MYCOLab Ai Logo - gold and army green

Efficacy and safety of isavuconazole for invasive fungal infections: A systematic review and meta-analysis of randomized controlled trials

Summary

Isavuconazole is an antifungal medication used to treat serious fungal infections that can occur in people with weakened immune systems. This research review looked at three clinical trials comparing isavuconazole to other antifungal drugs and found it works just as well while being easier on the liver. Notably, isavuconazole caused fewer drug-related side effects and liver problems compared to voriconazole, another common antifungal drug.

Background

Invasive fungal infections (IFIs) are life-threatening, especially in immunocompromised patients. Conventional antifungals like voriconazole and liposomal amphotericin B are effective but limited by hepatotoxicity, nephrotoxicity, and drug-drug interactions. Isavuconazole (ISA), a third-generation triazole, offers pharmacological advantages including minimal CYP3A4 interaction and no dose adjustment needed for renal impairment.

Objective

This systematic review and meta-analysis aimed to assess the efficacy and safety of isavuconazole compared with other antifungal agents through analysis of randomized controlled trials only, to provide high-quality evidence for clinical decision-making.

Results

Three RCTs met inclusion criteria. No statistically significant differences were observed between ISA and comparator agents for clinical response (53.6% vs 59.1%), mortality (30.6% vs 32.0%), or total adverse events. In subgroup analysis of filamentous fungal infections comparing ISA with voriconazole, ISA showed significantly lower incidence of drug-related adverse events (RR: 0.70) and hepatobiliary disorders (RR: 0.57).

Conclusion

ISA demonstrated efficacy comparable to other antifungal agents with a favorable safety profile in IFI patients, including filamentous fungal infections. ISA showed significant safety advantages over voriconazole regarding drug-related adverse events and hepatobiliary toxicity, supporting its use as a viable alternative particularly for patients at risk of hepatotoxicity.
  • Published in:Medical Mycology,
  • Study Type:Meta-analysis,
  • Source: PMID: 41014230, DOI: 10.1093/mmy/myaf089
Scroll to Top