PMID- 31242231
OWN - NLM
STAT- MEDLINE
DCOM- 20200224
LR  - 20200309
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 14
IP  - 6
DP  - 2019
TI  - Comparative study on liposomal amphotericin B and other therapies in the 
      treatment of mucosal leishmaniasis: A 15-year retrospective cohort study.
PG  - e0218786
LID - 10.1371/journal.pone.0218786 [doi]
LID - e0218786
AB  - 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.
FAU - Santos, Carolina Rocio
AU  - Santos CR
AD  - Departamento de Molestias Infecciosas e Parasitarias, Faculdade de Medicina, 
      Universidade de Sao Paulo, Sao Paulo, Sao Paulo, Brasil.
FAU - Tuon, Felipe Francisco
AU  - Tuon FF
AD  - School of Medicine, Pontificia Universidade Catolica do Parana, Curitiba, Parana, 
      Brasil.
FAU - Cieslinski, Juliette
AU  - Cieslinski J
AD  - School of Medicine, Pontificia Universidade Catolica do Parana, Curitiba, Parana, 
      Brasil.
FAU - de Souza, Regina Maia
AU  - de Souza RM
AD  - Laboratorio de Parasitologia LIM-46, Instituto de Medicina Tropical, Hospital das 
      Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, 
      Sao Paulo, Brasil.
FAU - Imamura, Rui
AU  - Imamura R
AD  - Departamento de Otorrinolaringologia, Hospital das Clinicas HCFMUSP, Faculdade de 
      Medicina, Universidade de Sao Paulo, Sao Paulo, Sao Paulo, Brasil.
FAU - Amato, Valdir Sabbaga
AU  - Amato VS
AUID- ORCID: 0000-0003-1245-9348
AD  - Departamento de Molestias Infecciosas e Parasitarias, Faculdade de Medicina, 
      Universidade de Sao Paulo, Sao Paulo, Sao Paulo, Brasil.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20190626
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 0 (Antiprotozoal Agents)
RN  - 0 (Drug Combinations)
RN  - 0 (Liposomes)
RN  - 0 (liposomal amphotericin B)
RN  - 005990WHZZ (Deoxycholic Acid)
RN  - 304NUG5GF4 (Itraconazole)
RN  - 673LC5J4LQ (Pentamidine)
RN  - 7XU7A7DROE (Amphotericin B)
RN  - 87687-70-5 (amphotericin B, deoxycholate drug combination)
RN  - 9IT35J3UV3 (Antimony)
SB  - IM
MH  - Acute Kidney Injury/chemically induced
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Amphotericin B/adverse effects/*therapeutic use
MH  - Antimony/adverse effects/therapeutic use
MH  - Antiprotozoal Agents/adverse effects/*therapeutic use
MH  - Brazil
MH  - Cohort Studies
MH  - Deoxycholic Acid/adverse effects/therapeutic use
MH  - Drug Combinations
MH  - Female
MH  - Humans
MH  - Itraconazole/adverse effects/therapeutic use
MH  - *Leishmania braziliensis
MH  - Leishmaniasis, Mucocutaneous/*drug therapy
MH  - Liposomes
MH  - Male
MH  - Middle Aged
MH  - Pentamidine/adverse effects/therapeutic use
MH  - Retrospective Studies
MH  - Treatment Outcome
PMC - PMC6594680
COIS- The authors have declared that no competing interests exist.
EDAT- 2019/06/27 06:00
MHDA- 2020/02/25 06:00
PMCR- 2019/06/26
CRDT- 2019/06/27 06:00
PHST- 2019/03/09 00:00 [received]
PHST- 2019/06/11 00:00 [accepted]
PHST- 2019/06/27 06:00 [entrez]
PHST- 2019/06/27 06:00 [pubmed]
PHST- 2020/02/25 06:00 [medline]
PHST- 2019/06/26 00:00 [pmc-release]
AID - PONE-D-19-06939 [pii]
AID - 10.1371/journal.pone.0218786 [doi]
PST - epublish
SO  - PLoS One. 2019 Jun 26;14(6):e0218786. doi: 10.1371/journal.pone.0218786. 
      eCollection 2019.