Abstract
Whether use of high-dose steroids in acute-stage allergic bronchopulmonary aspergillosis (ABPA) is associated with superior outcomes is not known. Herein, we compare the efficacy and safety of two glucocorticoid protocols in ABPA.
Treatment-naive ABPA subjects randomly received either high-dose or medium-dose oral prednisolone. The primary outcomes were exacerbation rates and glucocorticoid-dependent ABPA after 1 and 2 years, respectively, of treatment. The secondary end-points were composite response rates after 6 weeks, improvement in lung function, time to first exacerbation, cumulative dose and adverse effects.
92 subjects (high-dose n=44, medium-dose n=48) were included in the study. The numbers of subjects with exacerbation after 1 year (high-dose 40.9% versus medium-dose 50%, p=0.59) and glucocorticoid-dependent ABPA after 2 years (high-dose 11.4% versus medium-dose 14.6%, p=0.88) were similar in the two groups. Although composite response rates were significantly higher in the high-dose group, improvement in lung function and time to first exacerbation were similar in the two groups. Cumulative glucocorticoid dose and side-effects were significantly higher in the high-dose group.
Medium-dose oral glucocorticoids are as effective and safer than high-dose in treatment of ABPA.
Abstract
Medium-dose glucocorticoids are as effective as high-dose in treatment of allergic bronchopulmonary aspergillosis http://ow.ly/TLt4N
Footnotes
For editorial comment see Eur Respir J 2016; 47: 385–387 [DOI: 10.1183/13993003.01816-2015].
This article has supplementary material available from erj.ersjournals.com
Clinical trial: This study is registered at www.clinicaltrials.gov with identifier number NCT00974766.
Conflict of interest: None declared.
- Received September 4, 2015.
- Accepted October 12, 2015.
- Copyright ©ERS 2016