دورية أكاديمية
An open label randomized controlled trial of tamoxifen combined with amphotericin B and fluconazole for cryptococcal meningitis
| العنوان: | An open label randomized controlled trial of tamoxifen combined with amphotericin B and fluconazole for cryptococcal meningitis |
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| المؤلفون: | Nguyen, Thi Thuy Ngan, Nhat, Thanh Hoang Le, Nguyen, Ngo Vi Vi, Ninh, Thi Thanh Van, Nguyen, Thi Hoang Mai, Duong, Van Anh, Phan, Hai Trieu, Nguyen, Phu Huong Lan, Nguyen, Hoan Phu, Nguyen, Van Vinh Chau, Lalloo, David G, Hope, William, Beardsley, Justin, White, Nicholas J, Geskus, Ronald, Thwaites, Guy E, Krysan, Damian, Luong, Thi Hue Tai, Kestelyn, Evelyne, Tran, Quang Binh, Le, Quoc Hung, Nguyen, Le Nhu Tung, Day, Jeremy N |
| بيانات النشر: | eLife Sciences Publications, Ltd |
| سنة النشر: | 2021 |
| المجموعة: | The University of Liverpool Repository |
| الوصف: | Background Cryptococcal meningitis has high mortality. Flucytosine is a key treatment but is expensive and rarely available. The anticancer agent tamoxifen has synergistic anti-cryptococcal activity with amphotericin in vitro. It is off-patent, cheap, and widely available. We performed a trial to determine its therapeutic potential. Methods Open label randomized controlled trial. Participants received standard care - amphotericin combined with fluconazole for the first 2 weeks - or standard care plus tamoxifen 300 mg/day. The primary end point was Early Fungicidal Activity (EFA) - the rate of yeast clearance from cerebrospinal fluid (CSF). Trial registration https://clinicaltrials.gov/ct2/show/NCT03112031Test. Results Fifty patients were enrolled (median age 34 years, 35 male). Tamoxifen had no effect on EFA (-0.48log10 colony-forming units/mL/CSF control arm versus -0.49 tamoxifen arm, difference -0.005log10CFU/ml/day, 95% CI: -0.16, 0.15, p=0.95). Tamoxifen caused QTc prolongation. Conclusions High-dose tamoxifen does not increase the clearance rate of Cryptococcus from CSF. Novel, affordable therapies are needed. Funding The trial was funded through the Wellcome Trust Asia Programme Vietnam Core Grant 106680 and a Wellcome Trust Intermediate Fellowship to JND grant number WT097147MA. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | Collapse authors list. Nguyen, Thi Thuy Ngan, Nhat, Thanh Hoang Le, Nguyen, Ngo Vi Vi, Ninh, Thi Thanh Van, Nguyen, Thi Hoang Mai, Duong, Van Anh, Phan, Hai Trieu, Nguyen, Phu Huong Lan, Nguyen, Hoan Phu, Nguyen, Van Vinh Chau et al (show 13 more authors) , Lalloo, David G orcid:0000-0001-7680-2200 , Hope, William orcid:0000-0001-6187-878X , Beardsley, Justin, White, Nicholas J, Geskus, Ronald, Thwaites, Guy E, Krysan, Damian, Luong, Thi Hue Tai, Kestelyn, Evelyne, Tran, Quang Binh, Le, Quoc Hung, Nguyen, Le Nhu Tung and Day, Jeremy N (2021) An open label randomized controlled trial of tamoxifen combined with amphotericin B and fluconazole for cryptococcal meningitis. ELIFE, 10. e68929-. |
| DOI: | 10.7554/elife.68929 |
| الإتاحة: | https://doi.org/10.7554/elife.68929Test http://livrepository.liverpool.ac.uk/3147527Test/ |
| رقم الانضمام: | edsbas.542AC86D |
| قاعدة البيانات: | BASE |
| DOI: | 10.7554/elife.68929 |
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