25 results match your criteria: "UCL Louvain Medical School[Affiliation]"

Objectives: A post hoc analysis used pooled STRIVE/ReSTORE trial data to determine outcomes with rezafungin versus caspofungin by Candida species and antifungal susceptibility.

Methods: The efficacy and safety of once weekly rezafungin 400/200 mg versus once daily caspofungin 70/50 mg was demonstrated in the randomized, double-blind phase 2 STRIVE (NCT02734862) and phase 3 ReSTORE (NCT03667690) trials involving adults with candidaemia and/or invasive candidiasis. In this analysis, data were pooled for patients with a documented Candida infection within 96 hours of randomization who also received ≥1 dose of study drug.

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Background: Invasive candidiasis/candidemia (IC/C) is associated with a substantial health economic burden driven primarily by prolonged hospital stay. The once-weekly IV echinocandin, rezafungin acetate, has demonstrated non-inferiority to caspofungin in the treatment of IC/C. This paper reports a post hoc pooled exploratory analysis of length of stay (LoS) for hospital and intensive care unit (ICU) stays in two previously published clinical trials (ReSTORE [NCT03667690] and STRIVE [NCT02734862], that compared rezafungin with daily IV caspofungin (stable patients in the caspofungin group who met relevant criteria could step down to fluconazole after 3 days or more).

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Rezafungin versus caspofungin for patients with candidaemia or invasive candidiasis in the intensive care unit: pooled analyses of the ReSTORE and STRIVE randomised trials.

Crit Care

October 2024

Médecine Intensive Réanimation, Inserm U1285, CNRS, UMR 8576-UGSF-Unité de Glycobiologie Structurale et Fonctionnelle, CHU de Lille, Université de Lille, Lille, France.

Background: Rezafungin is an echinocandin approved in the US and EU to treat candidaemia and/or invasive candidiasis. This post-hoc, pooled analysis of the Phase 2 STRIVE and Phase 3 ReSTORE trials assessed rezafungin versus caspofungin in patients with candidaemia and/or invasive candidiasis (IC) in the intensive care unit (ICU) at randomisation.

Methods: STRIVE and ReSTORE were randomised double-blind trials in adults with systemic signs and mycological confirmation of candidaemia and/or IC in blood or a normally sterile site ≤ 96 h before randomisation.

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Article Synopsis
  • Rezafungin, a new once-weekly echinocandin, showed similar effectiveness to caspofungin in treating candidemia and invasive candidiasis in the ReSTORE trial, particularly in terms of day 30 all-cause mortality and day 14 global cure rates.
  • The study involved patients aged 18 and older, comparing the outcomes of those receiving rezafungin to those on caspofungin, with specific focus on patients who had a positive culture close to the time of treatment randomization.
  • Results indicated comparable safety and efficacy between the two treatments, with rezafungin showing potential advantages in early mycological response, suggesting it could be an effective option for treatment.
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Article Synopsis
  • Rezafungin is a newly approved drug for treating candidaemia and invasive candidiasis, showing effectiveness and safety comparable to caspofungin in clinical trials.
  • The analysis combined data from two trials (STRIVE and ReSTORE) involving 294 patients worldwide, where both drugs were evaluated for their efficacy and safety profiles.
  • Results indicated similar 30-day mortality rates for both treatments (around 19%), and a higher rate of mycological response by day 5 in the rezafungin group, with both medications exhibiting comparable safety.
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The optimization of patients' treatment in the intensive care unit (ICU) needs a lot of information and literature analysis. Many changes have been made in the last years to help evaluate sedated patients by scores to help take care of them. Patients were completely sedated and had continuous intravenous analgesia and neuromuscular blockades.

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Article Synopsis
  • * The review outlines major obstacles in managing IC, including inadequate epidemiological data, challenging diagnostic tools, undefined treatment outcomes, and uncertainty regarding optimal antifungal therapy duration.
  • * New antifungal compounds might help address some of these issues, but effective early identification of at-risk patients and innovative treatment approaches for difficult-to-reach infections remain significant challenges.
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Ammonia and nutritional therapy in the critically ill: when to worry, when to test and how to treat?

Curr Opin Clin Nutr Metab Care

March 2023

Department of Intensive Care, Brugmann University Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium.

Purpose Of Review: Hyperammonaemia is almost always develops in patients with severe liver failure and this remains the commonest cause of elevated ammonia concentrations in the ICU. Nonhepatic hyperammonaemia in ICU presents diagnostic and management challenges for treating clinicians. Nutritional and metabolic factors play an important role in the cause and management of these complex disorders.

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Introduction: Invasive candidiasis or candidemia is a severe infection affecting more than 250,000 people worldwide every year. It is present in up to 16% of ICU patients. The prognosis of these infections is unfavorable, with global death estimated around 50,000 per year, which corresponds to up to 40% depending on patient severity and comorbidities.

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