Efficacy and safety of sodium stibogluconate and liposomal amphotericin B in the treatment of Kala-azar: a retrospective analysis
10.3760/cma.j.cn114015-20240109-00019
- VernacularTitle:葡萄糖酸锑钠和两性霉素B脂质体治疗黑热病有效性和安全性的回顾性分析
- Author:
Jianping ZHANG
1
;
Zhongxia YANG
;
Rongrong ZHAO
;
Boxia LI
Author Information
1. 兰州大学第一医院药剂科，兰州 730000
- Publication Type:Journal Article
- Keywords:
Leishmaniasis, visceral;
Sodium stibogluconate;
Amphotericin B;
Efficiency;
Safety
- From:
Adverse Drug Reactions Journal
2024;26(7):399-404
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the efficacy and safety of sodium stibogluconate (SSG) and liposomal amphotericin (L-AmB) as well as their combination regimen in the treatment of Kala-azar (also known as visceral leishmaniasis) in China.Methods:Clinical data of patients with Kala-azar hospitalized in the First Hospital of Lanzhou University from January 2012 to December 2021 were collected, including patient demographic information, clinical characteristics of Kala-azar, previous treatment history, therapeutic drugs, clinical efficacy and adverse drug reactions (ADRs) in the treatment. The clinical characteristics, efficacy and occurrence of ADRs related to SSG and L-AmB in patients treated with SSG (SSG group) and L-AmB or SSG+L-AmB (L-AmB or SSG+L-AmB group) were analyzed by descriptive statistics.Results:A total of 44 patients were included in the analysis, including 25 males and 19 females; 25 were children (56.8%) and 19 were adults (43.2%). Thirty-seven patients (84.1%) were treated with SSG (SSG group), which was used as an initial treatment in 32 patients and was used also in previous treatment in 5 patients. Seven patients (15.9%) were treated with L-AmB, including 2 with L-AmB monotherapy and 5 with SSG+L-AmB, and all of them have been treated with SSG before. Among the 32 patients used SSG as initial treatments in the SSG group, 29 (90.6%) were clinically cured. All the 5 patients, who had been treated before, were also clinically cured after prolonged treatments. Seven patients in the L-AmB or SSG+L-AmB group were treated with a low-dose and long-term L-AmB regimen, and all of them were cured without Kala-azar recurrence. The common ADRs of SSG were abnormal liver function and elevated pancreatic enzymes; the common ADRs of L-AmB were hypokalemia and mild elevation of serum creatinine.Conclusions:The efficacy of SSG in initial treatment of patients with Kala-azar is more than 90%, and it can still be used as the preferred drug to treat Kala-azar. The monitoring of liver function and pancreatic enzymes should be paid attention to during the treatment. For patients that have been treated before, especially those with multiple Kala-azar recurrences, L-AmB or SSG+L-AmB should be advised. Low dose and long-term administration of L-AmB can obtain better efficacy and reduce the risk of ADR, and electrolytes and renal function should be monitored during the treatment.
