Caspofungin is the first in a new class of
antifungal agents, the
glucan synthesis inhibitors, that interfere with fungal cell wall synthesis.
Caspofungin exhibited in vitro and in vivo efficacy against a wide range of fungi and yeasts including Aspergillus and Candida species. A complete or partial response to
caspofungin therapy was seen in 40.7% of immunocompromised adults with invasive
aspergillosis who did not respond to, or did not tolerate, other
antifungal agents in a noncomparative multicentre study.
Caspofungin was effective in patients with oropharyngeal or oesophageal
candidiasis, according to the preliminary results of 2 randomised double-blind trials.
Caspofungin was generally well tolerated in a multicentre noncomparative trial involving patients with invasive
aspergillosis. One or more
drug-related clinical adverse effects were experienced by 13.8% of
caspofungin recipients (the most common were
fever,
nausea,
vomiting and complications associated with the vein into which
caspofungin was infused). The tolerability of
caspofungin appeared to be better than that of
amphotericin B and similar to that of
fluconazole in double-blind, randomised trials involving patients with mucosal
candidiasis.