Primary fungal prophylaxis in hematological malignancy: A network meta-analysis of randomized controlled trials.

Primary fungal prophylaxis in hematological malignancy: A network meta-analysis of randomized controlled trials. Antimicrob Agents Chemother. 2018 Jun 04;: Authors: Lee CH, Lin C, Ho CL, Lin JC Abstract Several new anti-fungal agents have become available for primary fungal prophylaxis of neutropenia fever in haematological malignancy patients. Our aim was to synthesize all evidence on efficacy and enable an integrated comparison of all current treatments.We performed a systematic literature review to identify all publicly available evidence from randomized controlled trials (RCT). We searched Embase, PubMed, the Cochrane Central Register of Controlled Clinical Trials, and the website www.ClinicalTrials.gov In total, 54 RCTs were identified, including 13 treatment options. The evidence was synthesised using a network meta-analysis. Relative risk (RR) was adopted.Posaconazole was ranked highest effectiveness for primary prophylaxis, being the most favorable in terms of (1) the RR for reduction of invasive fungal infection (0.19; 95% confidence interval (CI): 0.11-0.36) and (2) the probability of being the best (94% of the cumulative ranking). Posaconazole also demonstrated its efficacy in preventing invasive aspergillosis and proven fungal infections, with RR of 0.13 (CI: 0.03-0.65) and 0.14 (CI: 0.05-0.38), respectively. However, there was no significant difference among all the anti-fungal agents in all-cause mortality and overall a...
Source: Antimicrobial Agents and Chemotherapy - Category: Microbiology Authors: Tags: Antimicrob Agents Chemother Source Type: research