Superiority Trials in Invasive Aspergillosis: A Harsh Reality Check With the IA-DUET (HOVON502) Trial.

Lamberink, Hanne; Huygens, Sammy; Aerts, Robina; Lagrou, Katrien; van Leeuwen-Segarceanu, Elena; Lodewyck, Tom; Nieuwenhuizen, Laurens; Corsten, Maarten F et al. · Clin Infect Dis · 2025

rct · Level II

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Abstract

The IA-DUET study aimed to compare azole-echinocandin combination therapy with azole monotherapy for invasive aspergillosis. Recruitment was hindered by patient ineligibility, competing studies, and guidelines favoring combination therapy when azole resistance was unknown. The low IA-attributable mortality suggests future trials may benefit from cluster randomization or composite endpoints to enhance efficiency.

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