Evidence map›Paper›PMID 30157797›Full record

ArticleBMC infectious diseases2018

Retrospective cohort study comparing the risk of severe hepatotoxicity in hospitalized patients treated with echinocandins for invasive candidiasis in the presence of confounding by indication.

Francis Vekeman, Lisa Weiss, Jalal Aram, Raluca Ionescu-Ittu, Shahrzad Moosavi, Yongling Xiao, Wendy Y Cheng, Rachel H Bhak, Margaret Tawadrous, M Rita Capparella and 2 more

Open access · goldAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC infectious diseases, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
0.6field-weighted citation impact, top 33% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 13 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 5 institutions in 2 countries.

Francis VekemanAnalysis Group, Inc., 111 Huntington Avenue, 14th Floor, Boston, MA, 02199, USA.
Lisa WeissPfizer, Inc., New York, NY, USA.
Jalal AramPfizer, Inc., New York, NY, USA.
Raluca Ionescu-IttuAnalysis Group, Inc., 111 Huntington Avenue, 14th Floor, Boston, MA, 02199, USA.
Shahrzad MoosaviPfizer, Inc., New York, NY, USA.
Yongling XiaoAnalysis Group, Inc., 111 Huntington Avenue, 14th Floor, Boston, MA, 02199, USA.
Wendy Y ChengAnalysis Group, Inc., 111 Huntington Avenue, 14th Floor, Boston, MA, 02199, USA.
Rachel H BhakAnalysis Group, Inc., 111 Huntington Avenue, 14th Floor, Boston, MA, 02199, USA.
Margaret TawadrousPfizer, Inc., New York, NY, USA.
M Rita CapparellaPfizer PFE, Paris, France.
Philippe MontraversParis Diderot Sorbonne Cite University and Bichat-Claude Bernard University Hospital, Paris, France.
Mei Sheng DuhAnalysis Group, Inc., 111 Huntington Avenue, 14th Floor, Boston, MA, 02199, USA. mei.duh@analysisgroup.com.
Analysis Group (United States) · USPfizer (United States) · USHarvard University · USPfizer (France) · FRUniversité Claude Bernard Lyon 1 · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTo compare the risk of severe hepatotoxicity with anidulafungin versus caspofungin and micafungin in hospitalized adults.

methodsThis retrospective cohort study combined data from two large US- based hospital electronic medical record databases. Severe hepatotoxicity was a Grade ≥ 3 liver function test (LFT) post-echinocandin initiation. Adjusted incidence rate ratios (IRRs) were estimated for anidulafungin versus caspofungin and micafungin, overall and in patients with normal baseline LFT (Grade 0).

resultsTreatments included anidulafungin (n = 1700), caspofungin (n = 4431), or micafungin (n = 6547). The proportions with LFT Grade ≥ 3 pre-echinocandin initiation were: anidulafungin 40.4% versus caspofungin 25.9% (p <  0.001) and micafungin 25.6% (p <  0.001). Rates of severe underlying diseases or comorbidities were: critical care admissions: 75.3% versus 52.6 and 48.6%; and organ failures: 69.4% versus 46.7 and 51.5%. Adjusted IRRs of severe hepatotoxicity for anidulafungin versus caspofungin and micafungin were 1.43 (p = 0.002) and 1.19 (p = 0.183) overall, and 0.88 (P = 0.773) and 0.97 (P = 0.945) for normal baseline LFT, respectively.

conclusionsAccounting for confounders, severe hepatotoxicity risk was not significantly different across echinocandins in this real-world head-to-head study. Anidulafungin was used more frequently in patients with more comorbidities. Those with normal baseline LFT (least susceptible to confounding by indication), showed no elevated hepatotoxicity risk for anidulafungin.

Indexed as

AdolescentAdultAgedAged, 80 and overAntifungal AgentsCandidiasis, InvasiveChemical and Drug Induced Liver InjuryCritical CareEchinocandinsFemaleHospitalizationHospitalsHumansLiver Function TestsMaleMiddle AgedAntifungal AgentsEchinocandinsAnidulafunginCaspofunginEchinocandinMicafunginSevere hepatotoxicity

Identifiers

PMID30157797
PMCPMC6116432
OpenAlexW2888924239

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.