Details

Autor(en) / Beteiligte

• Agbetile, Joshua, MD
• Bourne, Michelle, RGN
• Fairs, Abbie, PhD
• Hargadon, Beverley, RGN
• Desai, Dhananjay, MD
• Broad, Clare
• Morley, Joseph, BSc
• Bradding, Peter, DM, FRCP
• Brightling, Christopher E., PhD, FRCP
• Green, Ruth H., DM, FRCP
• Haldar, Pranabashis, DM, MRCP
• Pashley, Catherine H., PhD
• Pavord, Ian D., DM, FRCP
• Wardlaw, Andrew J., PhD, FRCP

Titel

Effectiveness of voriconazole in the treatment of Aspergillus fumigatus –associated asthma (EVITA3 study)

Ist Teil von

• Journal of allergy and clinical immunology, 2014-07, Vol.134 (1), p.33-39

Ort / Verlag

New York, NY: Elsevier Inc

Erscheinungsjahr

2014

Quelle

Free E-Journal (出版社公開部分のみ）

Beschreibungen/Notizen

• Background IgE sensitization to Aspergillus fumigatus and a positive sputum fungal culture result are common in patients with refractory asthma. It is not clear whether these patients would benefit from antifungal treatment. Objectives We sought to determine whether a 3-month course of voriconazole improved asthma-related outcomes in patients with asthma who are IgE sensitized to A fumigatus. Methods Asthmatic patients who were IgE sensitized to A fumigatus with a history of at least 2 severe exacerbations in the previous 12 months were treated for 3 months with 200 mg of voriconazole twice daily, followed by observation for 9 months, in a double-blind, placebo-controlled, randomized design. Primary outcomes were improvement in quality of life at the end of the treatment period and a reduction in the number of severe exacerbations over the 12 months of the study. Results Sixty-five patients were randomized. Fifty-nine patients started treatment (32 receiving voriconazole and 27 receiving placebo) and were included in an intention-to-treat analysis. Fifty-six patients took the full 3 months of medication. Between the voriconazole and placebo groups, there were no significant differences in the number of severe exacerbations (1.16 vs 1.41 per patient per year, respectively; mean difference, 0.25; 95% CI, 0.19-0.31), quality of life (change in Asthma Quality of Life Questionnaire score, 0.68 vs 0.88; mean difference between groups, 0.2; 95% CI, −0.05 to −0.11), or any of our secondary outcome measures. Conclusion We were unable to show a beneficial effect of 3 months of treatment with voriconazole in patients with moderate-to-severe asthma who were IgE sensitized to A fumigatus on either the rate of severe exacerbations, quality of life, or other markers of asthma control.