Azoles for allergic bronchopulmonary aspergillosis associated with asthma

摘要: BACKGROUND Allergic bronchopulmonary aspergillosis is hypersensitivity to the fungus Aspergillus fumigatus that complicates patients with asthma and cystic fibrosis. The mainstay of treatment for allergic remains oral corticosteroids, though this does not completely prevent exacerbations may decline in lung function. OBJECTIVES purpose review was determine efficacy azoles aspergillosis. SEARCH STRATEGY We searched Cochrane Airways Group Asthma trials register using terms: (allergic OR pulmonary fungal disease mycotic disease) AND (azole triazole itraconazole ketoconazole). Date last search January 2003. SELECTION CRITERIA All controlled assessed effect azole antifungal agents compared placebo or other standard therapy were reviewed. Patients fibrosis included. DATA COLLECTION ANALYSIS Two reviewers independently trial quality extracted data. Study authors contacted additional information. Adverse effects information collected from trials. MAIN RESULTS Twelve identified, but only three prospective, randomised controlled. A total 94 participants One demonstrated a reduction immunological markers activity symptom scores ketoconazole 400 mg daily 12 months. There no significant improvement two examined use 16 weeks. In one there sputum eosinophils by 35% 19% (p < 0.01). same trial, number requiring corticosteroids 0.4 per patient 1.3 0.03). Meta-analysis data both showed treated more likely have serum IgE over 25% (Peto 3.30; 95% confidence intervals 1.30 8.15). REVIEWERS' CONCLUSIONS Itraconazole modifies immunologic activation associated improves clinical outcome, at least period Adrenal suppression inhaled potential concern.