Effectiveness of Low-Dose Itraconazole in Fungal-Associated Severe Asthma: A Retrospective Study
| Autor: | Shu-Min Lin, Han Pin Kuo, Chun Hua Wang, Yu-Lun Lo, Fu-Tsai Chung, Hung-Yu Huang, Yu-Chen Huang, Chun-Yu Lin |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty medicine.diagnostic_test Itraconazole business.industry Severe asthma Retrospective cohort study Sputum culture Pulmonary function testing Fungal sensitization Internal medicine Concomitant medicine Immunology and Allergy Sputum medicine.symptom business medicine.drug |
| Zdroj: | Journal of Asthma and Allergy. 13:453-461 |
| ISSN: | 1178-6965 |
| Popis: | Background The efficacy of antifungal therapy in fungal-associated severe asthma remains controversial. Objective We aimed to evaluate the differences in the clinical presentation and response to antifungal therapy between severe asthmatics with fungal sensitization and positive fungal isolates. Methods This retrospective study included 73 patients with severe asthma from January 2004 to December 2017. We examined the presentation, medication, exacerbations, pulmonary function, serum IgE, blood eosinophils, and sputum culture results. Follow-up care was provided to each patient for minimum 3 years. Results We classified the patients into four groups: group 1, neither fungal sensitization nor fungal isolates in the sputum (n=16); group 2, positive fungal sensitization (n=16); group 3, positive fungal isolates (n=31); and group 4, concomitant positive fungal sensitization and positive fungal isolates (n=10). There were four participants in group 2, 15 in group 3, and 6 in group 4 had received itraconazole therapy for 3 months. Patients in group 3 presented with lower serum IgE level than those in groups 2 and 4. Antifungal therapy significantly improved ACT score during the first year in groups 3 (from 18 [15-22] to 24 [23-24], p=0.0004) and resulted in a long-lasting ACT improvement till the third year in group 3 (from 18 [15-22] to 24 [22-24], p=0.0013). Conclusion Antifungal therapy could effectively control the symptoms in patients with severe asthma with positive fungal isolates, contrary to those with merely fungal sensitization; therefore, highlighting the need for a more precise treatment strategy in future for fungal-associated severe asthma. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|