HSCT, but increases AE and does not affect overall mortality.(PROSPERO Registration: CRD420111174)</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>22568999</pmid><doi>10.1038/bjc.2012.147</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
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| ispartof | British journal of cancer, 2012-05, Vol.106 (10), p.1626-1637 |
| issn | 0007-0920 1532-1827 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3349180 |
| source | MEDLINE; Nature; EZB-FREE-00999 freely available EZB journals; PubMed Central; SpringerLink Journals - AutoHoldings |
| subjects | 631/326/22/1292 692/699/255/1672 692/699/67/1059/99 692/700/565/545/576/1955 Adolescent Adult Aged Aged, 80 and over Antifungal Agents - therapeutic use Antineoplastic Agents - adverse effects Aspergillus Biological and medical sciences Biomedical and Life Sciences Biomedicine Cancer Research Cancer therapies Chemotherapy Child Child, Preschool Clinical Study Disease prevention Drug Resistance Epidemiology Fluconazole - therapeutic use Fungal infections Hematology Hematopoietic Stem Cell Transplantation - adverse effects Humans Infant Medical research Medical sciences Meta-analysis Middle Aged Molecular Medicine Mortality Mycoses - prevention & control Neoplasms - therapy Oncology Randomized Controlled Trials as Topic Stem cell transplantation Systematic review Tumors |
| title | Mould-active compared with fluconazole prophylaxis to prevent invasive fungal diseases in cancer patients receiving chemotherapy or haematopoietic stem-cell transplantation: a systematic review and meta-analysis of randomised controlled trials |
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