PMID- 25158109
OWN - NLM
STAT- MEDLINE
DCOM- 20150831
LR  - 20220309
IS  - 1532-4303 (Electronic)
IS  - 0277-0903 (Linking)
VI  - 52
IP  - 3
DP  - 2015 Apr
TI  - Efficacy and safety of nebulised amphotericin B (NAB) in severe asthma with 
      fungal sensitisation (SAFS) and allergic bronchopulmonary aspergillosis (ABPA).
PG  - 289-95
LID - 10.3109/02770903.2014.958853 [doi]
AB  - BACKGROUND AND RATIONALE: Antifungal therapy for severe asthma with fungal 
      sensitisation (SAFS) and allergic bronchopulmonary aspergillosis (ABPA) remains 
      poorly studied. We assessed the efficacy and safety of NAB as second and third 
      line therapy in SAFS and ABPA. METHODS: 21 adult asthmatics with SAFS (n = 11) 
      and ABPA (n = 10) who had either failed itraconazole (n = 8), voriconazole 
      proceeded by itraconazole (n = 5) or developed adverse events (AEs) to either 
      agent (n = 7) were treated with 10mg of NAB (Fungizone) twice daily. We audited 
      clinical and immunological response, using the Asthma Quality of Life 
      Questionnaire (AQLQ-J) scores, asthma control, FEV1, healthcare utilisation and 
      IgE. Patients were followed up for 12 months. RESULTS: Twenty-one patients were 
      treated (SAFS, n = 11) and (ABPA, n = 10), M: F = 8:12, median age 65 years 
      (range, 24-78). The median duration of therapy was 30 days (0-1825). Clinical 
      benefit was observed in three (14.3 %) in which overall mean AQLQ-J score 
      improved by + 2.9, mean FEV1 improved by 0.5 L and there was improvement in 
      overall asthma control. Seven (33%) failed initial dose (bronchospasm). Eleven 
      (52.4%) discontinued within 12 months of therapy due to delayed bronchospasm 
      (n = 3, within 4 weeks), equipment problems (n = 2, within 4 weeks) and lack of 
      clinical benefit (n = 4, within 16 weeks). CONCLUSION: Our data suggest that the 
      overall efficacy of NAB in this group of patients is poor and associated with 
      bronchospasm. However, the excellent response in 3 patients, suggest it may be 
      considered when other alternatives have been exhausted. Overcoming the initial 
      bronchospasm may improve tolerability.
FAU - Chishimba, Livingstone
AU  - Chishimba L
AD  - Manchester Academic Health Science Centre, University Hospital South Manchester 
      NHS Foundation Trust, The University of Manchester , Manchester , UK .
FAU - Langridge, Philip
AU  - Langridge P
FAU - Powell, Georgina
AU  - Powell G
FAU - Niven, Robert M
AU  - Niven RM
FAU - Denning, David W
AU  - Denning DW
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
DEP - 20140923
PL  - England
TA  - J Asthma
JT  - The Journal of asthma : official journal of the Association for the Care of 
      Asthma
JID - 8106454
RN  - 0 (Antifungal Agents)
RN  - 304NUG5GF4 (Itraconazole)
RN  - 7XU7A7DROE (Amphotericin B)
RN  - JFU09I87TR (Voriconazole)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Amphotericin B/administration & dosage/adverse effects/*therapeutic use
MH  - Antifungal Agents/administration & dosage/adverse effects/*therapeutic use
MH  - Aspergillosis, Allergic Bronchopulmonary/*drug therapy/*epidemiology
MH  - Asthma/*epidemiology
MH  - Female
MH  - Forced Expiratory Volume
MH  - Humans
MH  - Itraconazole/therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Nebulizers and Vaporizers
MH  - Quality of Life
MH  - Voriconazole/therapeutic use
OTO - NOTNLM
OT  - Asthma
OT  - allergic lung disease
OT  - aspergillus lung disease
OT  - asthma pharmacology
EDAT- 2014/08/27 06:00
MHDA- 2015/09/01 06:00
CRDT- 2014/08/27 06:00
PHST- 2014/08/27 06:00 [entrez]
PHST- 2014/08/27 06:00 [pubmed]
PHST- 2015/09/01 06:00 [medline]
AID - 10.3109/02770903.2014.958853 [doi]
PST - ppublish
SO  - J Asthma. 2015 Apr;52(3):289-95. doi: 10.3109/02770903.2014.958853. Epub 2014 Sep 
      23.