Aspergillose broncho-pulmonaire allergique traitée par voriconazole

Mulliez, P.; Croxo, C; Georges, F.; Darras, A.

doi:10.1016/s0761-8425(06)71469-3

Cited by 15 publications

(5 citation statements)

References 4 publications

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“…Pulse doses of intravenous methylprednisolone have also been used for treatment of severe exacerbations of ABPA [198,[206][207][208][209][210]. Newer antifungal agents including voriconazole [202,[211][212][213][214][215][216][217][218], and posaconazole [183,210] are also efficacious in ABPA, if tolerated. Without more data, these drugs are indicated in those intolerant to itraconazole or in itraconazole failures [219].…”

Section: Other Therapiesmentioning

confidence: 99%

Allergic bronchopulmonary aspergillosis: review of literature and proposal of new diagnostic and classification criteria

Agarwal

Chakrabarti

Shah

et al. 2013

Clin Experimental Allergy

749

794

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Allergic bronchopulmonary aspergillosis (ABPA) is an immunological pulmonary disorder caused by hypersensitivity to Aspergillus fumigatus, manifesting with poorly controlled asthma, recurrent pulmonary infiltrates and bronchiectasis. There are estimated to be in excess of four million patients affected world-wide. The importance of recognizing ABPA relates to the improvement of patient symptoms, and delay in development or prevention of bronchiectasis, one manifestation of permanent lung damage in ABPA. Environmental factors may not be the only pathogenetic factors because not all asthmatics develop ABPA despite being exposed to the same environment. Allergic bronchopulmonary aspergillosis is probably a polygenic disorder, which does not remit completely once expressed, although long-term remissions do occur. In a genetically predisposed individual, inhaled conidia of A. fumigatus germinate into hyphae with release of antigens that activate the innate and adaptive immune responses (Th2 CD4(+) T cell responses) of the lung. The International Society for Human and Animal Mycology (ISHAM) has constituted a working group on ABPA complicating asthma (www.abpaworkinggroup.org), which convened an international conference to summarize the current state of knowledge, and formulate consensus-based guidelines for diagnosis and therapy. New diagnosis and staging criteria for ABPA are proposed. Although a small number of randomized controlled trials have been conducted, long-term management remains poorly studied. Primary therapy consists of oral corticosteroids to control exacerbations, itraconazole as a steroid-sparing agent and optimized asthma therapy. Uncertainties surround the prevention and management of bronchiectasis, chronic pulmonary aspergillosis and aspergilloma as complications, concurrent rhinosinusitis and environmental control. There is need for new oral antifungal agents and immunomodulatory therapy.

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Section: Other Therapiesmentioning

confidence: 99%

Allergic bronchopulmonary aspergillosis: review of literature and proposal of new diagnostic and classification criteria

Agarwal

Chakrabarti

Shah

et al. 2013

Clin Experimental Allergy

749

794

View full text Add to dashboard Cite

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“…Newer oral triazoles with excellent anti-Aspergillus activity (voriconazole and posaconazole) have also been reported as beneficial in the treatment of ABPA, particularly in patients with CF [48,49,[89][90][91]. In one study, voriconazole was used as monotherapy in 13 CF patients with ABPA; significant and sustained improvements in clinical status, lung function and serologies occurred with prolonged treatment, although nine patients required oral steroids [48].…”

Section: Antifungal Therapy In Abpa and Safsmentioning

confidence: 99%

Treatment options in severe fungal asthma and allergic bronchopulmonary aspergillosis

Moss

2013

Eur Respir J

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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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“…Majority of the patients usually respond to systemic steroids. 1 Other therapeutic options among those not adequately responding include addition of itracanazole 7 or voriconazole, 8 pulse doses of IV methylprednisolone, 9 nebulized amphotericin, and budesonide. 10 Omalizumab (Xolair) is a humanized monoclonal anti-IgE antibody that binds to FceRI (high-affinity IgE receptor) and FceRII (low-affinity receptor) areas of the IgE heavy chain (CHe3 region), preventing the interaction of free IgE with its receptors on mast cells and basophils.…”

Section: Discussionmentioning

confidence: 99%

Anti-IgE Monoclonal Antibody in Allergic Bronchopulmonary Aspergillosis Not Responding to Systemic Steroids

Sharma

Ganga

2021

Journal of Health and Allied Sciences NU

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Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity disorder caused by Aspergillus fumigatus commonly among patients of bronchial asthma. Early diagnosis is the key to successful management and preventing parenchymal destruction. Most of the patients respond well to systemic steroids. In patients not responding to standard treatment, the other treatment options include pulse steroids, antifungals, immunosuppressants, and omalizumab. But exact indication for each of these is not well established. Here we report a 41-year-old ABPA patient who was not responding to systemic steroids became totally asymptomatic with the administration of omalizumab.

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Aspergillose broncho-pulmonaire allergique traitée par voriconazole

Cited by 15 publications

References 4 publications

Allergic bronchopulmonary aspergillosis: review of literature and proposal of new diagnostic and classification criteria

Allergic bronchopulmonary aspergillosis: review of literature and proposal of new diagnostic and classification criteria

Treatment options in severe fungal asthma and allergic bronchopulmonary aspergillosis

Anti-IgE Monoclonal Antibody in Allergic Bronchopulmonary Aspergillosis Not Responding to Systemic Steroids

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