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Effectiveness of voriconazole in the treatment of Aspergillus fumigatus-associated asthma (EVITA3 study).
[allergic bronchopulmonary aspergillosis]
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
.
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
.
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
.
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
.
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
.
Diseases
Validation
Diseases presenting
"primary outcomes"
symptom
allergic bronchopulmonary aspergillosis
child syndrome
congenital diaphragmatic hernia
hirschsprung disease
thoracic outlet syndrome
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