Vena, AntonioBouza, EmilioBassetti, MatteoMenichetti, FrancescoMerelli, MariaGrau Cerrato, SantiagoAguado, José MaríaMerino, PalomaMerino, PalomaBonache, FranciscoMuñoz-Millán, Patricia2021-04-292021-04-292020Vena A, Bouza E, Bassetti M, Menichetti F, Merelli M, Grau S, Fortun J, et al. Comparison of the safety and tolerance profile of micafungin with that of other echinocandins and azoles in patients with pre-existing child-pugh B or C liver disease: a case-control retrospective study. Infect Dis Ther. 2020 Mar; 9(1): 151-63. DOI: 10.1007/s40121-020-00282-w2193-6382http://hdl.handle.net/10230/47247Introduction: To assess the association between exposure to micafungin, other echinocandins, or azoles and the development of short-term liver injury (STLI) or long-term liver injury (LTLI) in patients with Child-Pugh B or C liver disease. Methods: Multicenter case-control study of patients with Child-Pugh B or C liver disease who received antifungals (AF) for ≥ 72 h (May 2009-May 2015) in six Spanish and Italian hospitals. All micafungin patients were randomly matched with one patient who received another echinocandin and with one patient who received azole treatment. Primary outcome was development of STLI or LTLI (development of any type of liver tumor during the follow-up period). Results: Of 2335 patients with chronic liver disease admitted to the six centers, 20 (0.85%) were found to have Child-Pugh B or C liver disease and received micafungin for ≥ 72 h. During AF treatment, the frequency of STLI was 10% in each group. Most cases of STLI were asymptomatic, and AFs had to be switched to another class of AF in only two patients (one micafungin and one azole). No patients developed acute liver insufficiency, were admitted to the ICU, or had to undergo transplantation. Follow-up data (median of 1.3 years) were available for 30 patients. LTLI was observed in only one patient, who had previously received treatment with azoles. Conclusions: Our study suggests that the administration of micafungin to patients with end-stage liver disease does not imply a higher risk of developing STLI or LTLI.application/pdfengCopyright © The Author(s) 2020. Open Access.This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/.info:eu-repo/semantics/articlehttp://dx.doi.org/10.1007/s40121-020-00282-wEnd-stage liver diseaseLiver injuryMicafunginSafetyinfo:eu-repo/semantics/openAccess