Posaconazole Prophylaxis in GVHD
A randomized, double-blind trial compared posaconazole and fluconazole prophylaxis in patients with GVHD.
  • Treatment regimen:
    fluconazole 400 mg qd or posaconazole 200 mg tid
  • Assessment:
    at end of treatment + 7 days and at 16 weeks
  • Mean days on therapy:
    fluconazole, 77 d; posaconazole, 80 d

  • Limitations:
    • Posaconazole exposure is greatly improved when taken with a fatty meal or nutritional supplement, which may have led to selection bias. (Serum concentrations were not routinely measured.)
    • Many patients (posaconazole group, 7%; fluconazole group, 10%) had a positive baseline galactomannan result suggesting that they were undergoing pre-emptive therapy rather than true prophylaxis.
    • Overall mortality was not reduced.
    • Clinical failure rates were similar in both groups.

Ullmann AJ, Lipton JH, Vesole DH, et al. N Engl J Med. 2007;356(4):335-347.