High loading dose AmBisome(R) is efficacious and well tolerated in the management of invasive fungal infection in hematology patients

McLintock, Lorna; Cook, Gordon; Holyoake, Tessa L.; Jones, Brian; Kinsey, Sally; Jackson, Graham

doi:10.3324/haematol.10531

Cited by 5 publications

(3 citation statements)

References 9 publications

(7 reference statements)

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“…If choosing to employ high-dose therapy, clinicians should follow best practices to monitor kidney function and changes in electrolytes daily whilst on amphotericin B therapy. Although response and mortality rates in our case series were consistent with previously reported literature, [14][15][16][17][18][19][20][21][22][23][24] the range of favourable responses in multi-patient studies (8-68%) is still dismally low.…”

Section: Discussionsupporting

confidence: 91%

“…A total of 11 manuscripts met inclusion criteria and were included in this review (Table 2). [14][15][16][17][18][19][20][21][22][23][24] Of these, seven were case reports or case series, one was a retrospective evaluation, and three were prospective studies (1 pilot, one open label, one randomized controlled trial). A total of 260 patients, ranging from 8 to 69 years of age, were represented in the published literature.…”

Section: Review Of the Literaturementioning

confidence: 99%

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High-dose amphotericin: yay or nay? A case series and literature review

Stover,

Jordan,

Wagner

et al. 2024

DIC

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Invasive fungal infections pose significant morbidity and mortality risks, particularly those caused by moulds. Available antifungal classes are limited by toxicities and are increasingly susceptible to resistance, particularly amongst challenging fungal pathogens. The purpose of this case series and literature review was to characterize the use of a high-dose lipid formulation of amphotericin B. A case series is presented including patients who received high-dose lipid formulation amphotericin B (≥7.5 mg/kg/day) between June 2012 and August 2021. Additionally, a systematic literature review was conducted by searching the PubMed database for English-language studies involving individuals who received high-dose amphotericin B therapy (≥7.5 mg/kg) using lipid formulations. Nine patients were included in the case series, receiving an average of 8.9 ± 1.3 mg/kg liposomal amphotericin B over a mean of 11.0 ± 10.8 days predominantly for mould infections including Mucorales, aspergillosis and Fusarium . The patients were primarily cared for in intensive care units, with varying treatment histories and outcomes. A total of 11 studies ( n =260 patients) met inclusion criteria for the literature review. Responses to high-dose liposomal amphotericin B ranged from 8% to 100%, often showing favourable outcomes. High doses of liposomal amphotericin B were well tolerated both in the case series and in published literature, with serum creatinine changes being the most commonly reported adverse event. However, multi-patient studies continue to report less than favourable (range 8–62%) response rates. High-dose liposomal amphotericin B, either alone or in combination with other antifungal agents, might be a viable strategy for managing invasive fungal infections when few treatment choices exist. This article is part of the Challenges and strategies in the management of invasive fungal infections Special Issue: https://www.drugsincontext.com/special_issues/challenges-and-strategies-in-the-management-of-invasive-fungal-infections

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Section: Discussionsupporting

confidence: 91%

Section: Review Of the Literaturementioning

confidence: 99%

High-dose amphotericin: yay or nay? A case series and literature review

Stover,

Jordan,

Wagner

et al. 2024

DIC

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“…They reported that a 15 mg/kg/day dose was well tolerated and can effectively treat aspergillosis and other filamentous fungal infections [76]. Lorna et al also concluded that a high dose of LAmB (10 mg/kg/day) efficacious and well tolerated in treating IFD in haematology patients [77]. These significant clinical findings have led to the largest AMBITION-cm global trial for HIV-associated cryptococcal meningitis patients in low-resource countries.…”

Section: Amphotericin Bmentioning

confidence: 99%

Recent Clinical Successes in Liposomal Nanomedicines

Gu¹,

Andrews²,

Tian³

2023

IJDDP

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Review Recent Clinical Successes in Liposomal Nanomedicines Wenjie Gu , Gavin P. Andrews , and Yiwei Tian , * School of Pharmacy, Queen’s University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, UK. * Correspondence: y.tian@qub.ac.uk Received: 19 December 2022 Accepted: 26 January 2023 Published: 3 February 2023 Abstract: The intrinsic limitations of cancer therapies promoted the development of safer liposomal nanocarriers capable of better distributing the payload away from normal tissues. Since then, liposomal nanocarriers have been considered the primary drug delivery system for many active pharmaceutical ingredients. These systems are now frequently investigated for the treatment of many infectious diseases. Along with the tremendous progress in the anticancer and antifungal liposomal nanomedicines, we have also gradually realised the difficulties associated with the existing liposomal nanocarrier designs. A better understanding of the nanocarrier-bio interactions may provide a new paradigm in liposomal nanocarrier design and better clinical endpoint efficacy. This short review focuses on the progress and benefits of two market-approved liposomal nanomedicines for cancer and fungal treatments.

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