# Observational study of the recent efficacy and economy of itraconazole vs. voriconazole in perioperative pulmonary aspergillosis

## TL;DR

This study compares itraconazole and voriconazole for treating pulmonary aspergillosis before and after surgery, finding both drugs similarly effective but itraconazole more cost-efficient.

## Contribution

The study provides new evidence on the cost-effectiveness of itraconazole versus voriconazole in perioperative pulmonary aspergillosis treatment.

## Key findings

- Itraconazole and voriconazole showed similar short-term efficacy and adverse event rates in treating pulmonary aspergillosis.
- Itraconazole was found to be more economical despite a longer treatment duration compared to voriconazole.
- Both drugs were equally effective in preventing recurrence of pulmonary aspergillosis during the perioperative period.

## Abstract

Antifungal therapy is a common treatment option for pulmonary aspergillosis, but its use to prevent recurrence and relieve symptoms in patients with pulmonary aspergillosis remains controversial. This study aimed to explore the short-term efficacy and cost of itraconazole vs. voriconazole in the treatment of pulmonary aspergillosis during the perioperative period.

We retrospectively collected the clinical data of 55 patients with pulmonary aspergillosis who underwent surgery and received itraconazole or voriconazole as antifungal therapy between January 1, 2016, and October 31, 2022, at the Department of Thoracic Surgery, Affiliated Hospital of Zunyi Medical University. We analyzed the effects of different antifungal therapies on the incidence of adverse events, short-term efficacy, and cost-effectiveness of pulmonary aspergillosis treatment.

Except for the younger average age of patients in the itraconazole group, there were no significant differences in baseline characteristics such as sex, BMI, underlying lung disease, accompanying symptoms, and lesion location between the voriconazole and itraconazole groups. There was no significant difference in the incidence of adverse events or short-term efficacy, including recovery, symptom improvement, and recurrence rates, during the administration of the antifungal regimens between the two groups. Regarding economic cost efficiency, there was no significant difference in the median hospitalization costs between the two groups. However, despite the longer antifungal treatment duration in the itraconazole group, the cost of itraconazole was significantly lower than that of voriconazole.

Both itraconazole and voriconazole effectively prevented the recurrence of pulmonary aspergillosis. They are similar in terms of the incidence of adverse events and short-term efficacy; however, itraconazole is more economical.