Posaconazole for the treatment of allergic bronchopulmonary aspergillosis in patients with cystic fibrosis.

Author: 

Periselneris J, Nwankwo L, Schelenz S, Shah A, Armstrong-James D.
J Antimicrob Chemother. 2019 Feb 25. pii: dkz075.

Abstract: 

OBJECTIVES:

Allergic bronchopulmonary aspergillosis (ABPA) can accelerate lung function decline in patients with cystic fibrosis (CF). Antifungal medication can be used in addition to systemic corticosteroid treatment.

PATIENTS AND METHODS:

We evaluated Aspergillus-specific IgE and the use of therapeutic drug monitoring of triazoles in a retrospective analysis of 32 patients.

RESULTS:

There was a significant reduction in Aspergillus IgE with posaconazole but not with other triazoles (P = 0.026). Aspergillus IgE levels were inversely correlated with the therapeutic drug level of posaconazole.

CONCLUSIONS:

These data suggest that posaconazole is better than comparator azoles at decreasing serological response to Aspergillus and that this response was better with therapeutic levels of posaconazole.