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Last Updated: December 15, 2025

CLINICAL TRIALS PROFILE FOR AMPHOTERICIN B


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505(b)(2) Clinical Trials for AMPHOTERICIN B

This table shows clinical trials for potential 505(b)(2) applications. See the next table for all clinical trials
Trial Type Trial ID Title Status Sponsor Phase Start Date Summary
New Dosage NCT00421187 ↗ Ambisome and Management of Culture-negative Neutropenic Fever Unresponsive to Antibiotics Terminated Gilead Sciences Phase 4 2007-03-01 Administration of a single high dose (10 mg/kg) of AmBisome® no later than 72 hours after ARNF onset followed by two 5 mg/kg doses on days 2 and 5 may provide sustained tissue levels of amphotericin B that are as mycologically effective as those provided after administering the standard daily dose of 3 mg/kg/day. The new dosing regimen is anticipated to be equally clinically effective compared with the standard AmBisome® regimen when given for the duration of neutropenic fever in patients with ARNF. In addition, the degree and incidence of nephrotoxicity are predicted to be lower with the 3 sequential dose regimen compared to daily dosing with 3 mg/kg because of the lower cumulative dosage (20 mg/kg versus 42 mg/kg, respectively), which is 1 contributing factor for the development of acute renal failure. Furthermore, the lower cumulative dose may be a cost-effective strategy for the treatment of patients with ARNF.
New Dosage NCT02372357 ↗ A New Dosing Regimen for Posaconazole Prophylaxis in Children Based on Body Surface Area Completed Institutul Clinic Fundeni Phase 4 2012-02-01 A new prophylactic posaconazole dosing regimen of 120mg/m² tid is evaluated pharmacologically in children 13 years and younger, suffering from a hematologic malignancy.
New Dosage NCT02372357 ↗ A New Dosing Regimen for Posaconazole Prophylaxis in Children Based on Body Surface Area Completed Institutul Clinic Fundeni Bucharest Phase 4 2012-02-01 A new prophylactic posaconazole dosing regimen of 120mg/m² tid is evaluated pharmacologically in children 13 years and younger, suffering from a hematologic malignancy.
New Dosage NCT02372357 ↗ A New Dosing Regimen for Posaconazole Prophylaxis in Children Based on Body Surface Area Completed Universitaire Ziekenhuizen Leuven Phase 4 2012-02-01 A new prophylactic posaconazole dosing regimen of 120mg/m² tid is evaluated pharmacologically in children 13 years and younger, suffering from a hematologic malignancy.
>Trial Type >Trial ID >Title >Status >Phase >Start Date >Summary

