New Agents for Treatment of Invasive Aspergillosis

this disease. This approach has left unanswered major questions regarding the efficacy of new agents, including lipid formulations of AmB, especially with regard to their use as primary therapy for this often lethal disease. Given this background, it is easy to see that Bowden et al. [5] should be congratulated on the completion of a randomized trial in which a lipid formulation of AmB (amphotericin B colloidal dispersion [ABCD]; Amphotec) was compared with AmB for use as primary therapy for invasive aspergillosis. The primary end point of efficacy in the study was assessed by use of an evaluable patient population who met the following criteria: diagnosis of proved or probable invasive aspergillosis and receipt of therapy for 17 days. In addition, successful responses to therapy were classified as complete response, partial response, or stable disease. By use of these parameters, successful responses occurred in 26 (52%) of 50 patients who received ABCD, 6 mg/kg/day, compared with 27 (51%) of 53 patients who received AmB. In addition, toxicity rates that required study drug discontinuation were similar in the 2 treatment groups (22% for the ABCD group vs. 24% for the AmB group). Of note, less nephrotoxicity was seen with the use of the lipid formulation, although greater infusional toxicities also