A randomized, double-blind comparative trial evaluating the safety of liposomal amphotericin B versus amphotericin B lipid complex in the empirical treatment of febrile neutropenia
Jr. Wingard et al., A randomized, double-blind comparative trial evaluating the safety of liposomal amphotericin B versus amphotericin B lipid complex in the empirical treatment of febrile neutropenia, CLIN INF D, 31(5), 2000, pp. 1155-1163
In this double-blind study to compare safety of 2 lipid formulations of amp
hotericin B, neutropenic patients with unresolved fever after 3 days of ant
ibacterial therapy were randomized (1:1:1) to receive amphotericin B lipid
complex (ABLC) at a dose of 5 mg/kg/d (n = 78), liposomal amphotericin B CL
Amph) at a dose of 3 mg/kg/d (n = 85), or L Amph at a dose of 5 mg/kg/d (n
= 81). L Amph (3 mg/kg/d and 5 mg/kg/d) had lower rates of fever (23.5% an
d 19.8% vs. 57.7% on day 1; P<.001), chills/rigors (18.8% and 23.5% vs. 79.
5% on day 1; P<.001), nephrotoxicity (14.1% and 14.8% vs. 42.3%; P<.01), an
d toxicity-related discontinuations of therapy (12.9% and 12.3% vs. 32.1%;
P =.004). After day 1, infusional reactions were less frequent with ABLC, b
ut chills/rigors were still higher (21.0% and 24.3% vs. 50.7%; P<.001). The
rapeutic success was similar in all 3 groups.