HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Guest Access | Sign In via User Name/Password

This Article Full Text (PDF) Free All Versions of this Article: chest.06-2441v1 131/5/1435    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Camuset, J. Articles by Cadranel, J. Search for Related Content PubMed PubMed Citation Articles by Camuset, J. Articles by Cadranel, J.

Treatment of chronic pulmonary aspergillosis by voriconazole in non-immunocompromised patients

¹MD, Department of Pneumology and Respiratory Intensive Care, AP-HP, Tenon Hospital, Paris, France jacques.cadranel@tnn.aphp.fr ²MD, Department of Pneumology, Victor Dupouy Hospital, Argenteuil, France juliette.camuset@ch-argenteuil.fr ³MD, Department of Pneumology, AP-HP, Avicenne Hospital, Bobigny, France hilario.nunes@avc.aphp.fr ⁴MD, Department of Pneumology, AP-HP, Bichat Hospital, Paris, France mariechristine.dombret@bch.aphp.fr ⁵MD, Department of Pneumology, AP-HP, Saint-Louis Hospital, Paris, France anne.bergeron@sls.aphp.fr ⁶MD, Department of Pneumology, AP-HP, George Pompidou European Hospital, Paris, France priscilla.henno@egp.aphp.fr ⁷MD, Department of Pneumology, Foch Hospital, Suresnes, France bx.phlippe@hopital-foch.org ⁸MD, Department of Pneumology, Beaujon Hospital, Clichy, France gaelle.dauriat@bch.aphp.fr ⁹MD, Department of Pneumology, Inter-Commune Hospital Centre, Creteil, France gilles.mangiapan@chicreteil.fr ¹⁰MD, Department of Pneumology, AP-HP, Hôtel-Dieu Hospital, France antoine.rabbat@htd.aphp.fr

jacques.cadranel{at}tnn.aphp.fr

Abstract

BackgroundThere is no recognized medical treatment for chronic pulmonary aspergillosis apart from surgery in simple aspergilloma. To evaluate the efficacy of voriconazole in this setting, we conducted a retrospective multicentre study over a 3-year period.

MethodsFor inclusion in the study, patients had to have received voriconazole for treatment of confirmed or probable chronic pulmonary aspergillosis with a follow-up of at least 6 months. Clinical, radiological and mycological data were collected at baseline, every 2 to 3 months, and at the end of treatment or at the date point.

Results24 patients were included among which 9 presented chronic cavitary pulmonary aspergillosis and 15 chronic necrotizing pulmonary aspergillosis CNPA. Voriconazole was given as a first-line treatment to 13 patients. The median duration of treatment and follow-up were 6.5 months and 10 months respectively. 3 patients had to stop voriconazole because of toxicity. Symptoms and imagery findings were improved in 16/24 and 17/24 respectively at the end of follow-up. Mycology, which was positive at baseline in 21/23 patients, was negative in 18/19 of them at the end of follow-up; serologic tests were also negative in 6/19 evaluable patients, all with CNPA. Improved radio-clinical findings and mycological eradication were observed at the end of follow-up in 11/19 58% of the patients. Patients in whom the disease was controlled had a significantly longer median duration of treatment than uncontrolled patients: 9 months versus 6 months p=0.04.

ConclusionVoriconazole provides effective treatment of chronic pulmonary aspergillosis with an acceptable toxicity.

Key Words: aspergillosis • triazole • lung disease