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The clinical usage of liposomal amphotericin B in patients receiving renal replacement therapy in Japan: a nationwide observational study
BACKGROUND: Liposomal amphotericin B (L-AMB), a broad-spectrum antifungicidal drug, is often used to treat fungal infections. However, clinical evidence of its use in patients with renal dysfunction, especially those receiving renal replacement therapy (RRT), is limited. Therefore, we evaluated the...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Singapore
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7925490/ https://www.ncbi.nlm.nih.gov/pubmed/33179180 http://dx.doi.org/10.1007/s10157-020-01989-3 |
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author | Obata, Yoko Takazono, Takahiro Tashiro, Masato Ota, Yuki Wakamura, Tomotaro Takahashi, Akinori Sato, Kumiko Miyazaki, Taiga Nishino, Tomoya Izumikawa, Koichi |
author_facet | Obata, Yoko Takazono, Takahiro Tashiro, Masato Ota, Yuki Wakamura, Tomotaro Takahashi, Akinori Sato, Kumiko Miyazaki, Taiga Nishino, Tomoya Izumikawa, Koichi |
author_sort | Obata, Yoko |
collection | PubMed |
description | BACKGROUND: Liposomal amphotericin B (L-AMB), a broad-spectrum antifungicidal drug, is often used to treat fungal infections. However, clinical evidence of its use in patients with renal dysfunction, especially those receiving renal replacement therapy (RRT), is limited. Therefore, we evaluated the usage and occurrence of adverse reactions during L-AMB therapy in patients undergoing RRT. METHODS: Using claims data and laboratory data, we retrospectively evaluated patients who were administered L-AMB. The presence of comorbidities, mortality rate, treatment with L-AMB and other anti-infective agents, and the incidence of adverse reactions were compared between patients receiving RRT, including continuous renal replacement therapy (CRRT) and maintenance hemodialysis (HD), and those that did not receive RRT. RESULTS: In total, 900 cases met the eligibility criteria: 24, 19, and 842 cases in the maintenance HD, CRRT, and non-RRT groups, respectively. Of the patients administered L-AMB, mortality at discharge was higher for those undergoing either CRRT (15/19; 79%) or maintenance HD (16/24; 67%) than for those not receiving RRT (353/842; 42%). After propensity score matching, the average daily and cumulative dose, treatment duration, and dosing interval for L-AMB were not significantly different between patients receiving and not receiving RRT. L-AMB was used as the first-line antifungal agent for patients undergoing CRRT in most cases (12/19; 63%). Although the number of subjects was limited, the incidence of adverse events did not markedly differ among the groups. CONCLUSION: L-AMB may be used for patients undergoing maintenance HD or CRRT without any dosing, duration, or interval adjustments. |
format | Online Article Text |
id | pubmed-7925490 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Springer Singapore |
record_format | MEDLINE/PubMed |
spelling | pubmed-79254902021-03-19 The clinical usage of liposomal amphotericin B in patients receiving renal replacement therapy in Japan: a nationwide observational study Obata, Yoko Takazono, Takahiro Tashiro, Masato Ota, Yuki Wakamura, Tomotaro Takahashi, Akinori Sato, Kumiko Miyazaki, Taiga Nishino, Tomoya Izumikawa, Koichi Clin Exp Nephrol Original Article BACKGROUND: Liposomal amphotericin B (L-AMB), a broad-spectrum antifungicidal drug, is often used to treat fungal infections. However, clinical evidence of its use in patients with renal dysfunction, especially those receiving renal replacement therapy (RRT), is limited. Therefore, we evaluated the usage and occurrence of adverse reactions during L-AMB therapy in patients undergoing RRT. METHODS: Using claims data and laboratory data, we retrospectively evaluated patients who were administered L-AMB. The presence of comorbidities, mortality rate, treatment with L-AMB and other anti-infective agents, and the incidence of adverse reactions were compared between patients receiving RRT, including continuous renal replacement therapy (CRRT) and maintenance hemodialysis (HD), and those that did not receive RRT. RESULTS: In total, 900 cases met the eligibility criteria: 24, 19, and 842 cases in the maintenance HD, CRRT, and non-RRT groups, respectively. Of the patients administered L-AMB, mortality at discharge was higher for those undergoing either CRRT (15/19; 79%) or maintenance HD (16/24; 67%) than for those not receiving RRT (353/842; 42%). After propensity score matching, the average daily and cumulative dose, treatment duration, and dosing interval for L-AMB were not significantly different between patients receiving and not receiving RRT. L-AMB was used as the first-line antifungal agent for patients undergoing CRRT in most cases (12/19; 63%). Although the number of subjects was limited, the incidence of adverse events did not markedly differ among the groups. CONCLUSION: L-AMB may be used for patients undergoing maintenance HD or CRRT without any dosing, duration, or interval adjustments. Springer Singapore 2020-11-11 2021 /pmc/articles/PMC7925490/ /pubmed/33179180 http://dx.doi.org/10.1007/s10157-020-01989-3 Text en © The Author(s) 2020, corrected publication 2020 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article Obata, Yoko Takazono, Takahiro Tashiro, Masato Ota, Yuki Wakamura, Tomotaro Takahashi, Akinori Sato, Kumiko Miyazaki, Taiga Nishino, Tomoya Izumikawa, Koichi The clinical usage of liposomal amphotericin B in patients receiving renal replacement therapy in Japan: a nationwide observational study |
title | The clinical usage of liposomal amphotericin B in patients receiving renal replacement therapy in Japan: a nationwide observational study |
title_full | The clinical usage of liposomal amphotericin B in patients receiving renal replacement therapy in Japan: a nationwide observational study |
title_fullStr | The clinical usage of liposomal amphotericin B in patients receiving renal replacement therapy in Japan: a nationwide observational study |
title_full_unstemmed | The clinical usage of liposomal amphotericin B in patients receiving renal replacement therapy in Japan: a nationwide observational study |
title_short | The clinical usage of liposomal amphotericin B in patients receiving renal replacement therapy in Japan: a nationwide observational study |
title_sort | clinical usage of liposomal amphotericin b in patients receiving renal replacement therapy in japan: a nationwide observational study |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7925490/ https://www.ncbi.nlm.nih.gov/pubmed/33179180 http://dx.doi.org/10.1007/s10157-020-01989-3 |
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