Antifungal prophylactic drugs reduce the risk of death for lung transplant patients: A study

Minnesota: Antifungal prophylactic drugs halve the risk of death in the first year after a lung transplant, according to a study of 667 patients who received a lung transplant at the Mayo Clinic between 2005 and 2018.

A retrospective study published in the Annals of the American Thoracic Society is the largest study evaluating the effectiveness of antifungal prophylactic drugs in lung transplant recipients who are particularly susceptible to invasive fungal infections.

These infections are associated with an almost threefold increase in mortality for lung transplant recipients. Researchers at the Mayo Clinic used data from well-known administrative lawsuits from OptumLabs Data Warehouse.

The study analyzed data for adult patients who underwent single or double lung transplantation or simultaneous heart and lung transplantation in the United States between January 1, 2005, and December 31, 2018. , received antifungal treatment, and did not do 28.3 percent or 42.3 percent.

Sixty-five patients died during the study, and patients receiving antifungal medications had a lower mortality rate from all causes. “The use of antifungal prophylactic drugs in lung transplant patients is increasingly common, but no efficacy has been established,” said Kelly Pennington, MD, the study’s first author.

“This is the first case to demonstrate a fatal benefit associated with the use of antifungal prophylaxis in lung transplant patients. We still do not know which lung transplant patients benefit the most from these drugs, and there are other unanswered questions that will require further research. Dr. Pennington is a Scientist at the Mayo Clinic in the Department of Pulmonary and Critical Care.

A 2019 Mayo Clinic study found that 90% of U.S. transplant centers routinely prescribe antifungal prophylactic drugs after lung transplantation, but no prospective study has established the benefits of these drugs.

“In our retrospective study, the risk of death in the first year of a posttransplant is twice as high in patients who do not receive antifungal prophylactic treatment as in those who do not,” says Dr. Pennington. was appointed in the case.

The proportion of fungal infections was lower in patients receiving antifungal medications than in those who did not, although the difference was not statistically significant.

Long-term use of antifungal drugs can adversely affect health, including cardiomyopathy, skin cancer, and liver dysfunction. Also, antifungal medications are expensive and can interact with other medications. For this reason, the health team should closely monitor antifungal medications.

“Given the change in practice between transplant centers, the potential for drug side effects, drug costs, and the risk of drug interactions, it was important to determine whether antifungal prophylactic drugs were beneficial for lung transplant recipients,” says MD, the lead author.

“Our finding of a significant reduction in the risk of death among lung transplant recipients receiving antifungal drugs is consistent with previous studies in patients with hematologic malignancies and bone marrow transplants.” Dr. Kennedy is a physician in Pulmonary and Critical Care Medicine at the Mayo Clinic.

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