Amphotericin B Lipid Complex Compared with Amphotericin B in the Treatment of Cryptococcal Meningitis in Patients with AIDS
The study objective was to obtain preliminary information regarding the safety and efficacy of amphotericin B (AmB) lipid complex (ABLC) in the treatment of AIDS-associated cryptococcal meningitis. Of 55 patients randomly assigned to 6 weeks of therapy with ABLC (1.2-5.0 mg/[kg·d], with ascending do...
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| Veröffentlicht in: | Clinical infectious diseases 1996-02, Vol.22 (2), p.315-321 |
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| creator | Patricia K. Sharkey John R. Graybill Johnson, Edward S. Stephen G. Hausrath Richard B. Pollard Antonia Kolokathis Mildvan, Donna Patty Fan-Havard Robert H. K. Eng Patterson, Thomas F. John C. Pottage, Jr Michael S. Simberkoff Wolf, Judith Meyer, Richard D. Renu Gupta Lily W. Lee David S. Gordon |
| description | The study objective was to obtain preliminary information regarding the safety and efficacy of amphotericin B (AmB) lipid complex (ABLC) in the treatment of AIDS-associated cryptococcal meningitis. Of 55 patients randomly assigned to 6 weeks of therapy with ABLC (1.2-5.0 mg/[kg·d], with ascending doses for three sequential cohorts) or AmB (0.7-1.2 mg/[kg·d]), 46 received ≥ 12 doses. Transfusion requirements, mean decreases in hemoglobin level, and mean increases in creatinine level were significantly greater with AmB than with ABLC. The total number of adverse events, infusion-related events, and occurrences of hypomagnesemia and hypokalemia associated with each form of therapy were similar. Among 21 recipients of ABLC at a dosage of 5 mg/kg (daily for 2 weeks and then thrice weekly for 4 weeks), symptoms and signs resolved for 18 (86%). Of those receiving ≥ 12 doses of ABLC, cultures converted to negative for 8 (42%), were undeterminable for 3 (16%), and remained positive for 8 (42%) despite resolution of symptoms. Although preliminary, these data suggest ABLC has significant activity in patients with AIDS-associated cryptococcal meningitis. Because this formulation has less hematologic and renal toxicity than does AmB, further evaluation of ABLC is warranted. |
| format | Article |
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Sharkey ; John R. Graybill ; Johnson, Edward S. ; Stephen G. Hausrath ; Richard B. Pollard ; Antonia Kolokathis ; Mildvan, Donna ; Patty Fan-Havard ; Robert H. K. Eng ; Patterson, Thomas F. ; John C. Pottage, Jr ; Michael S. Simberkoff ; Wolf, Judith ; Meyer, Richard D. ; Renu Gupta ; Lily W. Lee ; David S. Gordon</creator><creatorcontrib>Patricia K. Sharkey ; John R. Graybill ; Johnson, Edward S. ; Stephen G. Hausrath ; Richard B. Pollard ; Antonia Kolokathis ; Mildvan, Donna ; Patty Fan-Havard ; Robert H. K. Eng ; Patterson, Thomas F. ; John C. Pottage, Jr ; Michael S. Simberkoff ; Wolf, Judith ; Meyer, Richard D. ; Renu Gupta ; Lily W. Lee ; David S. Gordon</creatorcontrib><description>The study objective was to obtain preliminary information regarding the safety and efficacy of amphotericin B (AmB) lipid complex (ABLC) in the treatment of AIDS-associated cryptococcal meningitis. Of 55 patients randomly assigned to 6 weeks of therapy with ABLC (1.2-5.0 mg/[kg·d], with ascending doses for three sequential cohorts) or AmB (0.7-1.2 mg/[kg·d]), 46 received ≥ 12 doses. Transfusion requirements, mean decreases in hemoglobin level, and mean increases in creatinine level were significantly greater with AmB than with ABLC. The total number of adverse events, infusion-related events, and occurrences of hypomagnesemia and hypokalemia associated with each form of therapy were similar. Among 21 recipients of ABLC at a dosage of 5 mg/kg (daily for 2 weeks and then thrice weekly for 4 weeks), symptoms and signs resolved for 18 (86%). Of those receiving ≥ 12 doses of ABLC, cultures converted to negative for 8 (42%), were undeterminable for 3 (16%), and remained positive for 8 (42%) despite resolution of symptoms. Although preliminary, these data suggest ABLC has significant activity in patients with AIDS-associated cryptococcal meningitis. Because this formulation has less hematologic and renal toxicity than does AmB, further evaluation of ABLC is warranted.