A diagnostic-driven approach allows early treatment (in neutropenic patients with or without fever)1-4

A combination of diagnostic assessments is recommended:5

  • Routine galactomannan (GM) monitoring every 3-4 days
  • Appropriate clinical and microbiological evaluation
  • High-resolution computed tomography (CT) imaging

VFEND CT section

A diagnostic-driven approach has the potential to help you save lives6

  • Routine GM screening is shown to lead to the early initiation of antifungal therapy4
  • Initiating appropriate treatment on the basis of CT patterns has been shown to save lives*6
  • Increased survival was observed in patients with pulmonary invasive aspergillosis who presented with a halo sign versus those with other imaging findings at week 12: 71% vs 53%, respectively (p<0.01)6

*Analysis of chest CT findings at presentation from a large series (n=235) of patients with invasive pulmonary aspergillosis (IPA), to assess the prevalence of a "halo sign" and to evaluate the clinical utility of this imaging finding for early identification and treatment of IPA.6
Vfend® (voriconazole) is not indicated for the empirical treatment of invasive aspergillosis.

 

Example of a diagnostic-driven antifungal therapy integrated care pathway7

Example of a diagnostic-driven antifungal therapy integrated care pathway

*Check response on day 7. If no response to treatment, further diagnosis is required; if patient responds to treatment, consider the duration of therapy, "step down" therapy, and outpatient follow up.
Multidisciplinary team input important at this stage.
 

Voriconazole (Vfend®): for efficacy, patient outcomes8–10 and potential medium-term budgetary implications

 

IFD, invasive fungal disease; IMD, invasive mold disease; PCR, polymerase chain reaction

References
1. Rogers TR, et alBr J Haematol. 2011; 153(6): 681–97.
2. Freemantle N, et al. J Antimicrob Chemother. 2011; 66(Suppl 1): i25–35.
3. de Pauw BE& Viscoli C. J Antimicrob Chemother. 2011; 66(Suppl 1): i55–8.
4. Maertens J, et alClin Infect Dis. 2005; 41(9): 1242–50.
5. Marchetti O et al. Bone Marrow Transplant. 2012; 47(6): 846–54.
6. Greene RE, et alClin Infect Dis. 2007; 44(3): 373–9.
7. Agrawal S, et al. J Antimicrob Chemother. 2011; 66(Suppl 1): i45-53.
8. Vfend® Summary of Product Characteristics.
9. Marks DI, et alBr J Haematol. 2011; 155(3): 318–27.
10. Herbrecht R, et alN Engl J Med. 2002; 347(6): 408–15.

 

Date of Preparation: June 2017

PP-VFE-GBR-0050

 

Prescribing Information

Vfend® (voriconazole) – SPC 
Legal Category: POM      Basic NHS Cost: Pack of 28 50 mg tablets £275.68, Pack of 28 200 mg tablets £1,102.74, 30 ml vial of 200 mg powder for intravenous infusion £77.14, 30 ml vial of 200 mg powder for intravenous infusion with 50 ml bag containing Vfend solvent for solution for infusion £77.14, 100 ml bottle of 40 mg/ml powder for oral suspension £551.37

Diflucan® (fluconazole) 10 mg/ml powder for oral suspension – SPC  
Legal Category: POM      Basic NHS Cost: Diflucan powder for oral suspension 10 mg/ml £16.61 

Diflucan® (fluconazole) 150 mg Capsules – SPC  
Legal Category: POM      Basic NHS cost: Diflucan hard capsules 150 mg £7.12

Diflucan® (fluconazole) 2 mg/ml solution for infusion – SPC  
Legal Category: POM      Basic NHS cost: Diflucan 2 mg/ml solution for infusion 100 ml £29.28

Diflucan® (fluconazole) 200 mg hard capsules – SPC  
Legal Category: POM      Basic NHS cost: Diflucan hard capsules 200 mg £66.42

Diflucan® (fluconazole) 40 mg/ml powder for oral suspension – SPC  
Legal Category: POM      Basic NHS cost: Diflucan powder for oral suspension 40 mg/ml £66.42

Diflucan® (fluconazole) 50 mg hard capsules – SPC  
Legal Category: POM      Basic NHS cost: Diflucan hard capsules 50 mg £16.61