Acute Infusion-Related Side Effects of Amphotericin B Lipid Complex (ABLC) in Oncohematological Patients: Real-World Data from Brazilian Reference Centers
Abstract Introduction Amphotericin B lipid complex (ABLC) is an effective antifungal agent for treating invasive fungal infections (IFIs) even though its formulation is associated with potential adverse events, including those related to its infusion. This study aimed to analyze the incidence of acu...
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Adis, Springer Healthcare
2024-11-01
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| Series: | Infectious Diseases and Therapy |
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| Online Access: | https://doi.org/10.1007/s40121-024-01086-y |
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| author | Francelise Bridi Cavassin Marcello Mihailenko Chaves Magri Ariela Victoria Borgmann Isabela Dombeck Floriani Marina Rachid Barreto Tania Zaleski Fabianne Altruda de Moraes Costa Carlesse Giovanni Luís Breda Fábio de Araújo Motta Diego Rodrigues Falci Ana Verena Almeida Mendes Hugo Paz Morales Patrícia Silva Montes Mariane Taborda Talita Teles Teixeira Pereira João Luiz Baú-Carneiro Flávio Queiroz-Telles |
| author_facet | Francelise Bridi Cavassin Marcello Mihailenko Chaves Magri Ariela Victoria Borgmann Isabela Dombeck Floriani Marina Rachid Barreto Tania Zaleski Fabianne Altruda de Moraes Costa Carlesse Giovanni Luís Breda Fábio de Araújo Motta Diego Rodrigues Falci Ana Verena Almeida Mendes Hugo Paz Morales Patrícia Silva Montes Mariane Taborda Talita Teles Teixeira Pereira João Luiz Baú-Carneiro Flávio Queiroz-Telles |
| author_sort | Francelise Bridi Cavassin |
| collection | DOAJ |
| description | Abstract Introduction Amphotericin B lipid complex (ABLC) is an effective antifungal agent for treating invasive fungal infections (IFIs) even though its formulation is associated with potential adverse events, including those related to its infusion. This study aimed to analyze the incidence of acute infusion-related side effects (IRSE) associated with ABLC and their relationship with the profile of patients with oncohematological disease admitted in Brazilian reference tertiary hospitals. Methods This is an observational retrospective study that included clinical records of patients hospitalized, in a period of 6 years, diagnosed with probable or proved IFI and treated with at least two doses of ABLC. Results A total of 229 patients were included, with a male prevalence and an average age of 44 years for adults and 10 years for children. Seventy-nine (34.5%) developed some IRSE, 5.1% of which progressed in severe form to discontinuation of treatment. The most prevalent events in adults were fever (66.7%), tremor/chills (53.3%), and tachycardia (24.4%). In children, the most common were fever (64.7%), tremors/chills (50%), and skin rash/itching (17.6%). Statistical significance was found for premedication use from the first dose of ABLC in relation to the onset of infusion reactions (P = 0.006). Multivariate analysis revealed that ABLC, when compared to liposomal AMB (L-AMB), and neutropenia were associated with a higher risk of developing IRSE (odds ratio [OR] 3.04, P = 0.008; and OR 11.02, P = 0.025, respectively). Conclusions The use of premedication was a protective factor against the occurrence of IRSE. Therefore, services providing amphotericin B (AMB) must reinforce protocols or implement new measures that optimize tolerability and safety during the treatment of patients with oncohematological disease, with special attention to patients with neutropenia, prioritizing the liposomal formulation of AMB whenever possible. |
| format | Article |
| id | doaj-art-585d1f9ea36849b9bc99b531919404cd |
| institution | Kabale University |
| issn | 2193-8229 2193-6382 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Adis, Springer Healthcare |
| record_format | Article |
| series | Infectious Diseases and Therapy |
| spelling | doaj-art-585d1f9ea36849b9bc99b531919404cd2025-02-02T12:35:14ZengAdis, Springer HealthcareInfectious Diseases and Therapy2193-82292193-63822024-11-0114113314810.1007/s40121-024-01086-yAcute Infusion-Related Side Effects of Amphotericin B Lipid Complex (ABLC) in Oncohematological Patients: Real-World Data from Brazilian Reference CentersFrancelise Bridi Cavassin0Marcello Mihailenko Chaves Magri1Ariela Victoria Borgmann2Isabela Dombeck Floriani3Marina Rachid Barreto4Tania Zaleski5Fabianne Altruda de Moraes Costa Carlesse6Giovanni Luís Breda7Fábio de Araújo Motta8Diego Rodrigues Falci9Ana Verena Almeida Mendes10Hugo Paz Morales11Patrícia Silva Montes12Mariane Taborda13Talita Teles Teixeira