Correct!
3. Oral corticosteroids are the hallmark of therapy
ABPA generally responds well to steroids and once diagnosed patients should be treated with steroids to prevent the complications including respiratory failure and progression to fibrotic disease. Patients generally require 2-4 weeks of 0.5-0.75 mg/kg of prednisone put the disease into remission. Steroids may be tapered as the patient tolerates. As with most steroid responsive lung disease, it can occasionally be difficult to wean patients from steroids and there are some patients who require chronic or frequent oral steroids. In the past there has been some controversy about the use of anti-fungal agents in the treatment of ABPA, however, recent data suggest that a 16 week course of itraconazole does confer clinical benefit. Many practitioners use voriconazole as it is better tolerated by many patients.
Omalizumab is a monoclonal antibody that is active against IgE. There are case reports and at least one case series of the use of omalizumab in ABPA and it is increasingly being considered by practitioners as an option for the management of ABPA. However, there are no controlled trials of its use in ABPA.
Which of the following is true regarding the chronic monitoring and management of ABPA? (Click on the correct answer to proceed to the last panel)