</description><identifier>ISSN: 1058-4838</identifier><identifier>EISSN: 1537-6591</identifier><identifier>PMID: 8838189</identifier><identifier>CODEN: CIDIEL</identifier><language>eng</language><publisher>Chicago, IL: University of Chicago Press</publisher><subject>Adult ; AIDS ; AIDS-Related Opportunistic Infections - drug therapy ; Amphotericin B - administration & dosage ; Amphotericin B - adverse effects ; Amphotericin B - therapeutic use ; Antibiotics. Antiinfectious agents. Antiparasitic agents ; Antifungal agents ; Antifungal Agents - administration & dosage ; Antifungal Agents - adverse effects ; Antifungal Agents - therapeutic use ; Biological and medical sciences ; Clinical Articles ; Cohort Studies ; Cryptococcal meningitis ; Cryptococcus ; Dosage ; Drug Combinations ; Female ; Fungal infections ; Hemoglobins ; Humans ; Lipids ; Liposomes ; Male ; Medical sciences ; Medical treatment ; Meningitis, Cryptococcal - drug therapy ; Middle Aged ; Mycology ; Pharmacology. Drug treatments ; Phosphatidylcholines - administration & dosage ; Phosphatidylcholines - adverse effects ; Phosphatidylcholines - therapeutic use ; Phosphatidylglycerols - administration & dosage ; Phosphatidylglycerols - adverse effects ; Phosphatidylglycerols - therapeutic use ; Symptoms</subject><ispartof>Clinical infectious diseases, 1996-02, Vol.22 (2), p.315-321</ispartof><rights>Copyright 1996 The University of Chicago</rights><rights>1996 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/4459236$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/4459236$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>314,777,781,800,57998,58231</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2994487$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8838189$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Patricia K. Sharkey</creatorcontrib><creatorcontrib>John R. Graybill</creatorcontrib><creatorcontrib>Johnson, Edward S.</creatorcontrib><creatorcontrib>Stephen G. Hausrath</creatorcontrib><creatorcontrib>Richard B. Pollard</creatorcontrib><creatorcontrib>Antonia Kolokathis</creatorcontrib><creatorcontrib>Mildvan, Donna</creatorcontrib><creatorcontrib>Patty Fan-Havard</creatorcontrib><creatorcontrib>Robert H. K. Eng</creatorcontrib><creatorcontrib>Patterson, Thomas F.</creatorcontrib><creatorcontrib>John C. Pottage, Jr</creatorcontrib><creatorcontrib>Michael S. Simberkoff</creatorcontrib><creatorcontrib>Wolf, Judith</creatorcontrib><creatorcontrib>Meyer, Richard D.</creatorcontrib><creatorcontrib>Renu Gupta</creatorcontrib><creatorcontrib>Lily W. Lee</creatorcontrib><creatorcontrib>David S. Gordon</creatorcontrib><title>Amphotericin B Lipid Complex Compared with Amphotericin B in the Treatment of Cryptococcal Meningitis in Patients with AIDS</title><title>Clinical infectious diseases</title><addtitle>Clin Infect Dis</addtitle><description>The study objective was to obtain preliminary information regarding the safety and efficacy of amphotericin B (AmB) lipid complex (ABLC) in the treatment of AIDS-associated cryptococcal meningitis. Of 55 patients randomly assigned to 6 weeks of therapy with ABLC (1.2-5.0 mg/[kg·d], with ascending doses for three sequential cohorts) or AmB (0.7-1.2 mg/[kg·d]), 46 received ≥ 12 doses. Transfusion requirements, mean decreases in hemoglobin level, and mean increases in creatinine level were significantly greater with AmB than with ABLC. The total number of adverse events, infusion-related events, and occurrences of hypomagnesemia and hypokalemia associated with each form of therapy were similar. Among 21 recipients of ABLC at a dosage of 5 mg/kg (daily for 2 weeks and then thrice weekly for 4 weeks), symptoms and signs resolved for 18 (86%). Of those receiving ≥ 12 doses of ABLC, cultures converted to negative for 8 (42%), were undeterminable for 3 (16%), and remained positive for 8 (42%) despite resolution of symptoms. Although preliminary, these data suggest ABLC has significant activity in patients with AIDS-associated cryptococcal meningitis. Because this formulation has less hematologic and renal toxicity than does AmB, further evaluation of ABLC is warranted.