LSTM Home > LSTM Research > LSTM Online Archive

How applicable is the single-dose AMBITION regimen for HIV-associated cryptococcal meningitis to high-income settings?

Harrison, Thomas S, Lawrence, David S, Mwandumba, Henry ORCID: https://orcid.org/0000-0003-4470-3608, Boulware, David R, Hosseinipour, Mina C, Lortholary, Olivier, Meintjes, Graeme, Mosepele, Mosepele and Jarvis, Joseph N (2022) 'How applicable is the single-dose AMBITION regimen for HIV-associated cryptococcal meningitis to high-income settings?'. Clinical Infectious Diseases. (In Press)

[img]
Preview
Text
ciac792.pdf - Accepted Version
Available under License Creative Commons Attribution.

Download (727kB) | Preview

Abstract

The AMBITION-cm phase III randomized controlled trial, conducted in east and southern Africa, showed that a single high dose (10 mg/kg) of liposomal amphotericin B, given with an optimized oral backbone of fluconazole and flucytosine, was non-inferior to the World Health Organization (WHO)-recommended regimen of seven days of amphotericin B deoxycholate plus flucytosine for treatment of HIV-associated cryptococcal meningitis, and has been incorporated into updated WHO treatment guidelines. We believe the trial findings also have important implications for the treatment of HIV-associated cryptococcal meningitis in high-income settings. We advance the arguments, supported by evidence where available, that the AMBITION-cm study regimen is likely to be (i) as fungicidal as the currently recommended 14-day liposomal amphotericin based treatments, (ii) better tolerated with fewer adverse effects, and (iii) confer significant economic and practical benefits, therefore should be included as a treatment option in guidance for HIV-associated cryptococcal treatment in high-income country settings.

Item Type: Article
Subjects: QV Pharmacology > QV 4 General works
WC Communicable Diseases > Infection. Bacterial Infections > Bacterial Infections > WC 245 Meningococcal infections
WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503 Acquired immunodeficiency syndrome. HIV infections
WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503.5 Complications
Faculty: Department: Clinical Sciences & International Health > Malawi-Liverpool-Wellcome Programme (MLW)
Digital Object Identifer (DOI): https://doi.org/10.1093/cid/ciac792
SWORD Depositor: JISC Pubrouter
Depositing User: JISC Pubrouter
Date Deposited: 09 Nov 2022 14:16
Last Modified: 09 Nov 2022 14:16
URI: https://archive.lstmed.ac.uk/id/eprint/21270

Statistics

View details

Actions (login required)

Edit Item Edit Item