Abstract
Liposomal amphotericin B (L-AmB), which was developed to reduce side effects, has been shown to have a better safety profile than both the deoxycholate and lipid complex forms of amphotericin B; however, the frequency of major side effects is still unclear. Thus, the aim of the present study was to assess retrospectively the frequency of L-AmB-induced anaemia, thrombocytopenia, nephrotoxicity, hepatotoxicity and hypokalaemia as well as the relationship between daily dose of L-AmB and these side effects. A low red blood cell (RBC) count (post-/pre-treatment) and anaemia were observed in 7 and 10 of 21 adult patients, respectively. Thrombocytopenia was observed in 11 of 19 adult patients. Doses of L-AmB that are estimated to cause side effects of a low RBC count, anaemia and thrombocytopenia with 50% probability are 4.0, 3.3 and 3.0 mg/kg/day, respectively. Nephrotoxicity was observed in 6 of 22 patients. Variations of total bilirubin, γ-glutamyl transpeptidase, aspartate aminotransferase and alanine aminotransferase used as indices of hepatotoxicity were observed in 6, 7, 8 and 8 of 22 patients, respectively. Hypokalaemia was observed in 4 of 9 patients; however, nephrotoxicity, hepatotoxicity and hypokalaemia were not caused in a dose-dependent manner. In conclusion, the present analyses showed that L-AmB dose-dependently induced anaemia and thrombocytopenia in adult patients. It is important to pay attention to causing anaemia and thrombocytopenia when patients are receiving L-AmB at doses of >3.3 mg/kg/day and >3.0 mg/kg/day, respectively.
| Original language | English |
|---|---|
| Pages (from-to) | 417-420 |
| Number of pages | 4 |
| Journal | International Journal of Antimicrobial Agents |
| Volume | 38 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - 2011 Nov |
| Externally published | Yes |
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Keywords
- Anaemia
- Hepatotoxicity
- Hypokalaemia
- Liposomal amphotericin B
- Nephrotoxicity
- Thrombocytopenia
ASJC Scopus subject areas
- Microbiology (medical)
- Infectious Diseases
- Pharmacology (medical)
Cite this
Safety analysis of liposomal amphotericin B in adult patients : Anaemia, thrombocytopenia, nephrotoxicity, hepatotoxicity and hypokalaemia. / Shigemi, Akari; Matsumoto, Kazuaki; Ikawa, Kazuro; Yaji, Keiko; Shimodozono, Yoshihiro; Morikawa, Norifumi; Takeda, Yasuo; Yamada, Katsushi.
In: International Journal of Antimicrobial Agents, Vol. 38, No. 5, 11.2011, p. 417-420.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Safety analysis of liposomal amphotericin B in adult patients
T2 - Anaemia, thrombocytopenia, nephrotoxicity, hepatotoxicity and hypokalaemia
AU - Shigemi, Akari
AU - Matsumoto, Kazuaki
AU - Ikawa, Kazuro
AU - Yaji, Keiko
AU - Shimodozono, Yoshihiro
AU - Morikawa, Norifumi
AU - Takeda, Yasuo
AU - Yamada, Katsushi
PY - 2011/11
Y1 - 2011/11
N2 - Liposomal amphotericin B (L-AmB), which was developed to reduce side effects, has been shown to have a better safety profile than both the deoxycholate and lipid complex forms of amphotericin B; however, the frequency of major side effects is still unclear. Thus, the aim of the present study was to assess retrospectively the frequency of L-AmB-induced anaemia, thrombocytopenia, nephrotoxicity, hepatotoxicity and hypokalaemia as well as the relationship between daily dose of L-AmB and these side effects. A low red blood cell (RBC) count (post-/pre-treatment) and anaemia were observed in 7 and 10 of 21 adult patients, respectively. Thrombocytopenia was observed in 11 of 19 adult patients. Doses of L-AmB that are estimated to cause side effects of a low RBC count, anaemia and thrombocytopenia with 50% probability are 4.0, 3.3 and 3.0 mg/kg/day, respectively. Nephrotoxicity was observed in 6 of 22 patients. Variations of total bilirubin, γ-glutamyl transpeptidase, aspartate aminotransferase and alanine aminotransferase used as indices of hepatotoxicity were observed in 6, 7, 8 and 8 of 22 patients, respectively. Hypokalaemia was observed in 4 of 9 patients; however, nephrotoxicity, hepatotoxicity and hypokalaemia were not caused in a dose-dependent manner. In conclusion, the present analyses showed that L-AmB dose-dependently induced anaemia and thrombocytopenia in adult patients. It is important to pay attention to causing anaemia and thrombocytopenia when patients are receiving L-AmB at doses of >3.3 mg/kg/day and >3.0 mg/kg/day, respectively.
AB - Liposomal amphotericin B (L-AmB), which was developed to reduce side effects, has been shown to have a better safety profile than both the deoxycholate and lipid complex forms of amphotericin B; however, the frequency of major side effects is still unclear. Thus, the aim of the present study was to assess retrospectively the frequency of L-AmB-induced anaemia, thrombocytopenia, nephrotoxicity, hepatotoxicity and hypokalaemia as well as the relationship between daily dose of L-AmB and these side effects. A low red blood cell (RBC) count (post-/pre-treatment) and anaemia were observed in 7 and 10 of 21 adult patients, respectively. Thrombocytopenia was observed in 11 of 19 adult patients. Doses of L-AmB that are estimated to cause side effects of a low RBC count, anaemia and thrombocytopenia with 50% probability are 4.0, 3.3 and 3.0 mg/kg/day, respectively. Nephrotoxicity was observed in 6 of 22 patients. Variations of total bilirubin, γ-glutamyl transpeptidase, aspartate aminotransferase and alanine aminotransferase used as indices of hepatotoxicity were observed in 6, 7, 8 and 8 of 22 patients, respectively. Hypokalaemia was observed in 4 of 9 patients; however, nephrotoxicity, hepatotoxicity and hypokalaemia were not caused in a dose-dependent manner. In conclusion, the present analyses showed that L-AmB dose-dependently induced anaemia and thrombocytopenia in adult patients. It is important to pay attention to causing anaemia and thrombocytopenia when patients are receiving L-AmB at doses of >3.3 mg/kg/day and >3.0 mg/kg/day, respectively.
KW - Anaemia
KW - Hepatotoxicity
KW - Hypokalaemia
KW - Liposomal amphotericin B
KW - Nephrotoxicity
KW - Thrombocytopenia
UR - http://www.scopus.com/inward/record.url?scp=80053367981&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=80053367981&partnerID=8YFLogxK
U2 - 10.1016/j.ijantimicag.2011.07.004
DO - 10.1016/j.ijantimicag.2011.07.004
M3 - Article
C2 - 21885259
AN - SCOPUS:80053367981
VL - 38
SP - 417
EP - 420
JO - International Journal of Antimicrobial Agents
JF - International Journal of Antimicrobial Agents
SN - 0924-8579
IS - 5
ER -