Efficacy and Safety of Caspofungin for Invasive Pulmonary Aspergillosis Underlying Chronic Obstructive Pulmonary Disease

• Assessment of Safety of Caspofungin for IPA Underlying COPD [ Time Frame: at the time of enrollment, weekly during therapy, and 1 week after the end of therapy. ] [ Designated as safety issue: Yes ]
  Safety evaluation : Laboratory examinations are performed; Number of participants with adverse events are recorded.
• Global response to 2-week caspofungin therapy [ Time Frame: 2 week ] [ Designated as safety issue: No ]
• Factors such as severity of COPD, exposure to systemic corticosteroids,extended-spectrum antibiotics et al. affecting patients' response to caspofungin therapy [ Time Frame: 3 week ] [ Designated as safety issue: No ]
  Assessment of factors such as severity of COPD, exposure to systemic corticosteroids,extended-spectrum antibiotics,malnutrition or diabetes affecting patients' response to caspofungin therapy
• Clinical response at Day 7 of treatment [ Time Frame: 1 week ] [ Designated as safety issue: No ]

The investigators propose to study the efficacy and safety of three-week antifungal therapy with caspofungin in hospitalized patients with proven or probable IPA underlying chronic obstructive pulmonary disease.

Recently, there has been increasing appreciation of chronic obstructive pulmonary disease (COPD) as an important risk factor of invasive pulmoanry aspergillosis (IPA). However, clinical data on the morbidity and mortality of IPA underlying COPD as well as the efficacy and safety of antifungal treatment in such subset of patient population is very limited. In clinical pratice, capofungin is often used as primary antifungal therapy for IPA, especially in patients with impaired renal function. Based on this data, the investigators propose to study the efficacy and safety of three-week antifungal therapy with caspofungin in hospitalized patients with proven or probable IPA underlying COPD.

• Invasive Pulmonary Aspergillosis
• Chronic Obstructive Pulmonary Disease

Inclusion Criteria:

• Proven invasive pulmonary aspergillosis
• Probable invasive pulmonary aspergillosis
• Hospitalized in respiratory wards
• Not having received an empirical antifungal therapy for 72h before inclusion

Exclusion Criteria:

• A history of allergy to echinocandins
• Severe renal failure, severe hepatic insufficiency
• Inadequately treated bacterial infection
• Documented HIV infection
• Status of pregnancy or lactation