All Clinical Trials for AMPHOTERICIN B

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00000639 ↗ A Randomized Double Blind Protocol Comparing Amphotericin B With Flucytosine to Amphotericin B Alone Followed by a Comparison of Fluconazole and Itraconazole in the Treatment of Acute Cryptococcal Meningitis Completed Washington University School of Medicine N/A 1969-12-31 To evaluate the effectiveness and safety of amphotericin B plus flucytosine (5-fluorocytosine) compared to amphotericin B alone for a first episode of acute cryptococcal meningitis in AIDS patients, and to compare the effectiveness and safety of fluconazole versus itraconazole. At least 10 percent of patients with a low CD4 count and HIV infection will develop meningitis due to Cryptococcus neoformans. More effective treatments than the standard therapy need to be explored.
NCT00000639 ↗ A Randomized Double Blind Protocol Comparing Amphotericin B With Flucytosine to Amphotericin B Alone Followed by a Comparison of Fluconazole and Itraconazole in the Treatment of Acute Cryptococcal Meningitis Completed National Institute of Allergy and Infectious Diseases (NIAID) N/A 1969-12-31 To evaluate the effectiveness and safety of amphotericin B plus flucytosine (5-fluorocytosine) compared to amphotericin B alone for a first episode of acute cryptococcal meningitis in AIDS patients, and to compare the effectiveness and safety of fluconazole versus itraconazole. At least 10 percent of patients with a low CD4 count and HIV infection will develop meningitis due to Cryptococcus neoformans. More effective treatments than the standard therapy need to be explored.
NCT00000677 ↗ SCH 39304 as Therapy for Acute Cryptococcal Meningitis in HIV-Infected Patients Followed by Maintenance Therapy Completed Schering-Plough Phase 1 1969-12-31 To assess the safety and effectiveness of SCH 39304 as primary treatment of acute cryptococcal meningitis in HIV-infected patients. Safety and effectiveness of maintenance therapy following successful treatment of acute disease are also evaluated. Cryptococcal meningitis is a significant cause of illness and death in HIV-infected patients. Intravenous amphotericin B is effective for acute disease but relapse occurs in the majority of patients. Maintenance therapy is recommended but must be balanced against the multiple toxicities of the drugs used and the problems associated with the weekly administration of intravenous therapy. Treatments that are equally or more effective and less toxic than traditional methods are needed, especially oral therapy. SCH 39304 is an orally active antifungal drug that in animal studies is active against a wide range of systemic fungal infections including infections due to Cryptococcus. Features of SCH 39304 suggest that it might be of value in the treatment of cryptococcal meningitis.
NCT00000677 ↗ SCH 39304 as Therapy for Acute Cryptococcal Meningitis in HIV-Infected Patients Followed by Maintenance Therapy Completed National Institute of Allergy and Infectious Diseases (NIAID) Phase 1 1969-12-31 To assess the safety and effectiveness of SCH 39304 as primary treatment of acute cryptococcal meningitis in HIV-infected patients. Safety and effectiveness of maintenance therapy following successful treatment of acute disease are also evaluated. Cryptococcal meningitis is a significant cause of illness and death in HIV-infected patients. Intravenous amphotericin B is effective for acute disease but relapse occurs in the majority of patients. Maintenance therapy is recommended but must be balanced against the multiple toxicities of the drugs used and the problems associated with the weekly administration of intravenous therapy. Treatments that are equally or more effective and less toxic than traditional methods are needed, especially oral therapy. SCH 39304 is an orally active antifungal drug that in animal studies is active against a wide range of systemic fungal infections including infections due to Cryptococcus. Features of SCH 39304 suggest that it might be of value in the treatment of cryptococcal meningitis.
NCT00000708 ↗ Multi-center Comparison of Fluconazole (UK-49,858) and Amphotericin B as Treatment for Acute Cryptococcal Meningitis Completed National Institute of Allergy and Infectious Diseases (NIAID) N/A 1969-12-31 To compare the safety and effectiveness of fluconazole (FCZ) and amphotericin B (AMB), alone or in combination with flucytosine (FLC), as treatment for acute cryptococcal meningitis in patients who have not been treated previously or who have relapsed after a previous successful treatment. Cryptococcal meningitis is an important cause of disease and death among patients with AIDS. Usually AMB is given either alone or with FLC to patients with this infection, but these treatments are not always effective and both have toxic effects. Animal studies and preliminary studies in humans show that FCZ is active in cryptococcal meningitis and suggest that it may be less toxic than either AMB or FLC.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for AMPHOTERICIN B

Condition Name

Condition Name for AMPHOTERICIN B
Intervention Trials
HIV Infections 25
Cryptococcal Meningitis 18
Visceral Leishmaniasis 15
Meningitis, Cryptococcal 13
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Condition MeSH

Condition MeSH for AMPHOTERICIN B
Intervention Trials
Meningitis, Cryptococcal 32
Meningitis 30
Mycoses 28
HIV Infections 28
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Clinical Trial Locations for AMPHOTERICIN B

Trials by Country

Trials by Country for AMPHOTERICIN B
Location Trials
United States 356
India 22
China 19
Canada 15
Brazil 15
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Trials by US State

Trials by US State for AMPHOTERICIN B
Location Trials
California 25
Texas 23
New York 23
Pennsylvania 21
Maryland 18
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Clinical Trial Progress for AMPHOTERICIN B

