What is the role of medications in the treatment of mold-related allergic asthma?

Updated: Sep 18, 2017
  • Author: Shih-Wen Huang, MD; Chief Editor: Harumi Jyonouchi, MD  more...
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Answer

Depending on the severity of the disease according to the classification of the National Guideline of Asthma Education and Management, patients may receive one or more of the following agents: mast-cell stabilizer, short-term bronchodilator, long-term bronchodilator, leukotriene antagonists, inhalation corticosteroid, systemic corticosteroid, and theophylline. [20]

Patients with moderate-to-severe asthma who react to perennial allergens despite using inhaled corticosteroids may benefit from omalizumab treatment.

Two pivotal, 52-week, phase III trials were conducted in 1071 patients aged 12-76 years. The coprimary endpoint was mean asthma exacerbations per patient. Patients were randomly selected to receive subcutaneous omalizumab or placebo every 2-4 weeks. Inhaled corticosteroid doses were kept stable over the initial 16 weeks (stable-steroid phase) then tapered over 12 weeks (steroid-reduction phase). As add-on therapy to inhaled corticosteroids, omalizumab reduced exacerbations by 33-75% and 33-50% during the stable-steroid and steroid-reduction phases, respectively. The reductions were confirmed by improvements in other measurements of asthma control, including symptom scores (eg, nocturnal awakenings, daytime asthma symptoms).

The use of antifungal treatment for severe asthma with fungal sensitization was not well known. a study recently showed addition of itraconazole was beneficial. The study concluded severe asthma with fungal sensitization responded to oral antifungal therapy as judged by large improvement in quality of life in about 60% of patients.


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