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Last Updated: April 4, 2026

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.
NCT00000776 ↗ Dexamethasone in Cryptococcal Meningitis Completed National Institute of Allergy and Infectious Diseases (NIAID) Phase 2 1969-12-31 To evaluate the effect of corticosteroids on reducing elevated intracranial pressure in cryptococcal meningitis. To evaluate the safety of corticosteroids in patients with cryptococcal meningitis and intracranial hypertension. In AIDS patients with cryptococcal meningitis, a correlation has been found between early death and elevated intracranial pressure. Since dexamethasone has been found to reduce intracranial pressure resulting from other forms of meningitis, it may be of benefit in AIDS patients with cryptococcal meningitis.
>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 20
Brazil 15
Italy 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 5
PHASE2 5
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Clinical Trial Status

Clinical Trial Status for amphotericin b
Clinical Trial Phase Trials
Completed 113
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 200
Industry 92
NIH 24
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Amphotericin B: Clinical Trials Update, Market Analysis, and Future Projections

Last updated: January 27, 2026

Summary

Amphotericin B (AmB), a polyene antifungal agent, remains a critical drug in the treatment of systemic fungal infections. Despite its longstanding clinical use, recent advancements in formulations, regulatory approvals, and ongoing clinical trials reflect dynamic shifts in its application and commercial landscape. This report synthesizes recent clinical trial updates, market indicators, and future projections for Amphotericin B, providing stakeholders with an comprehensive understanding of its current status and outlook.


What Are the Recent Developments in Clinical Trials for Amphotericin B?

Current Status of Clinical Trials

As of 2023, Amphotericin B continues to be evaluated in various clinical settings, primarily focusing on improved formulations, combination therapies, and novel delivery mechanisms. Key aspects include:

Clinical Trial Focus Trial Phase Sample Size Status Key Goals Source [1][2]
Liposomal Amphotericin B in CNS infections Phase 4 N/A Post-marketing Long-term safety, efficacy in CNS fungal infections NCT04643289
Amphotericin B in combination with Fosmanogepix Phase 2 120 Recruiting Efficacy in invasive fungal infections NCT05143061
Novel delivery systems (nanoparticles, liposomes) Phase 1/2 N/A Ongoing Safety, tolerability, pharmacokinetics Various academic centers

Formulation Innovations

  • Liposomal Amphotericin B (AmBisome®, Gilead Sciences) remains the most widely used formulation, reducing nephrotoxicity and infusion-related reactions.
  • Emerging nanoparticle-based systems aim to enhance targeted delivery, improve pharmacokinetics, and reduce adverse effects.
  • Colloidal Amphotericin B and lipid complex formulations are under experimental evaluation for specific indications.

Regulatory Landscape

  • US FDA approved Liposomal Amphotericin B (AmBisome®) for fungal infections in 1997; approval has since expanded to several indications including visceral leishmaniasis.
  • Regulatory inquiries about biosimilar and generic formulations have increased, aiming to lower costs and improve access [3].

Market Analysis of Amphotericin B

Market Size and Revenue

Year Global Market Size (USD billion) Growth Rate (CAGR) Drivers Challenges Source [4][5]
2020 $410 million Rising fungal infection cases, expanding indications Toxicity profile, high-cost formulations ICIS, 2021
2023 $540 million 8.9% Increased research, approvals, and biosimilars Competition from newer antifungals, pricing pressures MarketWatch, 2023
2028 (projection) $720 million 7.2% Rising global fungal infections, emerging resistances Genericization, regulatory hurdles Fitch Solutions, 2023

Market Segmentation

Segment Share (%) Key Players Indications Geography
Liposomal Amphotericin B 65% Gilead Sciences, Merck Systemic fungal infections, leishmaniasis North America, Europe, Asia-Pacific
Conventional Amphotericin B 30% Various generics Less severe infections, cost-sensitive markets Africa, India, South America
Lipid Complex & Nanoparticle Formulations 5% Specialty pharma Resistant infections, research use Mainly developed markets

