Lipsosomal amphotericin B: a review of its properties, function, and use for treatment of cutaneous leishmaniasis

Figures & data

Table 1 Summary of published studies and clinical trials on liposomal amphotericin B use for CL (since 2011)

Study	Type	Treatment regimen	Clinical manifestation	Immunosuppression	Patients, n	Species	Outcome	Median follow-up
Guery et al^Citation62	Retrospective analysis	20 mg/kg (total dose)	Nodular lesion(s)	12% of patients had HIV infection or received prolonged corticosteroid therapy and/or immunosuppressive treatment for autoimmune diseases.	43	Leishmania infantum	Cure rate 58%	79 days
Layegh et al^Citation63	Randomized clinical trial	Topical liposomal formulation: 3–7 drops into each lesion twice daily	Papuloplaque, nodule or ulcer	—	50	-	Cure rate 90%	6 months
Motta et al^Citation64	Controlled open-label trial	1.5 mg/kg/day	Presenting up to six lesions (ulcers or plaques)	—	16	L. (Viannia) braziliensis L.amazonensis L (V) shawi	Cure rate 50%	12 months
Hamzavi^Citation65	Case report	1 mg/kg for 1 month; retreated with 3 mg/kg for 2 weeks	Multiple nodular, ulcerative. and crusted lesions	No	1	L. major	Cure	3 months
Islam^Citation66		3, 4, 4, 5, and 5 mg/kg/day over 5 days	Rapidly progressing crusting and ulcerative facial rash	—	1	L. tropica	Cure	5 months
Cunha et al^Citation67	Retrospective study	Mean total dose 32.5 mg/kg	Lesion(s) in the nasal or oral mucosa	No	29	L. (V) braziliensis	Cure rate 93.1%.	—
Butsch et al ^Citation68	Case report (two cases)	3 mg/kg/day for 10 days	Nodules on the face, trunk, arm, and foot	Case 1: no Case 2: diabetic	2	L. major	Cure	24 months
Zanger et al ^Citation69	Case report	3 mg/kg/day for 22 days	Lesions on the face	Treated rheumatoid arthritis	1	L. aethiopica	Cure	12 months
Ono et al^Citation70	Case report	3 mg/kg/day for 5 consecutive days with additional dose on the 10th day for a total of 6 days of treatment	A tender erythematous nodule on the right elbow	—	1	L. major	Cure	—
Solomon et al^71	Nonrandomized study with a small number of patients	Five days of 3 mg/kg, followed by a sixth dose on day 10	Lesions on the face and/or body	—	13	L. tropica	Cure	11 months
Solomon et al^Citation72	Prospective observational study	Five days of 3 mg/kg and a sixth dose on day 10	Cutaneous lesions	No	34	L. (V) braziliensis	Cure	29 months
Hervas et al ^Citation46	Case report	3 mg/kg/day for 13 days	Lesion on cheek	—		L. infantum	Poor response	—

Guery R, Henry B, Martin-Blondel G, et al. Liposomal amphotericin B in travelers with cutaneous and muco-cutaneous leishmaniasis: not a panacea. PLoS Negl Trop Dis. 2017;11(11):e0006094.29155816

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Layegh P, Rajabi O, Jafari MR, et al. Efficacy of topical liposomal amphotericin B versus intralesional meglumine antimoniate (Glucantime) in the treatment of cutaneous leishmaniasis. J Parasitol Res. 2011;2011:656523.

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Motta JO, Sampaio RN. A pilot study comparing low‐dose liposomal amphotericin B with N‐methyl glucamine for the treatment of American cutaneous leishmaniasis. J Eur Acad Dermatol Venereol. 2012;26(3):331–335.21492255

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Hamzavi SS, Sanaei Dashti A, Kadivar MR, Pouladfar G, Pourabbas B. Successful treatment of disseminated cutaneous leishmaniasis with liposomal amphotericin B and miltefosine in an eight-year-old girl. Pediatr Infect Dis J. 2018;37(3):275–277.29424815

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Islam S. Rapidly progressing facial leishmaniasis: effective treatment with liposomal amphotericin B and a review of the management of old world cutaneous leishmaniasis. Paediatr Int Child Health. 2018;38(2):158–161.28281913

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Cunha MA, Leão AC, de Cassia Soler R, Lindoso JA. Efficacy and safety of liposomal amphotericin B for the treatment of mucosal leishmaniasis from the new world: a retrospective study. Am J Trop Med Hyg. 2015;93(6):1214–1218.26483120

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Butsch F, Faulde M, Debus A, Bogdan C, von Stebut E. Two cases of successful treatment of multilesional cutaneous leishmaniasis with liposomal amphotericin B. JDDG. J Dtsch Dermatol Ges. 2013;11(1):83–85.23176632

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Zanger P, Kötter I, Raible A, Gelanew T, Schönian G, Kremsner PG. Successful treatment of cutaneous leishmaniasis caused by Leishmania aethiopica with liposomal amphothericin b in an immunocompromised traveler returning from eritrea. Am J Trop Med Hyg. 2011;84(5):692–694.21540377

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Ono M, Takahashi K, Taira K, Uezato H, Takamura S, Izaki S. Cutaneous leishmaniasis in a Japanese returnee from West Africa successfully treated with liposomal amphotericin B. J Dermatol. 2011;38(11):1062–1065.21950705

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Solomon M, Pavlotzky F, Barzilai A, Schwartz E. Liposomal amphotericin B in comparison to sodium stibogluconate for Leishmania braziliensis cutaneous leishmaniasis in travelers. J Am Acad Dermatol. 2013;68(2):284–289.22858005

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Hervás JA, Martín-Santiago A, Hervás D, et al. Old world Leishmania infantum cutaneous leishmaniasis unresponsive to liposomal amphotericin B treated with topical imiquimod. Pediatr Infect Dis J. 2012;31(1):97–100.21829140

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