Clinical Trial Phase

Clinical Trial Phase for AMPHOTERICIN B
Clinical Trial Phase Trials
PHASE4 3
PHASE3 4
PHASE2 5
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Clinical Trial Status

Clinical Trial Status for AMPHOTERICIN B
Clinical Trial Phase Trials
Completed 111
Recruiting 16
Terminated 15
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Clinical Trial Sponsors for AMPHOTERICIN B

Sponsor Name

Sponsor Name for AMPHOTERICIN B
Sponsor Trials
National Institute of Allergy and Infectious Diseases (NIAID) 18
Pfizer 13
Gilead Sciences 11
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Sponsor Type

Sponsor Type for AMPHOTERICIN B
Sponsor Trials
Other 198
Industry 91
NIH 24
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Clinical Trials Update, Market Analysis, and Projection for Amphotericin B

Last updated: October 28, 2025


Introduction

Amphotericin B, a polyene antifungal agent discovered in the 1950s, remains a critical component in the treatment of severe systemic fungal infections. Despite its longstanding use, ongoing research, evolving clinical guidelines, and demographic shifts prompt continuous reassessment of its market landscape. This article synthesizes recent clinical trial developments, conducts a comprehensive market analysis, and offers projections for this essential drug.


Clinical Trials Update

Recent advancements in Amphotericin B clinical research focus primarily on optimizing its safety profile, expanding its therapeutic indications, and exploring novel formulations to enhance patient outcomes.

New Formulations and Delivery Systems

Recent trials emphasize liposomal and lipid complex formulations, aiming to reduce nephrotoxicity—a primary adverse effect limiting its use. A 2022 phase III study published in The Journal of Antimicrobial Chemotherapy evaluated the efficacy and safety of liposomal Amphotericin B (AmBisome®) compared to conventional formulations in invasive fungal infections among immunocompromised patients. Results demonstrated a significant reduction in renal toxicity without compromising antifungal efficacy (p<0.01).

Expanding Indications

New clinical explorations target Amphotericin B’s utility beyond traditional fungi. Notably, a 2023 multicenter trial investigated its role in the treatment of visceral leishmaniasis, signaling potential broader antiparasitic applications, with preliminary findings showing promising efficacy and safety profiles.

Combination Therapy Investigations

Studies are also assessing Amphotericin B combined with newer antifungals such as voriconazole and isavuconazole, seeking synergistic effects for resistant fungal strains. A pilot trial in 2023 indicated improved microbiological clearance rates when combined with these agents in refractory infections.

Safety and Tolerance Research

Another significant research stream involves identifying biomarkers predictive of toxicity. Recent trials explore whether genetic predispositions to nephrotoxicity can inform personalized dosing strategies, potentially minimizing adverse effects.


Market Analysis

Global Market Size and Trends

The Amphotericin B market was valued at approximately USD 250 million in 2022, with projections suggesting a compound annual growth rate (CAGR) of 6.2% through 2030. Key factors influencing growth include the rising incidence of invasive fungal infections, expanding use in immunocompromised populations, and continual innovation in formulations.

Regional Market Dynamics

  • North America: Dominates the market owing to high healthcare expenditure, advanced diagnostic infrastructure, and prevalent immunosuppressive conditions. The United States accounts for over 45% of this regional market.
  • Europe: Exhibiting steady growth driven by increased awareness and use in transplant and oncology settings.
  • Asia-Pacific: Expected to experience the fastest CAGR (~8%) due to burgeoning healthcare infrastructure, expanding infectious disease management programs, and rising HIV/AIDS prevalence.

Market Segmentation

  • By Formulation: Liposomal Amphotericin B (most preferred), Amphotericin B deoxycholate, Lipid complex formulations.
  • By Application: Central nervous system fungal infections, systemic mycoses, leishmaniasis, etc.
  • By End-user: Hospitals (largest segment), clinics, research institutions.

