{"doi":"10.1093/mmy/myag033","title":"Lipid-based amphotericin B formulations (ABCD/L-AmB) were associated with better outcomes than deoxycholate (AmB-d) in non-HIV-associated cryptococcal meningitis: A retrospective cohort study","abstract":"<jats:title>Abstract</jats:title>\n                  <jats:p>This retrospective cohort study compared the efficacy and safety of lipid-based amphotericin B formulations (amphotericin B colloidal dispersion [ABCD] and liposomal amphotericin B [L-AmB]) versus conventional amphotericin B deoxycholate (AmB-d) for the treatment of non-human immunodeficiency virus (HIV)-associated cryptococcal meningitis (CM). Data from 199 patients were analyzed, divided into three groups based on induction therapy: AmB-d (n = 110), ABCD (n = 44), and L-AmB (n = 45). At baseline, a higher proportion of patients in the lipid-based groups presented with altered mental status. After 2 weeks, the ABCD and L-AmB groups showed significantly better clinical improvement (as measured by British Medical Research Council Stage 1) compared to the AmB-d group (63.6% and 77.8% vs. 35.5%; P &amp;lt; .001), and experienced substantially lower rates of renal impairment (54.5% and 53.3% vs. 79.1%; P = .001). Early fungicidal activity was similar across all groups. Multivariate analysis at 10 weeks indicated that both lipid-based formulations were associated with a lower risk of unsuccessful outcomes compared to AmB-d. Furthermore, 1-year survival analysis for clinical cure demonstrated a significantly higher cumulative incidence in the lipid-based AmB groups (Log-rank test, P = .016). In conclusion, induction regimens based on ABCD or L-AmB were associated with better outcomes than AmB-d for non-HIV-associated CM, offering better long-term outcomes and a more favorable safety profile, particularly regarding kidney toxicity.</jats:p>","journal":"Medical Mycology","year":2026,"id":640675,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":334282,"name":"Jia Liu","orcid":"0000-0001-9522-6624","position":1,"is_corresponding":false},{"id":1039342,"name":"Min Li","orcid":"0000-0001-5858-6903","position":2,"is_corresponding":false},{"id":1665182,"name":"Ruiqi Dong","orcid":null,"position":3,"is_corresponding":false},{"id":1665183,"name":"Dongcheng Li","orcid":null,"position":4,"is_corresponding":false},{"id":1163292,"name":"Jiajie Chen","orcid":"0009-0008-7402-6883","position":5,"is_corresponding":false},{"id":1665184,"name":"Wenhai Zeng","orcid":null,"position":6,"is_corresponding":false},{"id":289452,"name":"Zheqi Li","orcid":"0000-0003-1213-640X","position":7,"is_corresponding":false},{"id":845813,"name":"Xiaofeng Xu","orcid":"0000-0002-6553-6514","position":8,"is_corresponding":false},{"id":527384,"name":"Ying Jiang","orcid":"0000-0001-5760-281X","position":9,"is_corresponding":false},{"id":1665186,"name":"Fuhua Peng","orcid":null,"position":10,"is_corresponding":false},{"id":1481638,"name":"Junyu Liu","orcid":"0000-0002-3803-4068","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Lipid-based amphotericin B formulations (ABCD/L-AmB) were associated with better outcomes than deoxycholate (AmB-d) in non-HIV-associated cryptococcal meningitis: A retrospective cohort study","abstract":"<jats:title>Abstract</jats:title>\n                  <jats:p>This retrospective cohort study compared the efficacy and safety of lipid-based amphotericin B formulations (amphotericin B colloidal dispersion [ABCD] and liposomal amphotericin B [L-AmB]) versus conventional amphotericin B deoxycholate (AmB-d) for the treatment of non-human immunodeficiency virus (HIV)-associated cryptococcal meningitis (CM). Data from 199 patients were analyzed, divided into three groups based on induction therapy: AmB-d (n = 110), ABCD (n = 44), and L-AmB (n = 45). At baseline, a higher proportion of patients in the lipid-based groups presented with altered mental status. After 2 weeks, the ABCD and L-AmB groups showed significantly better clinical improvement (as measured by British Medical Research Council Stage 1) compared to the AmB-d group (63.6% and 77.8% vs. 35.5%; P &amp;lt; .001), and experienced substantially lower rates of renal impairment (54.5% and 53.3% vs. 79.1%; P = .001). Early fungicidal activity was similar across all groups. Multivariate analysis at 10 weeks indicated that both lipid-based formulations were associated with a lower risk of unsuccessful outcomes compared to AmB-d. Furthermore, 1-year survival analysis for clinical cure demonstrated a significantly higher cumulative incidence in the lipid-based AmB groups (Log-rank test, P = .016). In conclusion, induction regimens based on ABCD or L-AmB were associated with better outcomes than AmB-d for non-HIV-associated CM, offering better long-term outcomes and a more favorable safety profile, particularly regarding kidney toxicity.</jats:p>","is_dataset_classified":null,"base_score":0.0,"endowment":0.0,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"41990111","pmcid":null,"openalex_id":"https://openalex.org/W7154623918","authors":[],"funders":[{"funder_name":"Characteristic Technology Projects in Guangzhou","grant_id":"2026P-TS053","title":null},{"funder_name":"Clinical High-tech","grant_id":"","title":null}],"total_grants":2,"fwci":0.0,"citation_percentile":0.40763961,"influential_citations":0,"citation_trend":[],"oa_status":"closed","license":"https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model","oa_locations":[{"url":"https://academic.oup.com/mmy/advance-article-pdf/doi/10.1093/mmy/myag033/68093673/myag033.pdf","host_type":"publisher"},{"url":"https://academic.oup.com/mmy/article-pdf/64/5/myag033/68093673/myag033.pdf","host_type":"publisher"},{"url":"https://doi.org/10.1093/mmy/myag033","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/41990111","host_type":"repository"}],"fields_of_study":["Fungal Infections and Studies","Antifungal resistance and susceptibility","Orthopedic Infections and Treatments"],"mesh_terms":["Adult","Amphotericin B","Antifungal Agents","Deoxycholic Acid","Drug Combinations","Female","Humans","Male","Middle Aged","Retrospective Studies","Treatment Outcome","Meningitis, Cryptococcal","Young Adult"],"keywords":["Retrospective cohort study","Amphotericin B","Amphotericin B deoxycholate","Multivariate analysis","Incidence (geometry)","Group B","Cohort","Cohort study","Safety","efficacy","Cryptococcal Meningitis","Non-human Immunodeficiency Virus"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-07T13:14:31.820029Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}