Abstract | BACKGROUND: Allergic Broncho- pulmonary Aspergillosis (ABPA) is hypersensitivity to the fungus Aspergillus Fumigatus that complicates patients with asthma and cystic fibrosis. The condition usually results in an increase in symptoms, a greater reliance on corticosteroids to control the disease process and may lead to a progressive decline in lung function. The mainstay of treatment for ABPA remains oral corticosteroids, though this does not completely prevent exacerbations and may not prevent the decline in lung function. OBJECTIVES: SELECTION CRITERIA: All controlled trials that assessed the effect of azole antifungal agents compared to placebo or other standard, for any duration or dose regimen in subjects with ABPA of any age or severity were reviewed. Studies in languages other than English were included. DATA COLLECTION AND ANALYSIS: All identified trials were independently reviewed by both reviewers & all data collected. Trial quality was scored by the Cochrane assessment of allocation concealment & the Jadad scale of methodological quality. MAIN RESULTS: A total of 11 trials were identified concerning the use of azoles in ABPA. Only two prospective controlled trials were identified. The first trial examined the use of Ketoconazole 400 mg daily for 12 months and demonstrated a reduction in immunological markers of disease activity and symptom scores, there was no significant improvement in lung function. The other trial examined the use of itraconazole for 16 weeks. This demonstrated a reduction in corticosteroid usage, an improvement in immunological markers, an improvement in pulmonary function and exercise tolerance. This study was only available as an abstract and limited details were available. REVIEWER'S CONCLUSIONS: There is insufficient information available to recommend the use of azole anti-fungal agents in the routine treatment of patients with ABPA.
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Authors | P Wark, A W Wilson, P G Gibson |
Journal | The Cochrane database of systematic reviews
(Cochrane Database Syst Rev)
Issue 3
Pg. CD001108
( 2000)
ISSN: 1469-493X [Electronic] England |
PMID | 10908485
(Publication Type: Journal Article, Review, Systematic Review)
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Chemical References |
- Antifungal Agents
- Itraconazole
- Ketoconazole
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Topics |
- Antifungal Agents
(therapeutic use)
- Aspergillosis, Allergic Bronchopulmonary
(drug therapy)
- Controlled Clinical Trials as Topic
- Humans
- Itraconazole
(therapeutic use)
- Ketoconazole
(therapeutic use)
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