MCTAGGART B, MCKECHNIE M, GIN A, BOMBASSARO A, LUI E, CARLE S; Interscience Conference on Antimicrobial Agents and Chemotherapy (43rd: 2003: Chicago, Ill.).
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2003 Sep 14-17; 43: abstract no. M-965.
Hamilton Health Sci., Hamilton, ON, Canada.
BACKGROUND: There are currently two lipid formulations of amphotericin B in widespread use in Canada, amphotericin B lipid complex (ABLC, Abelcet) and liposomal AmB (L-AmB, Ambisome). These products have been shown to have less nephrotoxicity than amphotericin B deoxycholate. There is limited data comparing the nephrotoxic effects of these two lipid formulations. We compared the effects of these agents on renal function when used in routine practice in patients with hematological malignancy. METHODS: Retrospective data was collected at 12 tertiary care and 1 community hospital in Canada. Patients 2 years of age or older, who received a minimum of 4 doses of ABLC or L-AmB were eligible. The primary end point was the change from baseline to peak creatinine. RESULTS: 103 patients received ABLC and 62 received L-AmB. Patients were well matched in terms of underlying malignancy, neutropenic status, and concomitant nephrotoxins. 40.8%(ABLC) and 37.1%(L-AmB) of patients had undergone bone marrow transplantation. The mean change from baseline creatinine to peak creatinine was 46.5umol/L with ABLC and 41.3 with L-AmB (NS). The mean change from baseline to end of therapy was 9.8 for ABLC and 8.6 for L-AmB (NS). The percentage of patients experiencing an increase in creatinine of 1.5, 2 or 3 times baseline was 32 vs 32.3, 15.5 vs 17.7, and 1.9 vs 4.8 with ABLC and L-AmB respectively (NS). 1 pt in each arm required dialysis. CONCLUSIONS: No significant difference in nephrotoxicity was observed between ABLC and L-AmB when used in routine Canadian practice suggesting that selection of lipid formulation should be based on factors other than nephrotoxicity. Additional prospective trials in patients with hematological malignancy receiving usual clinical care are needed to confirm our findings.
Publication Types:
Keywords:
- Abelcet
- AmBisome
- Amphotericin B
- Canada
- Case-Control Studies
- Chemistry, Pharmaceutical
- Creatinine
- Deoxycholic Acid
- Drug Combinations
- Humans
- Lipids
- Liposomes
- Longitudinal Studies
- Phosphatidylcholines
- Phosphatidylglycerols
- amphotericin B-deoxycholate
Other ID:
UI: 102264868
From Meeting Abstracts