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Invasive fungal infections in solid organ transplant recipients
Invasive fungal infections and chronic obstructive pulmonary disease
Information on how to access prescribing information and adverse event reporting can be found towards the bottom of the page.
Invasive fungal infections and chronic obstructive pulmonary disease
Patient populations are emerging outside of groups conventionally regarded as high risk of developing invasive fungal infections in the intensive care unit (ICU), including those with chronic obstructive pulmonary disease (COPD).1
In recent years, there has been an increase in invasive pulmonary aspergillosis (IPA) infections in patients hospitalised with acute exacerbations of COPD, with the most severely ill COPD patients most likely to be affected.2
Incidence of IPA in COPD patients can vary: 1.9–22.1%3–7
Smoking and structural lung damage are often observed in COPD patients, which may contribute to the risk of developing IPA8–12
A recent retrospective, observational study of patients diagnosed with invasive aspergillosis in Australia and New Zealand found that ~25% patients (n=55/221) had chronic respiratory disease, and ~4% (n=8/221) had COPD as their only underlying condition13,a
Risk factors and predictors of IPA in COPD patients2,6
ICU admission
Poor lung function (GOLD III or IV)
Systemic corticosteroid use
Chronic heart failure
Prolonged antibiotic treatment (>10 days in past 3 months)
High doses of inhaled glucocorticoids
Viral infection including influenza and cytomegalovirus
Diagnostic tools and techniques
Early recognition of IPA in COPD is vital to improve outcomes. However, clinical manifestations are often non-specific and existing laboratory tests are not particularly sensitive for non-neutropenic patients, leading to delays in diagnosis and treatment.2,4 Mortality can reach up to 100% if untreated, so initiating appropriate antifungal therapy promptly is vital.4
The current strategy for IPA diagnosis in COPD patients involves a combination of risk factors, clinical manifestations, and laboratory tests.2
CRESEMBA® (isavuconazole) does not have an indication for treatment of COPD14
CRESEMBA® is indicated in adults for the treatment of:
• Invasive aspergillosis
• Mucormycosis in patients for whom amphotericin B is inappropriate
Consideration should be given to official guidance on the appropriate use of antifungal agents.
Please refer to the Summary of Product Characteristics for more details.
For more information on diagnostic tools and techniques for invasive fungal infections, visit our Diagnostics page.
How can CRESEMBA® help your patients?
Discover the value of CRESEMBA®
COPD, chronic obstructive pulmonary disease; DNA, deoxyribonucleic acid; GOLD, Global Initiative for Chronic Obstructive Lung Disease; ICU, intensive care unit; IgG, immunoglobulin G; IgM, immunoglobulin M; IPA, invasive pulmonary aspergillosis; mNGS, metagenomic next-generation sequencing; PCR, polymerase chain reaction.
a. Chronic pulmonary diseases included: predominantly COPD, followed by asthma, mycobacterial (tuberculous and non-tuberculous) infections, cystic fibrosis, bronchiectasis chronic pulmonary graft-versus-host-disease, alpha-1-antitrypsin deficiency and autoimmune pulmonary conditions.13
Prescribing Information
Click here for CRESEMBA® (isavuconazole) and VFEND (voriconazole) prescribing information
References:
Bassetti M and Bouza E. J Antimicrob Chemother 2017;72(suppl_1):i39–i47.
Guo L et al. Clin Respir J 2023;17:129–138.
Guinea J et al. Clin Microbiol Infect 2010;16:870–877.
Xu H et al. Clin Microbiol Infect 2012;18(4):403–408.
Gao X et al. Ann Saudi Med 2010;30(3):193–197.
Gu Y et al. Respir Res 2021;22:176.
Delsuc C et al. Crit Care 2015;19:421.
Chotirmall SH et al. Mycopathologia 2018;183(1):45–59.
Kosmidis C and Denning DW. Thorax 2015;70(3):270–227.
Bao Z et al. Oncotarget 2017;8(23):38069-38074.
Hammond EE et al. BMC Pulm Med 2020;20(1):241.
Bouza E et al. J Clin Microbiol 2005;43:2075–2079.
Shio TY et al. Lancet Reg Health West Pac 2023;40:100888.
CRESEMBA GB Summary of Product Characteristics.
How can CRESEMBA® help influenza patients with invasive mould infections in the ICU?
Learn more
What can CRESEMBA® do for COVID-19 patients with invasive mould infections in the ICU?
Learn more
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Adverse events should also be reported to Pfizer Medical Information on 01304 616161
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PP-UNP-GBR-7812. January 2024