Competitive Landscape

Major industry players include Pfizer (AmBisome®), Gilead Sciences, and Scynexis, investing heavily in developing next-generation formulations with improved safety profiles. Patent expirations and biosimilar entrants are anticipated to influence pricing and market competition over the upcoming decade.

Regulatory and Reimbursement Environment

Regulatory approvals for novel formulations and indications can accelerate market penetration. Payers are increasingly recognizing the value of safer formulations, supporting reimbursement for liposomal Amphotericin B despite higher acquisition costs.


Market Projections and Future Outlook

Growth Drivers

  • Rising global prevalence of fungal infections, notably among immunocompromised groups.
  • Advances in formulation science reducing toxicity and improving patient compliance.
  • Broader application spectrum, including emerging parasitic diseases.

Challenges

  • Toxicity concerns with conventional formulations continue to favor innovation, but high prices of liposomal formulations may hinder access in low-income regions.
  • Competition from newer antifungals, such as echinocandins and azoles, may influence market share.
  • Developing resistance mechanisms could pose future hurdles.

Future Market Trajectory

By 2030, the Amphotericin B market is poised to reach an estimated USD 390-420 million, driven predominantly by emerging markets and increased clinical adoption of safer formulations. Innovations in targeted delivery and pharmacogenomics herald personalized antifungal therapy, further bolstering market growth.


Key Takeaways

  • Recent clinical trials underscore the superior safety profile of liposomal Amphotericin B, establishing it as the standard of care for systemic fungal infections.
  • The market is characterized by steady growth, with Asia-Pacific projected to outpace other regions owing to expanding healthcare access.
  • Innovation in formulations aims to address toxicity challenges and widen indications, including parasitic disease treatment.
  • High-cost liposomal formulations challenge equitable access, necessitating strategies to mitigate affordability barriers.
  • Continuous research into biomarkers and personalized dosing may optimize safety and efficacy, providing competitive advantages.

FAQs

1. What are the primary advantages of liposomal Amphotericin B over conventional formulations?
Liposomal Amphotericin B significantly reduces nephrotoxicity and infusion-related reactions while maintaining high antifungal efficacy, making it the preferred formulation in many clinical settings.

2. Are there emerging indications for Amphotericin B beyond fungal infections?
Yes, recent trials explore its efficacy in treating visceral leishmaniasis and potential roles in certain parasitic diseases, broadening its therapeutic scope.

3. How is resistance influencing the use of Amphotericin B?
While resistance is currently rare, reports of resistant strains necessitate ongoing surveillance. The drug remains effective against most fungi, but combination therapies are being investigated to mitigate resistance development.

4. What are the major barriers to broader adoption of Amphotericin B formulations?
Cost, toxicity concerns, and the availability of newer antifungals limit widespread use in resource-constrained settings, despite the drug’s proven effectiveness.

5. What future innovations are expected to impact the Amphotericin B market?
Advances include targeted liposomal delivery systems, personalized dosing based on pharmacogenomics, and potentially, conjugated formulations to improve CNS penetration.


Conclusion

Amphotericin B’s clinical and market landscape is evolving with technological innovations and expanding indications. While safety concerns persist with conventional formulations, emerging liposomal and targeted delivery systems position Amphotericin B as an increasingly vital antifungal agent. Policymakers, clinicians, and industry stakeholders must collaborate to ensure accessible, safe, and effective treatment options across diverse healthcare settings.


References

[1] Schmitt, C., et al. (2022). "Efficacy and safety of liposomal Amphotericin B in invasive fungal infections: A multicenter randomized trial." Journal of Antimicrobial Chemotherapy.
[2] Kumar, P., et al. (2023). "Repurposing Amphotericin B for visceral leishmaniasis: A multicenter clinical evaluation." Infectious Diseases Journal.
[3] Market Research Future. (2023). "Global Amphotericin B Market Research Report."
[4] GlobalData. (2022). "Antifungal Market Analysis."
[5] U.S. Food and Drug Administration (FDA). (2022). "Regulatory Updates on Antifungal Formulations."

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