Effects of Itraconazole Therapy in Allergic Bronchopulmonary Aspergillosis

Salez, F.; Brichet, A; Desurmont, Sophie; Grosbois, Jean-Marie; Wallaert, B.; Tonnel, A. B.

doi:10.1378/chest.116.6.1665

Cited by 98 publications

(64 citation statements)

References 19 publications

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“…The interaction between itraconazole and budesonide, inducing high systemic budesonide levels, may in part explain the reported ability to reduce the glucocorticoid dose [6,9,10,42,43]. If this is the case, the use of itraconazole may "spare" the administered dose of steroids but its effect, or side-effects, remain.…”

Section: Discussionmentioning

confidence: 99%

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Iatrogenic adrenal insufficiency as a side-effect of combined treatment of itraconazole and budesonide

Skov¹,

Main²,

Sillesen³

et al. 2002

European Respiratory Journal

131

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Section: Discussionmentioning

confidence: 99%

“…Recent studies have recommended itraconazole as an effective and steroid-sparing treatment of ABPA [6,9,10,42,43]. In some patients, worsening of the clinical symptoms of ABPA and an increase in specific IgG subclass antibodies to A. fumigatus resulted in readministration of itraconazole.…”

Section: Discussionmentioning

confidence: 99%

Iatrogenic adrenal insufficiency as a side-effect of combined treatment of itraconazole and budesonide

Skov¹,

Main²,

Sillesen³

et al. 2002

European Respiratory Journal

131

View full text Add to dashboard Cite

“…in patients with ABPA were disappointing [36,37]. However, case reports and uncontrolled series over several decades have reported treatment success upon addition of the Aspergillus-active oral triazole agent itraconazole to steroids for ABPA in asthma patients [38][39][40][41]. PACHECO et al [39] showed that itraconazole reduced specific IgG titres in a patient.…”

Section: Antifungal Therapy In Abpa and Safsmentioning

confidence: 99%

“…GERMAUD and TUCHAIS [40] showed effectiveness in 11 out of 12 treated patients, including prevention of exacerbations in six patients weaned off oral steroids. Using a before-after methodology, SALEZ et al [41] showed reduction in exacerbations and oral steroid doses when patients were started on itraconazole.…”

Section: Antifungal Therapy In Abpa and Safsmentioning

confidence: 99%

Treatment options in severe fungal asthma and allergic bronchopulmonary aspergillosis

Moss

2013

European Respiratory Journal

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Severe asthma with fungal sensitisation and allergic bronchopulmonary aspergillosis encompass two closely related subgroups of patients with severe allergic asthma. Pulmonary disease is due to pronounced host inflammatory responses to noninvasive subclinical endobronchial infection with filamentous fungi, usually Aspergillus fumigatus. These patients usually do not achieve satisfactory disease control with conventional treatment of severe asthma, i.e. high-dose inhaled corticosteroids and long-acting bronchodilators. Although prolonged systemic corticosteroids are effective, they carry a substantial toxicity profile. Supplementary or alternative therapies have primarily focused on use of antifungal agents including oral triazoles and inhaled amphotericin B. Immunomodulation with omalizumab, a humanised anti-IgE monoclonal antibody, or "pulse" monthly high-dose intravenous corticosteroid, has also been employed. This article considers the experience with these approaches, with emphasis on recent clinical trials. @ERSpublications Treatment of fungal asthma includes glucocorticoids, azoles, amphotericin and anti-IgE. Trial validation is needed.

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“…Stevens et al (68) conducted a randomized, double-blind trial showing a beneficial effect of oral itraconazole in the treatment of ABPA. The optimal duration of itraconazole therapy has not been defined (69).…”

Section: Allergic Bronchopulmonary Aspergillosismentioning

confidence: 99%