Efficacy and safety of amphotericin B lipid-based formulations—A systematic review and meta-analysis

Steimbach, LM; Tonin, FS; Virtuoso, S; Borba, HHL; Sanches, ACC; Wiens, A; Fernandez-Llimós, F; Pontarolo, R

Efficacy and safety of amphotericin B lipid-based formulations—A systematic review and meta-analysis

Steimbach, LM Tonin, FS Virtuoso, S Borba, HHL Sanches, ACC Wiens, A Fernandez-Llimós, F

Pontarolo, R

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Publication Type:: Journal Article
Citation:: Mycoses, 2017, 60 (3), pp. 146 - 154
Issue Date:: 2017-03-01

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Field	Value	Language
dc.contributor.author	Steimbach, LM	en_US
dc.contributor.author	Tonin, FS	en_US
dc.contributor.author	Virtuoso, S	en_US
dc.contributor.author	Borba, HHL	en_US
dc.contributor.author	Sanches, ACC	en_US
dc.contributor.author	Wiens, A	en_US
dc.contributor.author	Fernandez-Llimós, F https://orcid.org/0000-0002-8529-9595	en_US
dc.contributor.author	Pontarolo, R	en_US
dc.date.available	2016-10-22	en_US
dc.date.issued	2017-03-01	en_US
dc.identifier.citation	Mycoses, 2017, 60 (3), pp. 146 - 154	en_US
dc.identifier.issn	0933-7407	en_US
dc.identifier.uri	http://hdl.handle.net/10453/124568
dc.description.abstract	© 2016 Blackwell Verlag GmbH Invasive fungal infections, an important cause of mortality, are primarily treated using amphotericin B, which is available in different formulations, both conventional and lipid-based (liposomal, lipid complex, colloidal dispersion and Intralipid® infusion). The aim of our study was to determine the efficacy and safety of conventional amphotericin B vs its lipid-based formulations. A systematic review followed by pairwise meta-analysis was performed, including randomised controlled trials (RCTs) that evaluated the use of lipid-based amphotericin B in patients with any degree of immunosuppression and susceptibility to invasive fungal infection. An electronic search was conducted using PubMed, Scopus, Web of Science and Scielo databases. Extracted outcomes were related to efficacy (cure) and safety (incidence of adverse events). Results were evaluated and meta-analyses were performed. Twenty-three RCTs were identified (n=2677 participants) for meta-analysis. No significant differences between conventional amphotericin B and any of the five formulations evaluated were observed, with regard to the efficacy analysis. With respect to the adverse events of nephrotoxicity, fever, chills and vomiting, all lipid formulations presented better profiles than the conventional formulation. The present systematic review and meta-analysis showed that conventional amphotericin B presents the same efficacy profile as lipid-based formulations, although the latter were associated with a safer profile.	en_US
dc.relation.ispartof	Mycoses	en_US
dc.relation.isbasedon	10.1111/myc.12585	en_US
dc.subject.classification	Microbiology	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Fever	en_US
dc.subject.mesh	Amphotericin B	en_US
dc.subject.mesh	Lipids	en_US
dc.subject.mesh	Soybean Oil	en_US
dc.subject.mesh	Phospholipids	en_US
dc.subject.mesh	Colloids	en_US
dc.subject.mesh	Emulsions	en_US
dc.subject.mesh	Antifungal Agents	en_US
dc.subject.mesh	Drug Compounding	en_US
dc.subject.mesh	Clinical Trials as Topic	en_US
dc.subject.mesh	Invasive Fungal Infections	en_US
dc.title	Efficacy and safety of amphotericin B lipid-based formulations—A systematic review and meta-analysis	en_US
dc.type	Journal Article
utslib.citation.volume	3	en_US
utslib.citation.volume	60	en_US
utslib.for	1103 Clinical Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Graduate School of Health
utslib.copyright.status	closed_access
pubs.issue	3	en_US
pubs.publication-status	Published	en_US
pubs.volume	60	en_US

Abstract:

© 2016 Blackwell Verlag GmbH Invasive fungal infections, an important cause of mortality, are primarily treated using amphotericin B, which is available in different formulations, both conventional and lipid-based (liposomal, lipid complex, colloidal dispersion and Intralipid® infusion). The aim of our study was to determine the efficacy and safety of conventional amphotericin B vs its lipid-based formulations. A systematic review followed by pairwise meta-analysis was performed, including randomised controlled trials (RCTs) that evaluated the use of lipid-based amphotericin B in patients with any degree of immunosuppression and susceptibility to invasive fungal infection. An electronic search was conducted using PubMed, Scopus, Web of Science and Scielo databases. Extracted outcomes were related to efficacy (cure) and safety (incidence of adverse events). Results were evaluated and meta-analyses were performed. Twenty-three RCTs were identified (n=2677 participants) for meta-analysis. No significant differences between conventional amphotericin B and any of the five formulations evaluated were observed, with regard to the efficacy analysis. With respect to the adverse events of nephrotoxicity, fever, chills and vomiting, all lipid formulations presented better profiles than the conventional formulation. The present systematic review and meta-analysis showed that conventional amphotericin B presents the same efficacy profile as lipid-based formulations, although the latter were associated with a safer profile.

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http://hdl.handle.net/10453/124568