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Anti-fungal drug offers great benefits to some with severe asthma
Date:12/28/2008

Some patients with severe asthma who also have allergic sensitivity to certain fungi enjoy great improvements in their quality of life and on other measures after taking an antifungal drug, according to new research from The University of Manchester in England.

The findings were reported in the first issue for January of the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine.

"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, F.R.C.P., F.R.C.Path., professor of medicine and medical mycology at The University of Manchester and lead investigator of the study.

In 2006, the most recent year for which official statistics are available, 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 asthmaticsabout 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.

In the prospective double-blind study, 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) were randomized to receive either an oral dose of itraconazole (200mg twice a day) or a placebo.

After 32 weeks of treatment, 1
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Contact: Keely Savoie
ksavoie@thoracic.org
212-315-8620
American Thoracic Society
Source:Eurekalert

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