Aspergillosis Status Affected by Nebulized Amphotericin B

Top line:

Nebulized amphotericin B does not improve progression-free status after 1 year in bronchopulmonary patients AspergillosisHowever, it may delay onset and onset.

methodology:

• The researchers searched PubMed and Embase databases for studies involving at least five patients with allergic bronchopulmonary aspergillosis who were managed with amphotericin B nebulization.

• They included five studies, two of which were randomized controlled trials (RCTs) and three of which were observational studies. There were a total of 188 patients.

• The primary objective of this systematic review and meta-analysis was to determine the frequency of patients without progression one year after starting treatment with nebulized amphotericin B.

remove:

• From studies with 1-year or 2-year progression data (1 observation, 2 RCTs; n = 84), the total proportion of patients who had no progression after 1 year with nebulized amphotericin B was 76%. did (I² = 64.6%).

• The combined risk difference between the two RCTs assessing progression-free status at 1 year was 0.33, and was not significantly different between the amphotericin B nebulized group and the saline nebulized control group.

• Two RCTs showed time to first exacerbation, which was significantly longer with nebulized amphotericin B than with nebulized saline (337 days vs. 177 days; P. = .004; i² = 82%).

• The proportion of patients experiencing 2 or more exacerbations was significantly lower with nebulized amphotericin B than with nebulized saline (9/33) [27.3%] vs 20/38 [52.6%]; P. = .03).

in fact:

“NAB increased time to first exacerbation.” [nebulized amphotericin B]It is an important indicator of the effectiveness of treatment. Also, fewer NAB subjects than controls experienced two or more exacerbations,” Valliappan Muthu, MD, and colleagues concluded. However, “the ideal duration and optimal dose of LAMB for nebulization are unknown.”

Research details

“Nebulized amphotericin B for prevention of exacerbations in allergic bronchopulmonary aspergillosis: a systematic review and meta-analysis” publish online of pulmonary pharmacology and therapeutics In May 2023.

Limitations

The current review is limited by the small number of included trials and may be at high risk of bias. Therefore, more evidence is needed for the use of nebulized amphotericin B in routine care. The authors have disclosed no conflicts of interest.

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