</description><subject>Adult</subject><subject>AIDS</subject><subject>AIDS-Related Opportunistic Infections - drug therapy</subject><subject>Amphotericin B - administration & dosage</subject><subject>Amphotericin B - adverse effects</subject><subject>Amphotericin B - therapeutic use</subject><subject>Antibiotics. Antiinfectious agents. Antiparasitic agents</subject><subject>Antifungal agents</subject><subject>Antifungal Agents - administration & dosage</subject><subject>Antifungal Agents - adverse effects</subject><subject>Antifungal Agents - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Clinical Articles</subject><subject>Cohort Studies</subject><subject>Cryptococcal meningitis</subject><subject>Cryptococcus</subject><subject>Dosage</subject><subject>Drug Combinations</subject><subject>Female</subject><subject>Fungal infections</subject><subject>Hemoglobins</subject><subject>Humans</subject><subject>Lipids</subject><subject>Liposomes</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medical treatment</subject><subject>Meningitis, Cryptococcal - drug therapy</subject><subject>Middle Aged</subject><subject>Mycology</subject><subject>Pharmacology. 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Sharkey</creator><creator>John R. Graybill</creator><creator>Johnson, Edward S.</creator><creator>Stephen G. Hausrath</creator><creator>Richard B. Pollard</creator><creator>Antonia Kolokathis</creator><creator>Mildvan, Donna</creator><creator>Patty Fan-Havard</creator><creator>Robert H. K. Eng</creator><creator>Patterson, Thomas F.</creator><creator>John C. Pottage, Jr</creator><creator>Michael S. Simberkoff</creator><creator>Wolf, Judith</creator><creator>Meyer, Richard D.</creator><creator>Renu Gupta</creator><creator>Lily W. Lee</creator><creator>David S. Gordon</creator><general>University of Chicago Press</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>M7N</scope></search><sort><creationdate>19960201</creationdate><title>Amphotericin B Lipid Complex Compared with Amphotericin B in the Treatment of Cryptococcal Meningitis in Patients with AIDS</title><author>Patricia K. Sharkey ; John R. Graybill ; Johnson, Edward S. ; Stephen G. Hausrath ; Richard B. Pollard ; Antonia Kolokathis ; Mildvan, Donna ; Patty Fan-Havard ; Robert H. K. Eng ; Patterson, Thomas F. ; John C. Pottage, Jr ; Michael S. Simberkoff ; Wolf, Judith ; Meyer, Richard D. ; Renu Gupta ; Lily W. Lee ; David S. Gordon</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-j287t-269d8b0e2c93504b443c320f9cb6124443c6ba3cddbb579852d6ba047fd1ef23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1996</creationdate><topic>Adult</topic><topic>AIDS</topic><topic>AIDS-Related Opportunistic Infections - drug therapy</topic><topic>Amphotericin B - administration & dosage</topic><topic>Amphotericin B - adverse effects</topic><topic>Amphotericin B - therapeutic use</topic><topic>Antibiotics. Antiinfectious agents. Antiparasitic agents</topic><topic>Antifungal agents</topic><topic>Antifungal Agents - administration & dosage</topic><topic>Antifungal Agents - adverse effects</topic><topic>Antifungal Agents - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Clinical Articles</topic><topic>Cohort Studies</topic><topic>Cryptococcal meningitis</topic><topic>Cryptococcus</topic><topic>Dosage</topic><topic>Drug Combinations</topic><topic>Female</topic><topic>Fungal infections</topic><topic>Hemoglobins</topic><topic>Humans</topic><topic>Lipids</topic><topic>Liposomes</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medical treatment</topic><topic>Meningitis, Cryptococcal - drug therapy</topic><topic>Middle Aged</topic><topic>Mycology</topic><topic>Pharmacology. 