Skip to main content

Main menu

  • Home
  • Current issue
  • ERJ Early View
  • Past issues
  • For authors
    • Instructions for authors
    • Submit a manuscript
    • Author FAQs
  • Alerts
  • Podcasts
  • Subscriptions
  • ERS Publications
    • European Respiratory Journal
    • ERJ Open Research
    • European Respiratory Review
    • Breathe
    • ERS Books
    • ERS publications home

User menu

  • Log in
  • Subscribe
  • Contact Us
  • My Cart

Search

  • Advanced search
  • ERS Publications
    • European Respiratory Journal
    • ERJ Open Research
    • European Respiratory Review
    • Breathe
    • ERS Books
    • ERS publications home

Login

European Respiratory Society

Advanced Search

  • Home
  • Current issue
  • ERJ Early View
  • Past issues
  • For authors
    • Instructions for authors
    • Submit a manuscript
    • Author FAQs
  • Alerts
  • Podcasts
  • Subscriptions

Caspofungin pulses for CPA (chronic pulmonary aspergillosis): A retrospective study

Michele Fernandes, Anand Shah, Sophie Brooks, Emily Grist, Robert Wilson, Michael Loebinger
European Respiratory Journal 2016 48: PA2643; DOI: 10.1183/13993003.congress-2016.PA2643
Michele Fernandes
University of London, St George's, London, United Kingdom
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Anand Shah
Host Defence, Royal Brompton Hospital, London, United Kingdom
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Sophie Brooks
University of London, St George's, London, United Kingdom
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Emily Grist
Host Defence, Royal Brompton Hospital, London, United Kingdom
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Robert Wilson
Host Defence, Royal Brompton Hospital, London, United Kingdom
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Michael Loebinger
Host Defence, Royal Brompton Hospital, London, United Kingdom
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Info & Metrics
Loading

Abstract

CPA is a fungal disease with high mortality and morbidity. Current guidelines suggest initial treatment with azoles. However, patients often develop treatment failure, triazole intolerance or resistance. Echinocandins (e.g. Caspofungin) have been used with success in invasive aspergillosis, but there is little evidence regarding their use in CPA.

We aimed to assess the efficacy of adding pulsed caspofungin therapy to existing azole treatment in patients with treatment failure or intolerance on triazole monotherapy.

We retrospectively examined records from 25 patients with a diagnosis of CPA treated with x8 6-weekly cycles of 14 days intravenous Caspofungin therapy (In addition to azoles if tolerant) between 2008 -2012 at the Royal Brompton hospital. Baseline characteristics and HRCT severity scores, FEV1, FVC, BMI and serology (ICAP, IgE, RAST, CRP) were assessed before and after pulsed Caspofungin.

Despite treatment 8/25 (32%) of patients died after a median follow-up of 428 days. (IQR 313-660). Improvements in serology were seen after 8 cycles of caspofungin. ICAP declined from 166.3mg/L to 94.2 mg/L. (p=0.006) IgE declined from 502.6 IU/mL to 109.8 IU/mL (p=0.09). Average diameter of cavities rose by 3.6 mm (p=0.09). Cavity wall thickness rose by 0.55 (p=0.002), pleural thickness by 0.2 (p=0.0001), and consolidation diminished by 0.37% on average (p=0.05).A subgroup also being treated for NTM showed reduction in tree-in-bud (p=0.25). BMI and lung function did not change significantly.

Patients with CPA have a high mortality despite treatment. Pulsed echinocandin therapy may present a strategy to stabilize aspects of CPA in a subset of patients with failure of, or intolerance to, azole treatment.

  • Infections
  • Copyright ©the authors 2016
Previous
Back to top
Vol 48 Issue suppl 60 Table of Contents
  • Table of Contents
  • Index by author
Email

Thank you for your interest in spreading the word on European Respiratory Society .

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Caspofungin pulses for CPA (chronic pulmonary aspergillosis): A retrospective study
(Your Name) has sent you a message from European Respiratory Society
(Your Name) thought you would like to see the European Respiratory Society web site.
Alerts
Sign In to Email Alerts with your Email Address
Citation Tools
Caspofungin pulses for CPA (chronic pulmonary aspergillosis): A retrospective study
Michele Fernandes, Anand Shah, Sophie Brooks, Emily Grist, Robert Wilson, Michael Loebinger
European Respiratory Journal Sep 2016, 48 (suppl 60) PA2643; DOI: 10.1183/13993003.congress-2016.PA2643

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero

Share
Caspofungin pulses for CPA (chronic pulmonary aspergillosis): A retrospective study
Michele Fernandes, Anand Shah, Sophie Brooks, Emily Grist, Robert Wilson, Michael Loebinger
European Respiratory Journal Sep 2016, 48 (suppl 60) PA2643; DOI: 10.1183/13993003.congress-2016.PA2643
del.icio.us logo Digg logo Reddit logo Technorati logo Twitter logo CiteULike logo Connotea logo Facebook logo Google logo Mendeley logo

Jump To

  • Article
  • Info & Metrics
  • Tweet Widget
  • Facebook Like
  • Google Plus One

More in this TOC Section

  • Epidemiological and clinical features of non tuberculous mycobacteria infection (NTM) in a five-year single centre experience
  • A study of the relation of microbiological etiology with analytical and clinical parameters in exacerbation of COPD
  • Positive microbiology findings in non-cystic fibrosis bronchiectasis and co-morbidities
Show more 10.1 Respiratory Infections

Related Articles

Navigate

  • Home
  • Current issue
  • Archive

About the ERJ

  • Journal information
  • Editorial board
  • Reviewers
  • CME
  • Press
  • Permissions and reprints
  • Advertising

The European Respiratory Society

  • Society home
  • myERS
  • Privacy policy
  • Accessibility

ERS publications

  • European Respiratory Journal
  • ERJ Open Research
  • European Respiratory Review
  • Breathe
  • ERS books online
  • ERS Bookshop

Help

  • Feedback

For authors

  • Instructions for authors
  • Submit a manuscript
  • ERS author centre

For readers

  • Alerts
  • Subjects
  • Collections
  • Podcasts
  • RSS

Subscriptions

  • Accessing the ERS publications

Contact us

European Respiratory Society
442 Glossop Road
Sheffield S10 2PX
United Kingdom
Tel: +44 114 2672860
Email: journals@ersnet.org

ISSN

Print ISSN:  0903-1936
Online ISSN: 1399-3003

Copyright © 2019 by the European Respiratory Society