Up to 150,000 people suffering from severe asthma in the UK could benefit from taking antifungal medication already available from pharmacists, new research has found.
University of Manchester scientists found that pills used to treat everyday fungal infections greatly improved symptoms of asthma in those patients that had an allergic reaction to one or more fungi.
The study, carried out at four hospitals in northwest England and published in the American Journal of Respiratory and Critical Care Medicine, is the first to show that antifungal therapy can improve the symptoms of those who suffer from severe asthma.
The researchers compared the oral antifungal drug itraconazole with a placebo over eight months and found that nearly 60% of patients taking the drug showed significant improvement in their symptoms.
"Only patients with a positive skin or blood test for fungal allergy were included in the study," said Professor David Denning, who is based at the University Hospital of South Manchester.
"Severe asthma affects between five and 10% of adult asthmatics and probably 25 to 50% of these patients showed allergy to one or more fungi. Since about 60% of those treated benefited from the treatment, we believe that antifungal therapy may be helpful in as many as 150,000 adults with asthma in the UK."
The clinical study of 58 patients at the University Hospital of South Manchester, Salford Royal, Royal Preston and North Manchester General hospitals showed statistically significant improvements in a validated quality of life score. Patients' asthma and nasal symptoms deteriorated within four months of stopping therapy.
Dr Robert Niven, from The University of Manchester and the University Hospital of South Manchester, said: "This pioneering study indicates that fungal allergy is important in some patients with severe asthma, and that oral antifungal therapy is worth trying in some difficult-to-treat patients. Clearly itraconazole will not suit everyone, and is not always helpful, but, when it is, the effect is dramatic."
Dr Ronan O'Driscoll, at Salford Royal Hospital, added: "It's good news for patients with severe asthma to have an existing anti-fungal drug recognised as having benefits for asthma patients with fungal allergy. We found that many patients were only picked up by extensive skin and blood test screening for fungal allergy, so a change of clinical practice will be required to identify all the patients who might respond to itraconazole."
Notes for editors:
Fungal allergies in patients tested included Aspergillus, Cladosporium, Penicillium, Candida, Alternaria and Trichophyton.
The University of Manchester research, led by Professor David Denning and Dr Robert Niven at the University Hospital of South Manchester, included patients from Salford Royal Hospital (Dr Ronan O'Driscoll), Royal Preston Hospital (Dr Aashish Vyas) and North Manchester General Hospital (Dr Jon Miles).
Roughly 18% of patients developed mild side effects and had to stop therapy; however, Itraconazole has been used to treat millions of patients around the world since being marketed in 1991.
The study was funded by a charitable research grant to The University of Manchester by the Moulton Trust.
The research is published in the prestigious American Journal of Respiratory and Critical Care Medicine, the lead publication of the American Thoracic Society.
A copy of the paper is available on request.
A number of patients with severe asthma have agreed to speak to the media if required. Please contact the press office for contact information.
Patients and practitioners can find out more information at the following website: http://www.safs.org.uk/
For further information contact:
Aeron Haworth
Media Officer
Faculty of Medical and Human Sciences
The University of Manchester
Mob: 07717 881 563
Email: aeron.haworth@manchester.ac.uk
Journal
American Journal of Respiratory and Critical Care Medicine