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Itraconazole Benefits Patients With Severe Asthma, Sensitivity to Fungi NEW YORK -- December 29, 2008 -- Some patients with severe asthma who also have bronchopulmonary aspergillosis enjoy great improvements in their quality of life and on other measures after taking itraconazole, according to a study published in January 2009 issue of the American Journal of Respiratory and Critical Care Medicine. “We knew that many people with severe asthma are sensitised to several airborne fungi which can worsen asthma without overt clinical signs. The question was: does antifungal therapy provide any clinical benefit,” said lead investigator David Denning, MD, University of Manchester, Manchester, United Kingdom. In the prospective double-blind study, 58 patients with severe asthma and allergic sensitivity to at least 1 of 7 different common fungi (confirmed by a skin-prick test and/or an IgE blood test) were randomised to receive either itraconazole 200mg BID or a placebo. After 32 weeks of treatment, 18 of the 29 patients (62%) who received itraconazole experienced significant improvements on their Asthma Quality of Life Questionnaires, and in runny nose and morning lung function. However, 11 of the patients who received the drug left the trial before completion, some citing side effects that included nausea, breathlessness, and muscle weakness. Unfortunately, 4 months after stopping antifungal treatment, symptoms 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,” said Dr. Denning. “Clearly itraconazole will not suit everyone and is not always helpful, but when it is the effect is dramatic. 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.” SOURCE: American Thoracic Society E-mail this page to a friend or colleague! To print, use this version