Biologic drugs in treating allergic bronchopulmonary aspergillosis in patients with cystic fibrosis: a systematic review

Manti, Sara; Giallongo, Alessandro; Parisi, Giuseppe Fabio; Papale, Maria; Mulé, Enza; Aloisio, Donatella; Rotolo, Novella; Leonardi, ﻿Salvatore

doi:10.1183/16000617.0011-2022

Cited by 15 publications

(11 citation statements)

References 77 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although most patients would respond to standard doses of glucocorticoids, some patients, such as our patient, may not adequately respond to oral glucocorticoid therapy 5 . In recent years, systematic reviews and case reports have reported the potential benefit of biologics, including benralizumab, for the treatment of ABPA in patients with asthma or cystic fibrosis 6–12 . However, the efficacy and safety of benralizumab in ABPA remains to be fully studied.…”

Section: Discussionmentioning

confidence: 94%

See 1 more Smart Citation

Rapid onset of effect of benralizumab in a severe eosinophilic and allergic asthma patient with allergic bronchopulmonary aspergillosis

Alaga

Ashraff

Khan

2023

Respirology Case Reports

View full text Add to dashboard Cite

There is limited data on the use of benralizumab in patients with severe asthma, who have allergic bronchopulmonary aspergillosis (ABPA). We report the case of a 65‐year‐old woman with combined severe eosinophilic and allergic asthma, who presented with refractory respiratory symptoms, hypereosinophilia and high immunoglobulin E (IgE) level. The patient had consistently poor Asthma Control Test (ACT) scores, despite a maximum dose of inhalation therapy. Upon further investigations, she was diagnosed with concomitant ABPA. The patient was started on oral prednisolone and itraconazole, but her symptoms persisted. She was then started on subcutaneous omalizumab, but switched to benralizumab after developing a severe allergic reaction. The patient experienced rapid clinical improvements after the first dose of subcutaneous benralizumab. Benralizumab demonstrated a significant role in reducing the exacerbation rate and oral corticosteroid use in this patient, as well as improving lung function, asthma control, and quality of life measures.

show abstract

Section: Discussionmentioning

confidence: 94%

“…5 In recent years, systematic reviews and case reports have reported the potential benefit of biologics, including benralizumab, for the treatment of ABPA in patients with asthma or cystic fibrosis. [6][7][8][9][10][11][12] However, the efficacy and safety of benralizumab in ABPA remains to be fully studied.…”

Section: Discussionmentioning

confidence: 99%

Rapid onset of effect of benralizumab in a severe eosinophilic and allergic asthma patient with allergic bronchopulmonary aspergillosis

Alaga

Ashraff

Khan

2023

Respirology Case Reports

View full text Add to dashboard Cite

show abstract

“…Lastly, a few studies have investigated the safety and efficacy of drug combination in children; in a small retrospective study in leukemic patients with invasive fungal disease, 9 of which with invasive aspergillosis, the combination of voriconazole and caspofungin was safe and effective but further studies are needed [ 27 ]. Data providing evidence for biologic drug use in ABPA are scarce at the moment [ 37 ].…”

Section: Resultsmentioning

confidence: 99%

Management of pulmonary aspergillosis in children: a systematic review

et al. 2023

View full text Add to dashboard Cite

Invasive pulmonary aspergillosis (IPA) is a severe condition in immunocompromised children, but the optimal management is still under debate. In order to better clarify this issue, a literature search was performed through MEDLINE/PubMed database to describe current risk factors and diagnostic, therapeutic and prophylactic tools for invasive pulmonary aspergillosis (IPA) in the paediatric age. Observational studies and clinical trials regarding diagnosis, treatment and prophylaxis were considered, and results were summarised. Five clinical trials and 25 observational studies (4453 patients) were included.Haematological malignancies, previous organ transplant and other primary or acquired immunodeficiency were identified as risk factors for IPA in children.Current diagnostic criteria distinguish between "proven", "probable" and "possible" disease. Consecutive galactomannan assays have good sensitivity and specificity, especially when performed on broncho-alveolar lavage. At the same time, β-D-glucan should not be used since cut-off in children is unclear. PCR assays cannot currently be recommended for routine use.Voriconazole is the recommended first-line agent for IPA in children older than 2 years of age. Liposomal amphotericin B is preferred in younger patients or cases of intolerance to voriconazole. Its plasma concentrations should be monitored throughout the treatment. The optimal duration of therapy has yet to be determined. Posaconazole is the preferred prophylactic agent in children older than 13 years old, whereas oral voriconazole or itraconazole are the drugs of choice for those between 2–12 years. Further good-quality studies are warranted to improve clinical practice.

show abstract

“…The benefits of using biologics appear to be greater in patients with ABPA and asthma than in patients with cystic fibrosis [ 34 ]. However, robust data are lacking, and more controlled trials are needed before anti-IgE or other biologic therapies can be recommended to manage ABPA [ 42 ].…”

Section: Allergic Fungal Diseasesmentioning

confidence: 99%

Clinical Manifestations of Human Exposure to Fungi

Oliveira

Lisboa

et al. 2023

JoF

View full text Add to dashboard Cite

Biological particles, along with inorganic gaseous and particulate pollutants, constitute an ever-present component of the atmosphere and surfaces. Among these particles are fungal species colonizing almost all ecosystems, including the human body. Although inoffensive to most people, fungi can be responsible for several health problems, such as allergic fungal diseases and fungal infections. Worldwide fungal disease incidence is increasing, with new emerging fungal diseases appearing yearly. Reasons for this increase are the expansion of life expectancy, the number of immunocompromised patients (immunosuppressive treatments for transplantation, autoimmune diseases, and immunodeficiency diseases), the number of uncontrolled underlying conditions (e.g., diabetes mellitus), and the misusage of medication (e.g., corticosteroids and broad-spectrum antibiotics). Managing fungal diseases is challenging; only four classes of antifungal drugs are available, resistance to these drugs is increasing, and no vaccines have been approved. The present work reviews the implications of fungal particles in human health from allergic diseases (i.e., allergic bronchopulmonary aspergillosis, severe asthma with fungal sensitization, thunderstorm asthma, allergic fungal rhinosinusitis, and occupational lung diseases) to infections (i.e., superficial, subcutaneous, and systemic infections). Topics such as the etiological agent, risk factors, clinical manifestations, diagnosis, and treatment will be revised to improve the knowledge of this growing health concern.

show abstract

Biologic drugs in treating allergic bronchopulmonary aspergillosis in patients with cystic fibrosis: a systematic review

Cited by 15 publications

References 77 publications

Rapid onset of effect of benralizumab in a severe eosinophilic and allergic asthma patient with allergic bronchopulmonary aspergillosis

Rapid onset of effect of benralizumab in a severe eosinophilic and allergic asthma patient with allergic bronchopulmonary aspergillosis

Management of pulmonary aspergillosis in children: a systematic review

Clinical Manifestations of Human Exposure to Fungi

Contact Info

Product

Resources

About