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Pollard</au><au>Antonia Kolokathis</au><au>Mildvan, Donna</au><au>Patty Fan-Havard</au><au>Robert H. K. Eng</au><au>Patterson, Thomas F.</au><au>John C. Pottage, Jr</au><au>Michael S. Simberkoff</au><au>Wolf, Judith</au><au>Meyer, Richard D.</au><au>Renu Gupta</au><au>Lily W. Lee</au><au>David S. Gordon</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Amphotericin B Lipid Complex Compared with Amphotericin B in the Treatment of Cryptococcal Meningitis in Patients with AIDS</atitle><jtitle>Clinical infectious diseases</jtitle><addtitle>Clin Infect Dis</addtitle><date>1996-02-01</date><risdate>1996</risdate><volume>22</volume><issue>2</issue><spage>315</spage><epage>321</epage><pages>315-321</pages><issn>1058-4838</issn><eissn>1537-6591</eissn><coden>CIDIEL</coden><abstract>The study objective was to obtain preliminary information regarding the safety and efficacy of amphotericin B (AmB) lipid complex (ABLC) in the treatment of AIDS-associated cryptococcal meningitis. Of 55 patients randomly assigned to 6 weeks of therapy with ABLC (1.2-5.0 mg/[kg·d], with ascending doses for three sequential cohorts) or AmB (0.7-1.2 mg/[kg·d]), 46 received ≥ 12 doses. Transfusion requirements, mean decreases in hemoglobin level, and mean increases in creatinine level were significantly greater with AmB than with ABLC. The total number of adverse events, infusion-related events, and occurrences of hypomagnesemia and hypokalemia associated with each form of therapy were similar. Among 21 recipients of ABLC at a dosage of 5 mg/kg (daily for 2 weeks and then thrice weekly for 4 weeks), symptoms and signs resolved for 18 (86%). Of those receiving ≥ 12 doses of ABLC, cultures converted to negative for 8 (42%), were undeterminable for 3 (16%), and remained positive for 8 (42%) despite resolution of symptoms. Although preliminary, these data suggest ABLC has significant activity in patients with AIDS-associated cryptococcal meningitis. Because this formulation has less hematologic and renal toxicity than does AmB, further evaluation of ABLC is warranted.</abstract><cop>Chicago, IL</cop><pub>University of Chicago Press</pub><pmid>8838189</pmid><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1058-4838 |
| ispartof | Clinical infectious diseases, 1996-02, Vol.22 (2), p.315-321 |
| issn | 1058-4838 1537-6591 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_15572673 |
| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Jstor Complete Legacy; Oxford University Press Journals All Titles (1996-Current) |
| subjects | Adult AIDS AIDS-Related Opportunistic Infections - drug therapy Amphotericin B - administration & dosage Amphotericin B - adverse effects Amphotericin B - therapeutic use Antibiotics. Antiinfectious agents. Antiparasitic agents Antifungal agents Antifungal Agents - administration & dosage Antifungal Agents - adverse effects Antifungal Agents - therapeutic use Biological and medical sciences Clinical Articles Cohort Studies Cryptococcal meningitis Cryptococcus Dosage Drug Combinations Female Fungal infections Hemoglobins Humans Lipids Liposomes Male Medical sciences Medical treatment Meningitis, Cryptococcal - drug therapy Middle Aged Mycology Pharmacology. Drug treatments Phosphatidylcholines - administration & dosage Phosphatidylcholines - adverse effects Phosphatidylcholines - therapeutic use Phosphatidylglycerols - administration & dosage Phosphatidylglycerols - adverse effects Phosphatidylglycerols - therapeutic use Symptoms |
| title | Amphotericin B Lipid Complex Compared with Amphotericin B in the Treatment of Cryptococcal Meningitis in Patients with AIDS |
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