Goldsmith David R, Perry Caroline M
Adis International Limited, Auckland, New Zealand.
Drugs. 2004;64(17):1905-11; discussion 1912-3. doi: 10.2165/00003495-200464170-00004.
Amphotericin B lipid complex is a lipid formulation of amphotericin B, an antifungal drug with activity against Leishmania spp. Amphotericin B lipid complex appears to enhance uptake of amphotericin B by infected macrophages in patients with visceral leishmaniasis (VL). In randomised, open-label, dose-ranging studies, short-course treatment with once-daily amphotericin B lipid complex (5-15 mg/kg total cumulative dose over 5 days), administered by intravenous infusion, produced high rates of apparent (day 19) [93-100%] and definitive (6 months) [79-100%] cures in Indian patients with antimonial-resistant VL. Amphotericin B lipid complex appeared to be as effective as liposomal amphotericin B or the conventional deoxycholate formulation in a randomised, open-label study conducted in India in a mixed population of patients with previously untreated or antimonial-resistant VL. In patients with HIV infection and VL, amphotericin B lipid complex 3 mg/kg/day for 5 or 10 days appeared to be as effective as meglumine antimonate 20 mg/kg/day for 28 days in a small randomised pilot study in southern Europe. Amphotericin B lipid complex was generally well tolerated in patients with VL. Infusion-related reactions were the most common adverse events associated with amphotericin B lipid complex.
两性霉素B脂质复合物是两性霉素B的一种脂质制剂,两性霉素B是一种对利什曼原虫属有活性的抗真菌药物。两性霉素B脂质复合物似乎可增强内脏利什曼病(VL)患者中受感染巨噬细胞对两性霉素B的摄取。在随机、开放标签、剂量范围研究中,对印度锑剂耐药的VL患者进行短疗程治疗,每日一次静脉输注两性霉素B脂质复合物(5天内总累积剂量为5 - 15mg/kg),产生了较高的表观治愈率(第19天)[93 - 100%]和确定治愈率(6个月)[79 - 100%]。在印度对未经治疗或锑剂耐药的VL患者混合人群进行的一项随机、开放标签研究中,两性霉素B脂质复合物似乎与脂质体两性霉素B或传统脱氧胆酸盐制剂一样有效。在欧洲南部的一项小型随机试验研究中,对于HIV感染合并VL的患者,两性霉素B脂质复合物3mg/kg/天,持续5或10天,似乎与葡甲胺锑酸盐20mg/kg/天,持续28天一样有效。两性霉素B脂质复合物在VL患者中一般耐受性良好。与两性霉素B脂质复合物相关的最常见不良事件是输液相关反应。