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Comparative study on liposomal amphotericin B and other therapies in the treatment of mucosal leishmaniasis: A 15-year retrospective cohort study

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Date
2019-06
Author
Santos, Carolina Rocio
Author
Tuon, Felipe Francisco
Author
Cieslinski, Juliette
Author
Souza, Regina Maia de
Author
Imamura, Rui
Author
Amato, Valdir Sabbaga
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Abstract
BACKGROUND: Liposomal amphotericin B (L-AMB) has been used for mucosal leishmaniasis (ML), but comparative studies on L-AMB and other drugs used for the treatment of ML have not been conducted. The present study aimed to evaluate the outcome of patients with ML who were treated with L-AMB. METHODS: This is a 15-year retrospective study of Brazilian patients with a confirmed diagnosis of ML. The therapeutic options for the treatment of ML consisted of L-AMB, amphotericin B lipid complex (ABLC), deoxycholate amphotericin B (d-AMB), itraconazole, antimonial pentavalent, or pentamidine. Healing, cure rate and adverse effects (AEs) associated with the drugs used to treat this condition were analyzed. RESULTS: In 71 patients, a total of 105 treatments were evaluated. The outcome of the treatment with each drug was compared, and results showed that L-AMB was superior to other therapeutic regimens (P = 0.001; odds ratio [OR] = 4.84; 95% confidence interval [CI] = 1.78–13.17). d-AMB had worse AEs than other treatment regimens (P = 0.001, OR = 0.09; 95% CI = 0.09–0.43). Approximately 66% of the patients presented with AEs during ML treatment. Although L-AMB was less nephrotoxic than d-AMB, it was associated with acute kidney injury compared with other drugs (P <0.05). CONCLUSION: L-AMB was more effective than other therapies for the treatment of ML. However, a high incidence of toxicity was associated with its use. Therapeutic choices should be reassessed, and the development of new drugs is necessary for the treatment of ML.
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PLoS One. 2019 Jun 26;14(6):e0218786. doi: 10.1371/journal.pone.0218786.
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https://doi.org/10.1371/journal.pone.0218786
Subject
Acute Kidney Injury
 
Amphotericin B
 
Antimony
 
Antiprotozoal Agents
 
Cohort Studies
 
Deoxycholic Acid
 
Itraconazole
 
Leishmaniasis, Mucocutaneous
 
Liposomes
 
Pentamidine
 
Retrospective Studies
 
URI
http://digital.bibliotecaorl.org.br/handle/forl/425
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Contact Us | Send Feedback

Divisão de Biblioteca e Documentação do Departamento
de Otorrinolaringologia da Faculdade de Medicina USP

Rua Artur de Azevedo, 46 CEP: 05404-000 São Paulo/SP - Brasil

Tel: (11) 3062-4097 Email: biblioteca@forl.org.br

Medicina USPFORL
Desenvolvido por Logo DGL Sistemas