Severe asthma patients with allergic sensitivity to certain fungi can significantly improve quality of their life with antifungal drug. A man holds an inhaler
© AFP/Getty Images/File Spencer PlattDecember 29, 2008, (Sawf News) - Severe asthma patients with allergic sensitivity to certain fungi can significantly improve quality of their life with antifungal drug.
“We knew that many people with severe asthma are sensitized to several airborne fungi which can worsen asthma without overt clinical signs. The question was: does antifungal therapy provide any clinical benefit,” said David Denning of The University of Manchester and lead investigator of the study.
According to 2006 official statistics there were more than 16 million adults with self-reported asthma in the U.S.; about 20 percent of them have severe asthma.
A small number of severe asthmatics—about one percent— are known to have a syndrome called allergic bronchopulmonary aspergillosis, an extreme allergy to Aspergillus fumigatus fungus that is associated with the long-term colonization of their respiratory tracts with the fungus. But many more — 20 to 50 percent— are sensitized to a variety of fungi without showing overt clinical signs or demonstrable colonization. It is these patients with severe asthma with fungal sensitization, or “SAFS”, as the researchers named the syndrome, who are most likely to enjoy marked improvement with the antifungal therapy.
Researchers enrolled 58 patients with severe asthma and allergic sensitivity to at least one of seven different common fungi (confirmed by a skin-prick test and/or an IgE blood test for the study) who randomly received either an oral dose of itraconazole (200mg twice a day) or a placebo.
After 32 weeks of treatment 62 percents randomized to receive the drug experienced significant improvements on their Asthma, runny nose and morning lung function.
However, four months after stopping antifungal treatment, symptoms had returned.
“This study indicates that fungal allergy is important in some patients with severe asthma, and that oral antifungal therapy is worth trying in difficult-to-treat patients. Clearly itraconazole will not suit everyone and is not always helpful, but when it is the effect is dramatic,” said Dr. Denning. “These findings open the door to a new means of helping patients with severe asthma, and raise intriguing questions related to fungal allergy and asthma.”
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