ABPA, Airway Clearance, Allergic Bronchopulmonary Aspergillosis, Allergic Bronchopulmonary Aspergillosis (ABPA), Amphotericin B, Bronchoscope, Mucus Plug
Conditions
Keywords
Allergic Bronchopulmonary Aspergillosis, ABPA, Amphotericin B, bronchoscope, Airway Clearance, mucus plug
Brief summary
To evaluate the efficacy and safety of bronchoscopic airway clearance and amphotericin B spraying in the treatment of allergic bronchopulmonary aspergillosis
Interventions
PROCEDUREThe patients were treated with bronchoscopic airway clearance and amphotericin B spraying
In addition to standard medical therapy (oral glucocorticoids with or without oral antifungal agents), bronchoscopic airway clearance and bronchoscopic spraying of amphotericin B (depending on the effectiveness of bronchoscopic mucus plug removal, At least one time of bronchoscopic airway clearance and amphotericin B spraying). The previous treatment for bronchial asthma was maintained, including inhaled corticosteroids + long-acting β-receptor agonists, leukotriene receptor antagonists, etc.
Sponsors
Qianfoshan Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Meet the diagnostic criteria of allergic bronchopulmonary aspergillosis, according to the ISHAM guidelines for the diagnosis and treatment of allergic bronchopulmonary aspergillosis (2024 revision), and the presence of mucus plugs or hyperattenuated mucus confirmed by chest high-resolution CT (HRCT). 2. Active disease: Newly diagnosed allergic bronchopulmonary aspergillosis or an acute exacerbation after discontinuation of treatment (defined as a \> 14 day history of clinical worsening or radiographic progression of allergic bronchopulmonary aspergillosis and a ≥50% increase in total serum IgE from the last recorded value during the stable phase, excluding other causes of the acute exacerbation) in patients with previously diagnosed allergic bronchopulmonary aspergillosis. 3. Age ≥ 18 years old.
Exclusion criteria
1. Allergic bronchopulmonary aspergillosis - serotype (i.e., meets the diagnostic criteria for allergic bronchopulmonary aspergillosis, but chest CT shows no obvious abnormality); 2. Patients with absolute or relative contraindications to electronic bronchoscopy; 3. Known history of allergy to amphotericin B or any of its excipients; 4. Patients with bronchiectasis caused by human immunodeficiency virus infection, active tuberculosis, pulmonary malignant tumor or other non-allergic bronchopulmonary aspergillosis; 5. Combined with other diseases requiring long-term systemic use of glucocorticoids or immunosuppressants (such as autoimmune diseases); 6. Patients with previous or current smoking history; 7. Pregnant or lactating women; 8. Currently participating in other interventional clinical research; 9. Any other conditions considered by the investigator to preclude participation in the study (e.g., nonadherence, predicted survival \<1 year, or severe mental illness that prevented cooperation).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Radiographic response rate after 4 months of treatment | 4 months | Radiographic remission: defined as the removal of mucus plugs in the airway on radiographic examination |
| Immunological remission rate after 4 months of treatment | 4 months | Immunological remission: defined as at least a 50% decrease in total serum IgE from baseline |
| The remission rate of clinical symptoms after 4 months of treatment | 4 months | Clinical symptom relief: The semi-quantitative rating of clinical symptoms was evaluated using Likert scores with at least 50% improvement in symptoms |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| psychological Scale (Hospital Anxiety and Depression Scale, HADS) | 2 years | — |
| Aspergillus fumigatus sIgE | 2 years | — |
| Number of acute exacerbations within 1 year of drug withdrawal after 4 months of treatment | 1 year | — |
| Number of acute exacerbations within 2 years after 4 months of treatment | 2 years | — |
| Treatment response rate at 8 weeks | 8 weeks | — |
| Number of hospitalizations due to acute exacerbations of allergic bronchopulmonary aspergillosis | 2 years | — |
| Time from discontinuation to first exacerbation | 2 years | — |
| Quality of life score (AQLQ or mini-AQLQ) | 2 years | — |
| After drug withdrawal, the number of patients who achieved treatment remission | 2 years | The remission phase was defined as sustained (\>6 months) clinical-radiologic improvement in the absence of (or discontinuation of) glucocorticoid therapy and the absence of an increase in total serum IgE of 50% or more from the last recorded value during the stable phase |
| Serum total IgE | 2 years | — |
| All-cause mortality | 2 years | — |
Countries
China
Contacts
CONTACTQian Qi, Dr.
Outcome results
None listed