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Efficacy and safety of amphotericin B lipid‐based formulations—A systematic review and meta‐analysis
Author(s) -
Steimbach Laiza M.,
Tonin Fernanda S.,
Virtuoso Suzane,
Borba Helena H. L.,
Sanches Andréia C. C.,
Wiens Astrid,
FernandezLlimós Fernando,
Pontarolo Roberto
Publication year - 2017
Publication title -
mycoses
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.13
H-Index - 69
eISSN - 1439-0507
pISSN - 0933-7407
DOI - 10.1111/myc.12585
Subject(s) - amphotericin b , meta analysis , adverse effect , medicine , amphotericin b deoxycholate , nephrotoxicity , web of science , chills , pharmacology , antifungal , dermatology , toxicity , caspofungin
Summary 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 ( RCT s) 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 RCT s 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.