Successful control of exacerbation of Allergic Bronchopulmonary Aspergillosis due to Aspergillus terreus in a cystic fibrosis patient with short-term adjunctive therapy with voriconazole: A case report

Hassanzad, Maryam; Mortezaee, Vida; Bongomin, Felix; Poorabdollah, Mihan; Sharifynia, Somayeh; Maleki, Mohammadreza; Hedayati, Newsha; Velayati, Ali Akbar; Hedayati, Mohammad Taghi

doi:10.1016/j.mycmed.2019.02.001

Cited by 7 publications

(4 citation statements)

References 15 publications

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“…7 Voriconazole has been shown to improve serologies, reduce oral corticosteroid doses, and improve lung function in patients with ABPA and CF. [8][9][10] When posaconazole was compared with other triazoles in ABPA management, posaconazole was found to be the only triazole to result in a significant reduction in Aspergillus-specific IgE. 11 Posaconazole was also evaluated in a prospective, open-label observational study, which reported a significant increase in forced expiratory volume in the first second (FEV 1 ) percentage predicted and symptomatic improvement.…”

Section: Azole Antifungalsmentioning

confidence: 99%

Beyond the Guidelines: Treatment of Allergic Bronchopulmonary Aspergillosis in Cystic Fibrosis

Tompkins

Pettit

2021

Ann Pharmacother

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Objective: To review the available literature addressing alternative allergic bronchopulmonary aspergillosis (ABPA) treatment options for patients with cystic fibrosis (CF). Data Sources: A literature search of PubMed was performed (January 2002 to April 2021) using the following search terms: allergic bronchopulmonary aspergillosis, aspergillus-related lung disease, cystic fibrosis. Manufacturer prescribing information, clinical practice guidelines, and data from ClinicalTrials.gov were incorporated in the reviewed data. Study Selection and Data Extraction: Relevant English-language studies or those conducted in humans were considered for inclusion. Data Synthesis: Available literature for alternative ABPA treatments in CF is lacking randomized controlled trials, but there is considerable support in case reports and case series describing the benefits in pediatric and adult patients. Recent literature has begun to explore the place in therapy for novel, corticosteroid-sparing treatment approaches. The alternative therapies summarized in this review all resulted in clinical improvement and subsequent discontinuation or dose reductions of oral corticosteroids, with minimal reported adverse drug effects. Relevance to Patient Care and Clinical Practice: Although corticosteroids are the cornerstone of ABPA management, the toxicities can be significant limitations in an already high-risk patient population. Patients may fail or become intolerant to guideline-recommended therapies and require alternative treatment approaches. Conclusions: Alternative treatment modalities for ABPA in patients with CF, including azole antifungals, pulsed intravenous glucocorticoids, omalizumab, mepolizumab, and inhaled amphotericin, appear to be efficacious and well tolerated. Pharmacological properties including route of administration, storage and stability, beyond use dating, and adverse effects of the various treatment modalities must be considered when selecting a practical care plan for patients.

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Section: Azole Antifungalsmentioning

confidence: 99%

Beyond the Guidelines: Treatment of Allergic Bronchopulmonary Aspergillosis in Cystic Fibrosis

Tompkins

Pettit

2021

Ann Pharmacother

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“…A case report by Hassanzad et al 54 was performed in a 12‐year old CF patient who was treated for ABPA due to A. terreus that was unresponsive to 2 months of itraconazole and prednisolone therapy (Table 2). The change from itraconazole to voriconazole resulted in improvements in FEV 1 , sputum samples, and serum IgE 54 (Table 2).…”

Section: Efficacy/tolerabilitymentioning

confidence: 99%

Optimization of antimicrobials in the treatment of cystic fibrosis pulmonary exacerbations:  II. Therapies for allergic bronchopulmonary aspergillosis

Epps

Zobell

et al. 2020

Pediatric Pulmonology

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This review is the second article in the State‐of‐the‐Art series and aims to evaluate medications used in the treatment of allergic bronchopulmonary aspergillosis (ABPA) in pediatric and adult patients with cystic fibrosis (CF). ABPA is one of several organisms that are found in the airways of CF patients. This review provides an evidence‐based summary of pharmacokinetic (PK)/pharmacodynamic (PD), tolerability, and efficacy studies of medications including corticosteroids, amphotericin B, azole antifungals (isavuconazole, itraconazole, posaconazole, and voriconazole), and a monoclonal antibody omalizumab in the treatment of ABPA and identifies areas where further study is warranted.

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“…Ochratoxin A (OTA) makes A. ochraceus notorious for their role as contaminants in mycotoxigenic food and feed. Moreover, increasing cases have suggested A. ochraceus acts as human and animal pathogens causing onychomycosis ( Xu et al, 2021 ), allergic bronchopulmonary aspergillosis ( Hassanzad et al, 2019 ), and otomycosis ( Ghibaudo and Peano, 2010 ). Some novel IgE-binding proteins have been identified from A. ochraceus , indicating the allergenic potency of mycelial proteins ( Roy et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

The Secondary Metabolites and Biosynthetic Diversity From Aspergillus ochraceus

Chen

et al. 2022

Front. Chem.

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Aspergillus ochraceus, generally known as a food spoilage fungus, is the representative species in Aspergillus section Circumdati. A. ochraceus strains are widely distributed in nature, and usually isolated from cereal, coffee, fruit, and beverage. Increasing cases suggest A. ochraceus acts as human and animal pathogens due to producing the mycotoxins. However, in terms of benefits to mankind, A. ochraceus is the potential source of industrial enzymes, and has excellent capability to produce diverse structural products, including polyketides, nonribosomal peptides, diketopiperazine alkaloids, benzodiazepine alkaloids, pyrazines, bis-indolyl benzenoids, nitrobenzoyl sesquiterpenoids, and steroids. This review outlines recent discovery, chemical structure, biosynthetic pathway, and bio-activity of the natural compounds from A. ochraceus.

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Successful control of exacerbation of Allergic Bronchopulmonary Aspergillosis due to Aspergillus terreus in a cystic fibrosis patient with short-term adjunctive therapy with voriconazole: A case report

Cited by 7 publications

References 15 publications

Beyond the Guidelines: Treatment of Allergic Bronchopulmonary Aspergillosis in Cystic Fibrosis

Beyond the Guidelines: Treatment of Allergic Bronchopulmonary Aspergillosis in Cystic Fibrosis

Optimization of antimicrobials in the treatment of cystic fibrosis pulmonary exacerbations:  II. Therapies for allergic bronchopulmonary aspergillosis

The Secondary Metabolites and Biosynthetic Diversity From Aspergillus ochraceus

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Successful control of exacerbation of Allergic Bronchopulmonary Aspergillosis due to Aspergillus terreus in a cystic fibrosis patient with short-term adjunctive therapy with voriconazole: A case report

Cited by 7 publications

References 15 publications

Beyond the Guidelines: Treatment of Allergic Bronchopulmonary Aspergillosis in Cystic Fibrosis

Beyond the Guidelines: Treatment of Allergic Bronchopulmonary Aspergillosis in Cystic Fibrosis

Optimization of antimicrobials in the treatment of cystic fibrosis pulmonary exacerbations: II. Therapies for allergic bronchopulmonary aspergillosis

The Secondary Metabolites and Biosynthetic Diversity From Aspergillus ochraceus

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Optimization of antimicrobials in the treatment of cystic fibrosis pulmonary exacerbations:  II. Therapies for allergic bronchopulmonary aspergillosis