Lipid Nanocrystal Amphotericin B: A Novel Oral Formulation for Cryptococcal Meningitis

In a phase 2 study, oral amphotericin B had similar cryptococcal clearance and outcomes with less toxicity than the IV formulation.

The currently recommended therapy for HIV-related cryptococcal meningitis (CM) is intravenous amphotericin B (IV AmB) combined with 5-fluorocytosine (5FC) followed by fluconazole. However, this regimen has major toxicities. Lipid nanocrystal (LNC) AmB is a novel formulation that combines AmB with calcium and phosphatidylserine, allowing for oral absorption and targeted intracellular delivery, resulting in drug delivery to the infection site with reduced toxicity.

In an open-label, randomized, phase 2 study, investigators in Uganda enrolled 141 patients with HIV-1 infection and recently diagnosed CM from July 2020 to October 2022. Patients receiving LNC AmB had an initial 2-week course of 5FC with or without initial induction with IV AmB; all…

Reviewing Author

Neil M. Ampel, MD

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Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Lipid Nanocrystal Amphotericin B: A Novel Oral Formulation for Cryptococcal Meningitis

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Reviewing Author