Skip to main content
. 2020 Apr 28;2020(4):CD013594. doi: 10.1002/14651858.CD013594
Study Method Participants Interventions Primary outcome(s) Setting Disease severity Overall risk of bias Narrative of efficacy findings (95% CIs) Narrative of safety findings
ACTG120, 1992 Single arm trial 59 with PDH ITRA 300 mg BD for 3 days then 200 mg BD for 12 weeks "Response to therapy"
Death
USA Mild to moderate Serious Clinical success:
50/59 participants
85% (73% to 93%)
Death:
1/59
2/59 participants withdrew due to adverse events, and responded to AmB.
ACTG174, 1994 Single arm trial 49 with PDH Initial protocol
FCN 1200 mg, then 600 mg OD for 8 weeks
Revised protocol
FCN 1200 mg, then 80 mg OD for 8 weeks
"Treatment response" USA Mild to moderate Serious Clinical success:
36/49 participants.
74% (59% to 85%)
Revised protocol
2 discontinuations due to toxicity, unclear if induction or maintenance.
Johnson 2002 RCT 81 with PDH lAmB (55 participants)
dAmB (26 participants)
Efficacy: "Clinical success"
Safety: early discontinuation
USA Moderate to severe Low Clinical success:
lAmB: 82% (69% to 91%)
45/55 participants.
dAmB: 56% (37% to 76%)
14/25 participants.
RR 1.46
(1.01 to 2.11)
Death:
lAmB: 1/53 (2%)
dAmB: 3/24 (13%)
RR 0.15
(0.02 to 1.38)
Early discontinuation: 1/53 (2%) with lAmB vs 2/24 (8%) with dAmB
RR 0.23
(95% CI 0.02 to 2.38)
Nephrotoxicity: 5/53 (9%) with lAmB vs 9/24 (37%) with dAmB
RR 0.25
(95% CI 0.09 to 0.67)
Of note, authors did not report specific data in relation to other commonly recognized adverse effects, including anaemia.
Luckett 2015 Retrospective cohort study 56 with HIV and PDH ITRA/VORI/POSA
AmB
Death
(90‐day histoplasmosis‐related)
Triazole failure
USA Mild to severe Serious Death
5/56 participants.
Not reported by treatment regimen.
Clinical success:
triazole induction successful in 20/24 participants
83% (62% to 95%)
No safety issues reported.
AmB: amphotericin B; BD: twice daily; CI: confidence interval; dAmB: deoxycholate amphotericin B; FCN: fluconazole; ITRA: itraconazole; IAmB: liposomal amphotericin B; n: number of participants; OD: once daily; PDH: progressive disseminated histoplasmosis; POSA: posaconazole; RCT: randomized controlled trial; RR: risk ratio; VORI: voriconazole.