PMID- 19128719
OWN - NLM
STAT- MEDLINE
DCOM- 20090505
LR  - 20131121
IS  - 1916-0216 (Electronic)
IS  - 1916-0208 (Linking)
VI  - 37
IP  - 6
DP  - 2008 Dec
TI  - Effectiveness of itraconazole in the management of refractory allergic fungal 
      rhinosinusitis.
PG  - 870-4
AB  - OBJECTIVES: Conventional management of allergic fungal rhinosinusitis (AFRS) 
      after surgery consists of the use of steroids to immunomodulate the body's 
      response to fungi. However, there are many side effects to prolonged steroid use, 
      and some patients are unresponsive to standard treatment. The role of systemic 
      antifungal drugs in AFRS is still largely unknown. This was a pilot study to 
      evaluate the effectiveness of itraconazole, an oral antifungal drug, in the 
      treatment of refractory AFRS. METHOD: Thirty-two patients with AFRS who had had 
      surgery and were refractory to prednisone, steroid, and amphotericin B nasal 
      sprays were treated with itraconazole for at least 3 months. They were evaluated 
      with pre- and posttreatment endoscopic examinations, serum immunoglobulin E 
      (IgE), and the 31-Item Rhinosinusitis Outcome Measure (RSOM-31) questionnaires. 
      Monthly liver function tests were done to monitor for the hepatic side effects of 
      itraconazole. RESULTS: Twelve cases had endoscopic improvement. Fifteen had no 
      difference, and five had a worse endoscopic stage after 3 months. One patient had 
      to stop treatment due to abnormal liver function tests. The mean pre- and 
      posttreatment IgE levels were 581 microg/L and 766 microg/L, respectively. 
      Subjectively, 9 patients (28%) reported a significant improvement, 9 (28%) had 
      moderate improvements, and 14 (44%) reported little or no change. There was no 
      correlation between the subjective and the endoscopic changes. CONCLUSION: 
      Itraconazole may be useful as an adjunct in the management of AFRS. However, more 
      studies, including a prospective randomized clinical trial, are required to 
      determine if itraconazole is effective in the management of AFRS.
FAU - Chan, Kwai-Onn
AU  - Chan KO
AD  - Department of Otolaryngology, Changi General Hospital, Singapore.
FAU - Genoway, Krista A
AU  - Genoway KA
FAU - Javer, Amin R
AU  - Javer AR
LA  - eng
PT  - Journal Article
PL  - England
TA  - J Otolaryngol Head Neck Surg
JT  - Journal of otolaryngology - head & neck surgery = Le Journal 
      d'oto-rhino-laryngologie et de chirurgie cervico-faciale
JID - 101479544
RN  - 0 (Antifungal Agents)
RN  - 304NUG5GF4 (Itraconazole)
SB  - IM
MH  - Adult
MH  - Antifungal Agents/*therapeutic use
MH  - Cohort Studies
MH  - Female
MH  - *Fungi
MH  - Humans
MH  - Itraconazole/*therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Respiratory Hypersensitivity/*drug therapy/microbiology
MH  - Retrospective Studies
MH  - Rhinitis/*drug therapy/microbiology
MH  - Sinusitis/*drug therapy/microbiology
MH  - Treatment Outcome
EDAT- 2009/01/09 09:00
MHDA- 2009/05/06 09:00
CRDT- 2009/01/09 09:00
PHST- 2009/01/09 09:00 [entrez]
PHST- 2009/01/09 09:00 [pubmed]
PHST- 2009/05/06 09:00 [medline]
PST - ppublish
SO  - J Otolaryngol Head Neck Surg. 2008 Dec;37(6):870-4.