Hospital resource use of patients receiving isavuconazole vs voriconazole for invasive mold infections in the phase III SECURE trial.

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Citation: Journal of Medical Economics. 19(7):728-34, 2016 JulPMID: 26960060Institution: MedStar Washington Hospital CenterDepartment: Medicine/Pulmonary-Critical CareForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Antifungal Agents/tu [Therapeutic Use] | *Length of Stay/ec [Economics] | *Mycoses/dt [Drug Therapy] | *Mycoses/ec [Economics] | *Nitriles/tu [Therapeutic Use] | *Pyridines/tu [Therapeutic Use] | *Triazoles/tu [Therapeutic Use] | *Voriconazole/tu [Therapeutic Use] | Adolescent | Adult | Aged | Aged, 80 and over | Antifungal Agents/ec [Economics] | Aspergillosis/dt [Drug Therapy] | Aspergillosis/ec [Economics] | Body Mass Index | Double-Blind Method | Female | Glomerular Filtration Rate | Hospital Charges/sn [Statistics & Numerical Data] | Humans | Kaplan-Meier Estimate | Male | Middle Aged | Nitriles/ec [Economics] | Pyridines/ec [Economics] | Triazoles/ec [Economics] | Voriconazole/ec [Economics] | Young Adult=520 \\Year: 2016ISSN:
  • 1369-6998
Name of journal: Journal of medical economicsAbstract: CONCLUSIONS: Isavuconazole may reduce hospital LOS in certain subgroups of patients with IMD, especially those with moderate-to-severe renal impairment.LIMITATIONS: As the patient subgroups analyzed were small, sub-group findings should be interpreted with caution in light of the lack of statistical significance for each sub-group-by-treatment interaction.METHODS: The analysis population comprised adults with proven/probable/possible IMD enrolled in SECURE. The primary endpoint was hospital length of stay (LOS) in the overall trial population. Patients were also stratified by estimated glomerular filtration rate-modification of diet in renal disease category (< 60mL/min/1.73 m(2) [moderate-to-severe impairment] and >60mL/min/1.73 m(2) [mild or no impairment]), body mass index (BMI; <25, >25-<30, and >30kg/m(2)), and age (<45, >45-<65, and >65 years).RESULTS: Data from 516 patients (258 per arm) were evaluated. Overall, median LOS was not statistically significantly different between the isavuconazole (15.0 days) and voriconazole (16.0 days; p=0.607) arms. Median LOS was statistically significantly shorter in patients with moderate-to-severe renal impairment treated with isavuconazole (9.0 days) vs voriconazole (19.0 days; hazard ratio [HR]: 3.44; 95% confidence interval [CI]=1.51-7.83). Median LOS was shorter, but not significantly, in patients with a BMI >30kg/m(2) (isavuconazole 13.5 days vs voriconazole 22 days; HR=1.57; 95% CI=0.70-3.52) or aged >65 years (isavuconazole 15.0 days vs voriconazole 20.0 days; HR=1.37; 95% CI=0.87-2.16).All authors: Azie N, Franks B, Goff D, Horn D, Khandelwal N, Shi F, Shorr AF, Spalding JFiscal year: FY2017Digital Object Identifier: Date added to catalog: 2017-05-24
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Journal Article MedStar Authors Catalog Article 26960060 Available 26960060

CONCLUSIONS: Isavuconazole may reduce hospital LOS in certain subgroups of patients with IMD, especially those with moderate-to-severe renal impairment.

LIMITATIONS: As the patient subgroups analyzed were small, sub-group findings should be interpreted with caution in light of the lack of statistical significance for each sub-group-by-treatment interaction.

METHODS: The analysis population comprised adults with proven/probable/possible IMD enrolled in SECURE. The primary endpoint was hospital length of stay (LOS) in the overall trial population. Patients were also stratified by estimated glomerular filtration rate-modification of diet in renal disease category (< 60mL/min/1.73 m(2) [moderate-to-severe impairment] and >60mL/min/1.73 m(2) [mild or no impairment]), body mass index (BMI; <25, >25-<30, and >30kg/m(2)), and age (<45, >45-<65, and >65 years).

RESULTS: Data from 516 patients (258 per arm) were evaluated. Overall, median LOS was not statistically significantly different between the isavuconazole (15.0 days) and voriconazole (16.0 days; p=0.607) arms. Median LOS was statistically significantly shorter in patients with moderate-to-severe renal impairment treated with isavuconazole (9.0 days) vs voriconazole (19.0 days; hazard ratio [HR]: 3.44; 95% confidence interval [CI]=1.51-7.83). Median LOS was shorter, but not significantly, in patients with a BMI >30kg/m(2) (isavuconazole 13.5 days vs voriconazole 22 days; HR=1.57; 95% CI=0.70-3.52) or aged >65 years (isavuconazole 15.0 days vs voriconazole 20.0 days; HR=1.37; 95% CI=0.87-2.16).

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