Renal effects of amphotericin B lipid complex

Luke, Robert G.; Boyle, James A.

doi:10.1016/s0272-6386(98)70046-0

Cited by 58 publications

(22 citation statements)

References 9 publications

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“…These problems have lessened with the introduction of AMB formulations using lipid carriers or liposome encapsulation, enabling significant progress to be made in the treatment of patients with deep mycoses [2,3,13,16,21,38]. The association with lipids enables larger doses of AMB to be given with a longer duration of effective serum and tissue concentrations of this antifungal, without the toxic effects of AMB deoxycholate at lower concentrations [8,19,25,37]. Liposome-encapsulated AMB's lower affinity for mammalian cells and its improved distribution volume account for its decreased toxicity and greater antifungal efficacy [1,15,23].…”

Section: Introductionmentioning

confidence: 99%

Comparative in vitro Antifungal Activity of Amphotericin B Lipid Complex, Amphotericin B and Fluconazole

Carrillo-Muñoz¹,

Quindós

Tur³

et al. 2000

Chemotherapy

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Amphotericin B (AMB) is considered the gold standard in the treatment of serious systemic mycoses in spite of its nephrotoxicity and adverse effects. Association with lipids enables larger doses of AMB to be given with a longer t_½ and C_max, without the toxic effects at lower concentrations. Liposome-encapsulated AMB shows a lower affinity for mammalian cells and improves V_d, thus decreasing toxicity. Amphotericin B lipid complex (ABLC) is an AMB formulation associated with a biodegradable phospholipid matrix (5% molar) from which the drug is released by cell phospholipases. ABLC is recommended for serious mycoses refractory to conventional antifungal therapy or when AMB is contraindicated. We compared the in vitro antifungal activity of ABLC, AMB and fluconazole (FLZ) against 328 strains of clinically significant opportunistic fungi using a microdilution method (NCCLS, M-27A). 64.9% of the yeasts were inhibited by MIC of ABLC ≤ AMB resulting in a similar or slightly superior efficacy compared to AMB when tested against Candida albicans, C. glabrata, C. guilliermondii, C. parapsilosis and C. tropicalis. Effectiveness against C. krusei was lower for ABLC (5.99 μg/ml for ABLC, 1.58 μg/ml for AMB). However, for Aspergillus fumigatus, the activities of AMB and ABLC were 1.62 and 2.46 μg/ml, respectively; A. niger 0.72 μg/ml, 0.76 μg/ml (ABLC and AMB, respectively); A. clavatus, A. candidus, A. tenuissima, A. corymbifera and Exophiala jeanselmei, Scedosporium spp. and Miceliophtora spp. showed a low susceptibility to both AMB formulations. ABLC is a useful alternative to AMB or FLZ for the treatment of severe fungal infections, due to the broad spectrum of antifungal actions observed in this study.

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Section: Introductionmentioning

confidence: 99%

Comparative in vitro Antifungal Activity of Amphotericin B Lipid Complex, Amphotericin B and Fluconazole

Carrillo-Muñoz¹,

Quindós

Tur³

et al. 2000

Chemotherapy

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“…These results confirm previous findings that ABLC is superior to AmB in terms of effects on renal function. 20,21 There was no antagonism between antifungal agents when ABLC was started concomitantly with, or sequentially after, itraconazole therapy. 22 Interestingly however, none of seven patients responded when itraconazole was continued after ABLC was started.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of amphotericin B lipid complex (ABLC) treatment in allogeneic hematopoietic cell transplant (HCT) recipients with invasive aspergillosis (IA)

Ito

Chandrasekar

Hooshmand‐Rad³

2005

Bone Marrow Transplant

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Summary:A total of 85 allogeneic hematopoietic cell transplant (HCT) recipients with invasive aspergillosis treated with amphotericin B lipid complex (ABLC) were identified from the Collaborative Exchange of Antifungal Research (CLEAR) database. Of these patients, 78% (66/85) presented with pulmonary aspergillosis. Graft-versus-host disease (GVHD) was present in 24 of 85 patients. The response rate to ABLC was 31% (26/85) overall and 21% (5/24) in patients with GVHD. The overall response rate to first-line ABLC treatment was 41% (11/27). Four of nine (44%) patients with GVHD responded to first-line treatment with ABLC, while only one of 13 (8%) responded to ABLC as second-line therapy. Five of 18 (28%) and four of 14 (29%) patients, respectively, responded to sequential or concurrent treatment with ABLC and itraconazole. None of seven patients responded who continued receiving itraconazole after the start of ABLC therapy. At the end of ABLC therapy, serum creatinine had doubled in 12% of patients (10/85), and 2% (2/85) had developed a requirement for dialysis. These data suggest that ABLC, especially when administered as first-line therapy, can result in clinical response even in the most immunocompromised patients, that is, HCT recipients with GVHD, with minimal effects on renal function.

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“…Although the new lipid formulations of AmB have a lower frequency of nephrotoxicity in comparison with AmB-DOC, they all exhibit this adverse effect in a considerable number of patients (10,11,12). AmB most likely produces renal injury by a variety of mechanisms; however, the exact nephrotoxic mechanism remains an open question (2,13).…”

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confidence: 99%

Renal Handling of Amphotericin B and Amphotericin B-Deoxycholate and Potential Renal Drug-Drug Interactions with Selected Antivirals

Trejtnar

Mandíková

Kočíncová

et al. 2014

Antimicrob Agents Chemother

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Renal effects of amphotericin B lipid complex

Cited by 58 publications

References 9 publications

Comparative in vitro Antifungal Activity of Amphotericin B Lipid Complex, Amphotericin B and Fluconazole

Comparative in vitro Antifungal Activity of Amphotericin B Lipid Complex, Amphotericin B and Fluconazole

Effectiveness of amphotericin B lipid complex (ABLC) treatment in allogeneic hematopoietic cell transplant (HCT) recipients with invasive aspergillosis (IA)

Renal Handling of Amphotericin B and Amphotericin B-Deoxycholate and Potential Renal Drug-Drug Interactions with Selected Antivirals

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