Evidence map›Paper›PMID 36411251›Full record

SynthesisThe Journal of antimicrobial chemotherapy2022

Population pharmacokinetics of liposomal amphotericin B in adults with HIV-associated cryptococcal meningoencephalitis.

Katharine E Stott, Melanie Moyo, Ajisa Ahmadu, Cheusisime Kajanga, Ebbie Gondwe, Wezzie Chimang'anga, Madalitso Chasweka, Tshepo B Leeme, Mooketsi Molefi, Awilly Chofle and 11 more

Registry-linked trialOpen access · hybridAbstract readMeta-Analysis
In one paragraph

Synthesis in The Journal of antimicrobial chemotherapy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07215273 (A Phase 2, Multicenter, Randomized, Double-blind Study of Safety and Efficacy of EL219), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.5field-weighted citation impact, top 35% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07215273 phase2recruitingnot on this mapstarted 2026, after this paper: background citation

A Phase 2, Multicenter, Randomized, Double-blind Study of Safety and Efficacy of EL219 (Turletricin) Versus Liposomal Amphotericin B or Voriconazole for Early Antifungal Therapy of Invasive Mould Infections (TREAT-1)

TypeinterventionalSponsorElion Therapeutics, Inc.Ran2026 to 2026Enrolled60ConditionsInvasive Mould InfectionArmsEL219, Active Comparator- IV Antifungal (LAmB or voriconazole)
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 7 citations in OpenAlex.

  1. Review
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors at 6 institutions in 4 countries.

Katharine E StottAntimicrobial Pharmacodynamics and Therapeutics, Department of Pharmacology, University of Liverpool, UK.
Melanie MoyoMalawi Liverpool Wellcome Programme, Kamuzu University of Health Sciences, Malawi.
Ajisa AhmaduMalawi Liverpool Wellcome Programme, Kamuzu University of Health Sciences, Malawi.
Cheusisime KajangaMalawi Liverpool Wellcome Programme, Kamuzu University of Health Sciences, Malawi.
Ebbie GondweMalawi Liverpool Wellcome Programme, Kamuzu University of Health Sciences, Malawi.
Wezzie Chimang'angaMalawi Liverpool Wellcome Programme, Kamuzu University of Health Sciences, Malawi.
Madalitso ChaswekaMalawi Liverpool Wellcome Programme, Kamuzu University of Health Sciences, Malawi.
Tshepo B LeemeBotswana-University of Pennsylvania Partnership, Gaborone, Botswana.
Mooketsi MolefiUniversity of Botswana, Gaborone, Botswana.
Awilly ChofleNational Institute of Medical Research, Mwanza, Tanzania.
Gabriella BidwellNational Institute of Medical Research, Mwanza, Tanzania.
John ChangaluchaNational Institute of Medical Research, Mwanza, Tanzania.
Jenny UnsworthAntimicrobial Pharmacodynamics and Therapeutics, Department of Pharmacology, University of Liverpool, UK.
Ana Jimenez-ValverdeAntimicrobial Pharmacodynamics and Therapeutics, Department of Pharmacology, University of Liverpool, UK.
David S LawrenceDepartment of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
Henry C MwandumbaMalawi Liverpool Wellcome Programme, Kamuzu University of Health Sciences, Malawi.
David G LallooLiverpool School of Tropical Medicine, Liverpool, UK.
Thomas S HarrisonInstitute of Infection and Immunity, St George's University Hospital, London, UK.
Joseph N JarvisDepartment of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
William HopeAntimicrobial Pharmacodynamics and Therapeutics, Department of Pharmacology, University of Liverpool, UK.
Anne-Grete MärtsonAntimicrobial Pharmacodynamics and Therapeutics, Department of Pharmacology, University of Liverpool, UK.ORCID 0000-0001-6478-1959
University of Liverpool · GBNational Institute for Medical Research · TZLondon School of Hygiene & Tropical Medicine · GBUniversity of Botswana · BWLiverpool School of Tropical Medicine · GBUniversity of Exeter · GB

Funding

Department of Health RP-2017-08-ST2-012Medical Research Council G1001760Medical Research Council MC_PC_MR/P006922/1Medical Research Council MR/N023005/1Medical Research Council MR/P006922/1Medical Research Council MR/P020526/1Medical Research Council MR/V033417/1Wellcome TrustWellcome Trust 203919/Z/16/Z
6 · The paper itself

Abstract

backgroundSingle, high-dose liposomal amphotericin B (LAmB; AmBisome, Gilead Sciences) has demonstrated non-inferiority to amphotericin B deoxycholate in combination with other antifungals for averting all-cause mortality from HIV-associated cryptococcal meningitis. There are limited data on the pharmacokinetics (PK) of AmBisome. The aim of this study was to describe population PK of AmBisome and conduct a meta-analysis of the available studies to suggest the optimal dosing for cryptococcal meningoencephalitis.

methodsData from a Phase II and Phase III trial of high-dose, short-course AmBisome for cryptococcal meningoencephalitis were combined to develop a population PK model. A search was conducted for trials of AmBisome monotherapy and meta-analysis of clinical outcome data was performed.

resultsA two-compartment model with first-order clearance of drug from the central compartment fitted the data best and enabled the extent of inter-individual variability in PK to be quantified. Mean (SD) population PK parameter estimates were: clearance 0.416 (0.363)  L/h; volume of distribution 4.566 (4.518) L; first-order transfer of drug from central to peripheral compartments 2.222 (3.351)  h-1, and from peripheral to central compartment 2.951 (4.070)  h-1. Data for the meta-analysis were insufficient to suggest optimal dosing of AmBisome for cryptococcal meningoencephalitis.

conclusionsThis study provides novel insight into the PK of AmBisome at the population level and the variability therein. Our analysis also serves to highlight the paucity of data available on the pharmacodynamics (PD) of AmBisome and underscores the importance of thorough and detailed PK/PD analysis in the development of novel antifungals, by demonstrating the challenges associated with post hoc PK/PD analysis.

Indexed as

Cryptococcus neoformansHIV InfectionsMeningitis, CryptococcalMeningoencephalitisAmphotericin BAntifungal AgentsHumansAmphotericin BAntifungal Agentsliposomal amphotericin B

Identifiers

PMID36411251
PMCPMC9780527
OpenAlexW4309522641

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.