• Yuichi Shibata, Mao Hagihara, Hideo Kato, Noriyo Kawasumi, Jun Hirai, Naoya Nishiyama, Nobuhiro Asai, Yusuke Koizumi, Yuka Yamagishi, Katsuhiko Matsuura, and Hiroshige Mikamo.
• Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan; Department of Pharmacy, Aichi Medical University Hospital, Japan.
• J. Infect. Chemother. 2017 Jun 1; 23 (6): 349-353.

BackgroundOne of the major adverse events of caspofungin and micafungin is hepatotoxicity, however, there are few reports compared the incidence of hepatotoxicity between caspofungin and micafungin. Herein, the primary objective of this study was to compare the incidence of hepatotoxicity between caspofungin and micafungin treatments for patients with fungal or suspected fungal infection.MethodsIn total, 201 patients [caspofungin group: 66 patients; micafungin group: 135 patients] treated with echinocandins from April 2014 to November 2015 at Aichi Medical University Hospital. Investigation item were as follows; sex, age, weight, height, duration of treatment, total dose, disease type, clinical isolates, liver enzyme levels, concomitant medications. Liver function was assessed in accordance with Common Terminology Criteria for Adverse Events (CTCAE) Version 4.0. We divided into two groups depend on their liver enzyme levels before treated with echinocandins; normal group (liver enzyme levels ≤ CTCAE Grade 1), abnormal group (liver enzyme levels ≥ CTCAE Grade 2).ResultsThe overall incidence of serious hepatotoxicity (Grade 3 or higher) was 6.1% (4/66) in the caspofungin group and 7.4% (10/135) in the micafungin group. The proportion of patients used caspofungin and micafungin showed serious hepatotoxicity were 0% (0/47) and 6.5% (7/108) in normal group (p = 0.17), and 21.1% (4/19) and 10.7% (3/28) in abnormal group (p = 0.42).ConclusionThere was no notable difference in serious hepatotoxicity between the caspofungin group and the micafungin group, even though in patients with abnormal liver enzyme levels (CTCAE grade 2 or higher).Copyright © 2017 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

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