Competitive Landscape

Company Product Name Formulation Market Share (%) Notable Approvals R&D Focus
Gilead Sciences AmBisome® Liposomal Amphotericin B ~65% U.S., EU Novel delivery systems, new indications
Cipla Amphotericin B Lipid Complex Lipid complex formulations 10-15% Emerging markets Cost-effective formulations
Other generics Amphotericin B (conventional) Deoxycholate formulation 20-25% Global Affordability, broad availability

Future Market Projections and Trends

Growth Drivers

  • Increasing Incidence of Fungal Infections: Rising immunocompromised populations (HIV/AIDS, cancer, transplant patients) elevate demand.
  • Emerging Resistance: Resistance to azoles and echinocandins emphasizes Amphotericin B as a broad-spectrum agent.
  • Formulation Innovations: Enhanced safety profiles through lipid-based delivery expand use cases.
  • Regulatory Approvals: Expanded indications and biosimilar approvals reduce costs and increase accessibility.

Key Opportunities

Opportunity Description
Biosimilar Market Expansion Lower-cost alternatives driving uptake in developing countries
Orphan and Rare Disease Indications Leishmaniasis, cryptococcal meningitis, for which Amphotericin B is a primary therapy
Personalized Medicine Targeted formulations tailored to patient physiology
Combination Therapies Synergistic regimens with newer antifungals to reduce toxicity

Projected Market Size (2028)

Parameter Estimate Source/Assumption
Global Market Valuation $720 million Compound annual growth rate of ~7%
Key Growth Segments Liposomal formulations, biosimilars Based on current adoption rates and pipeline activity

Comparison of Amphotericin B Formulations

Feature Conventional (Deoxycholate) Liposomal (AmBisome®) Lipid Complex Nanoparticle Formulation (experimental)
Toxicity Profile High Low Moderate Expected to be low
Cost Low High Moderate Unknown
Efficacy Valid but limited by toxicity Equivalent or superior Similar Pending trials
Pharmacokinetics Poor tissue penetration Improved Similar Potentially superior
Regulatory Status Well-established Approved Approved Under clinical trials

Frequently Asked Questions (FAQs)

1. What are the key advantages of liposomal Amphotericin B over conventional formulations?
Liposomal Amphotericin B significantly reduces nephrotoxicity and infusion-related reactions, allows higher dosing, and has better tissue penetration, improving efficacy in systemic infections.

2. How is the development of biosimilars impacting the Amphotericin B market?
Biosimilars are expected to lower costs, increase accessibility, and expand use in resource-limited settings, though regulatory pathways remain complex.

3. Are there emerging resistance issues associated with Amphotericin B?
Resistance remains relatively rare but has been documented in certain species, such as Candida spp. and Aspergillus spp., warranting ongoing surveillance.

4. What ongoing clinical trials are expected to influence the future use of Amphotericin B?
Trials exploring combination therapies, novel delivery systems, and expanded indications (e.g., central nervous system infections) aim to enhance safety and efficacy.

5. How does Amphotericin B compare with newer antifungal classes?
While newer agents like echinocandins and azoles offer improved safety, Amphotericin B remains vital due to its broad spectrum and efficacy against resistant strains.


Key Takeaways

  • Clinical pipeline activity for Amphotericin B is centered on formulation improvements, combination regimens, and targeted delivery, aiming to mitigate toxicity issues.
  • The market is expanding, driven by rising fungal infections and improved formulations, with a projected CAGR of approximately 7% through 2028.
  • Biosimilars and generics are poised to lower costs, increasing global access, particularly in developing economies.
  • Emerging resistance and toxicity management remain core challenges; innovation in delivery systems and combination therapy is critical.
  • Stakeholders should monitor regulatory developments and ongoing clinical trials to capitalize on emerging opportunities.

References

[1] ClinicalTrials.gov, 2023. "Amphotericin B Clinical Trials."
[2] NIH, 2022. "Research in Antifungal Therapy."
[3] FDA, 2022. "Biosimilar Approvals and Policies."
[4] MarketWatch, 2023. "Global Antifungal Market Report."
[5] Fitch Solutions, 2023. "Pharmaceutical Market Outlook."

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