A Prospective Study on Optimizing Treatment for ABPA

NCT ID: NCT05129033

Last Updated: 2021-11-22

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-11-15

Study Completion Date

2023-12-30

Brief Summary

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This study is being done to evaluate the efficacy of treatment using oral glucocorticoid, anti-fungal agent, anti-IgE mAb for patient with ABPA.

Detailed Description

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This is a study randomly treating ABPA patients with either anti-fungal agent plus OCS or anti-IgE mAb (omalizumab) plus OCS.

OCS is the basic treatment for ABPA by suppressing allergy and inflammation. Prednisone tablets is given orally 0.5mg/kg/d for 4 weeks and gradually reduced to for a total usage of 6 months. Reduction may failed if disease exacerbate.

Anti-fungal agent (mainly itraconazole) could reduce the load of fungus but its application is still controversial. The investigators use itraconazole 200mg bid for 8 months and 100mg bid for another 8 months.

Omalizumab was given 600mg q4w for at least 6 months. The investigators use Anti-fungal agent and Omalizumab as a supplement to OCS to evaluate the better treatment plan for ABPA patients.

Conditions

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Allergic Bronchopulmonary Aspergillosis

Keywords

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Allergic Bronchopulmonary Aspergillosis anti-fungal agent Omalizumab oral corticosteroids

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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anti-fungal agent plus OCS

Prednisone tablets is given orally 0.5mg/kg/d for 4 weeks and gradually reduced to stop for a total usage of 6 months Itraconazole is given orally 200mg bid for 8 months and 100mg bid for another 8 months

Group Type ACTIVE_COMPARATOR

Prednisone tablet

Intervention Type DRUG

Basic medication for allergic airway inflammation such as asthma and ABPA, to relieve inflammation. Reduction may failed if disease exacerbate.

itraconazole

Intervention Type DRUG

Anti-fungal medication to reduce fugal load.

anti-IgE mAb plus OCS

Prednisone tablets is given orally 0.5mg/kg/d for 4 weeks and gradually reduced to stop for a total usage of 6 months Omalizumab is given by subcutaneous injection of 600mg q4w for at least 6 months

Group Type ACTIVE_COMPARATOR

Prednisone tablet

Intervention Type DRUG

Basic medication for allergic airway inflammation such as asthma and ABPA, to relieve inflammation. Reduction may failed if disease exacerbate.

Omalizumab

Intervention Type BIOLOGICAL

Anti-IgE monoclonal antibody, used for high IgE allergic disease.

Interventions

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Prednisone tablet

Basic medication for allergic airway inflammation such as asthma and ABPA, to relieve inflammation. Reduction may failed if disease exacerbate.

Intervention Type DRUG

itraconazole

Anti-fungal medication to reduce fugal load.

Intervention Type DRUG

Omalizumab

Anti-IgE monoclonal antibody, used for high IgE allergic disease.

Intervention Type BIOLOGICAL

Eligibility Criteria

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Inclusion Criteria

* 18\~75 years old, male or female
* associated past medical history, including asthma, bronchiectasis, COPD ect.
* elevated serum total IgE (\>100IU/mL)
* elevated aspergillus specific IgE

Exclusion Criteria

* According to the investigator, the patient has other factors that may affect the results of the study or lead to the termination of the study, such as alcohol abuse, drug abuse, other serious diseases (including mental illness).
* Pregnancy or breastfeeding
* Abnormality of liver or kidney function
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Shanghai Zhongshan Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Meiling Jin, MD

Role: STUDY_CHAIR

Department of Respiratory, Zhongshan Hospital, Fudan University Shanghai, China

Central Contacts

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Meiling Jin, MD

Role: CONTACT

Phone: +86 13701640522

Email: [email protected]

References

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Agarwal R. Allergic bronchopulmonary aspergillosis. Chest. 2009 Mar;135(3):805-826. doi: 10.1378/chest.08-2586.

Reference Type BACKGROUND
PMID: 19265090 (View on PubMed)

Agarwal R, Aggarwal AN, Gupta D, Jindal SK. Aspergillus hypersensitivity and allergic bronchopulmonary aspergillosis in patients with bronchial asthma: systematic review and meta-analysis. Int J Tuberc Lung Dis. 2009 Aug;13(8):936-44.

Reference Type BACKGROUND
PMID: 19723372 (View on PubMed)

Agarwal R, Nath A, Aggarwal AN, Gupta D, Chakrabarti A. Aspergillus hypersensitivity and allergic bronchopulmonary aspergillosis in patients with acute severe asthma in a respiratory intensive care unit in North India. Mycoses. 2010 Mar 1;53(2):138-43. doi: 10.1111/j.1439-0507.2008.01680.x. Epub 2009 Jan 24.

Reference Type BACKGROUND
PMID: 19207831 (View on PubMed)

Agarwal R, Chakrabarti A, Shah A, Gupta D, Meis JF, Guleria R, Moss R, Denning DW; ABPA complicating asthma ISHAM working group. Allergic bronchopulmonary aspergillosis: review of literature and proposal of new diagnostic and classification criteria. Clin Exp Allergy. 2013 Aug;43(8):850-73. doi: 10.1111/cea.12141.

Reference Type BACKGROUND
PMID: 23889240 (View on PubMed)

Mou Y, Ye L, Ye M, Yang D, Jin M. A retrospective study of patients with a delayed diagnosis of allergic bronchopulmonary aspergillosis/allergic bronchopulmonary mycosis. Allergy Asthma Proc. 2014 Mar-Apr;35(2):e21-6. doi: 10.2500/aap.2014.35.3731.

Reference Type BACKGROUND
PMID: 24717781 (View on PubMed)

Agarwal R, Gupta D, Aggarwal AN, Saxena AK, Chakrabarti A, Jindal SK. Clinical significance of hyperattenuating mucoid impaction in allergic bronchopulmonary aspergillosis: an analysis of 155 patients. Chest. 2007 Oct;132(4):1183-90. doi: 10.1378/chest.07-0808. Epub 2007 Jul 23.

Reference Type BACKGROUND
PMID: 17646221 (View on PubMed)

Other Identifiers

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2020ZSLC26

Identifier Type: -

Identifier Source: org_study_id