Pereira14João Luiz Baú-Carneiro15Flávio Queiroz-Telles16Universidade Federal do Paraná (UFPR)Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC/FAMUSP)Faculdades Pequeno Príncipe (FPP)Faculdades Pequeno Príncipe (FPP)Faculdades Pequeno Príncipe (FPP)Universidade do Estado do Paraná (UNESPAR)Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM)Hospital de Clínicas da Universidade Federal do Paraná (HC/UFPR)Hospital Pequeno Príncipe (HPP)Hospital de Clínicas de Porto Alegre (HCPA)Hospital São Rafael (HSR)Hospital Erasto Gaertner (HEG)Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC/FAMUSP)Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC/FAMUSP)Hospital São Rafael (HSR)Faculdades Pequeno Príncipe (FPP)Universidade Federal do Paraná (UFPR)Abstract Introduction Amphotericin B lipid complex (ABLC) is an effective antifungal agent for treating invasive fungal infections (IFIs) even though its formulation is associated with potential adverse events, including those related to its infusion. This study aimed to analyze the incidence of acute infusion-related side effects (IRSE) associated with ABLC and their relationship with the profile of patients with oncohematological disease admitted in Brazilian reference tertiary hospitals. Methods This is an observational retrospective study that included clinical records of patients hospitalized, in a period of 6 years, diagnosed with probable or proved IFI and treated with at least two doses of ABLC. Results A total of 229 patients were included, with a male prevalence and an average age of 44 years for adults and 10 years for children. Seventy-nine (34.5%) developed some IRSE, 5.1% of which progressed in severe form to discontinuation of treatment. The most prevalent events in adults were fever (66.7%), tremor/chills (53.3%), and tachycardia (24.4%). In children, the most common were fever (64.7%), tremors/chills (50%), and skin rash/itching (17.6%). Statistical significance was found for premedication use from the first dose of ABLC in relation to the onset of infusion reactions (P = 0.006). Multivariate analysis revealed that ABLC, when compared to liposomal AMB (L-AMB), and neutropenia were associated with a higher risk of developing IRSE (odds ratio [OR] 3.04, P = 0.008; and OR 11.02, P = 0.025, respectively). Conclusions The use of premedication was a protective factor against the occurrence of IRSE. Therefore, services providing amphotericin B (AMB) must reinforce protocols or implement new measures that optimize tolerability and safety during the treatment of patients with oncohematological disease, with special attention to patients with neutropenia, prioritizing the liposomal formulation of AMB whenever possible.https://doi.org/10.1007/s40121-024-01086-yAmphotericin BAdverse eventsOncohematologyPatient safety |
| spellingShingle | Francelise Bridi Cavassin Marcello Mihailenko Chaves Magri Ariela Victoria Borgmann Isabela Dombeck Floriani Marina Rachid Barreto Tania Zaleski Fabianne Altruda de Moraes Costa Carlesse Giovanni Luís Breda Fábio de Araújo Motta Diego Rodrigues Falci Ana Verena Almeida Mendes Hugo Paz Morales Patrícia Silva Montes Mariane Taborda Talita Teles Teixeira Pereira João Luiz Baú-Carneiro Flávio Queiroz-Telles Acute Infusion-Related Side Effects of Amphotericin B Lipid Complex (ABLC) in Oncohematological Patients: Real-World Data from Brazilian Reference Centers Infectious Diseases and Therapy Amphotericin B Adverse events Oncohematology Patient safety |
| title | Acute Infusion-Related Side Effects of Amphotericin B Lipid Complex (ABLC) in Oncohematological Patients: Real-World Data from Brazilian Reference Centers |
| title_full | Acute Infusion-Related Side Effects of Amphotericin B Lipid Complex (ABLC) in Oncohematological Patients: Real-World Data from Brazilian Reference Centers |
| title_fullStr | Acute Infusion-Related Side Effects of Amphotericin B Lipid Complex (ABLC) in Oncohematological Patients: Real-World Data from Brazilian Reference Centers |
| title_full_unstemmed | Acute Infusion-Related Side Effects of Amphotericin B Lipid Complex (ABLC) in Oncohematological Patients: Real-World Data from Brazilian Reference Centers |
| title_short | Acute Infusion-Related Side Effects of Amphotericin B Lipid Complex (ABLC) in Oncohematological Patients: Real-World Data from Brazilian Reference Centers |
| title_sort | acute infusion related side effects of amphotericin b lipid complex ablc in oncohematological patients real world data from brazilian reference centers |
| topic | Amphotericin B Adverse events Oncohematology Patient safety |
| url | https://doi.org/10.1007/s40121-024-01086-y |
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