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Abstract：
UNASSIGNED: To review the available literature addressing alternative allergic bronchopulmonary aspergillosis (ABPA) treatment options for patients with cystic fibrosis (CF).
UNASSIGNED: A literature search of PubMed was performed (January 2002 to April 2021) using the following search terms: allergic bronchopulmonary aspergillosis, aspergillus-related lung disease, cystic fibrosis. Manufacturer prescribing information, clinical practice guidelines, and data from ClinicalTrials.gov were incorporated in the reviewed data.
UNASSIGNED: Relevant English-language studies or those conducted in humans were considered for inclusion.
UNASSIGNED: Available literature for alternative ABPA treatments in CF is lacking randomized controlled trials, but there is considerable support in case reports and case series describing the benefits in pediatric and adult patients. Recent literature has begun to explore the place in therapy for novel, corticosteroid-sparing treatment approaches. The alternative therapies summarized in this review all resulted in clinical improvement and subsequent discontinuation or dose reductions of oral corticosteroids, with minimal reported adverse drug effects.
UNASSIGNED: Although corticosteroids are the cornerstone of ABPA management, the toxicities can be significant limitations in an already high-risk patient population. Patients may fail or become intolerant to guideline-recommended therapies and require alternative treatment approaches.
UNASSIGNED: Alternative treatment modalities for ABPA in patients with CF, including azole antifungals, pulsed intravenous glucocorticoids, omalizumab, mepolizumab, and inhaled amphotericin, appear to be efficacious and well tolerated. Pharmacological properties including route of administration, storage and stability, beyond use dating, and adverse effects of the various treatment modalities must be considered when selecting a practical care plan for patients.
UNASSIGNED: A literature search of PubMed was performed (January 2002 to April 2021) using the following search terms: allergic bronchopulmonary aspergillosis, aspergillus-related lung disease, cystic fibrosis. Manufacturer prescribing information, clinical practice guidelines, and data from ClinicalTrials.gov were incorporated in the reviewed data.
UNASSIGNED: Relevant English-language studies or those conducted in humans were considered for inclusion.
UNASSIGNED: Available literature for alternative ABPA treatments in CF is lacking randomized controlled trials, but there is considerable support in case reports and case series describing the benefits in pediatric and adult patients. Recent literature has begun to explore the place in therapy for novel, corticosteroid-sparing treatment approaches. The alternative therapies summarized in this review all resulted in clinical improvement and subsequent discontinuation or dose reductions of oral corticosteroids, with minimal reported adverse drug effects.
UNASSIGNED: Although corticosteroids are the cornerstone of ABPA management, the toxicities can be significant limitations in an already high-risk patient population. Patients may fail or become intolerant to guideline-recommended therapies and require alternative treatment approaches.
UNASSIGNED: Alternative treatment modalities for ABPA in patients with CF, including azole antifungals, pulsed intravenous glucocorticoids, omalizumab, mepolizumab, and inhaled amphotericin, appear to be efficacious and well tolerated. Pharmacological properties including route of administration, storage and stability, beyond use dating, and adverse effects of the various treatment modalities must be considered when selecting a practical care plan for patients.
摘要：
■回顾关于囊性纤维化（CF）患者的替代性过敏性支气管肺曲霉病（ABPA）治疗方案的现有文献。
■使用以下搜索词对PubMed进行了文献检索（2002年1月至2021年4月）：过敏性支气管肺曲霉病，曲霉菌相关性肺病,囊性纤维化.制造商处方信息，临床实践指南，来自ClinicalTrials.gov的数据被纳入审查的数据中。
■考虑纳入相关的英语研究或在人类中进行的研究。
■关于CF替代ABPA治疗的现有文献缺乏随机对照试验，但在描述儿科和成人患者获益的病例报告和病例系列中有相当多的支持。最近的文献已经开始探索小说疗法中的位置，保留皮质类固醇的治疗方法。本综述中总结的替代疗法均导致临床改善，随后停用或减少口服皮质类固醇的剂量。报道的药物不良反应最小。
■尽管皮质类固醇是ABPA管理的基石，在已经高风险的患者群体中,毒性可能是显著的局限性.患者可能对指南推荐的治疗失败或变得不耐受，需要替代治疗方法。
■CF患者ABPA的替代治疗方式，包括唑类抗真菌药,脉冲静脉内糖皮质激素，奥马珠单抗，美波利单抗，吸入两性霉素，似乎是有效的和良好的耐受性。药理学特性，包括给药途径，储存和稳定性，超越使用约会，在为患者选择切实可行的护理计划时，必须考虑各种治疗方式的不利影响。
■使用以下搜索词对PubMed进行了文献检索（2002年1月至2021年4月）：过敏性支气管肺曲霉病，曲霉菌相关性肺病,囊性纤维化.制造商处方信息，临床实践指南，来自ClinicalTrials.gov的数据被纳入审查的数据中。
■考虑纳入相关的英语研究或在人类中进行的研究。
■关于CF替代ABPA治疗的现有文献缺乏随机对照试验，但在描述儿科和成人患者获益的病例报告和病例系列中有相当多的支持。最近的文献已经开始探索小说疗法中的位置，保留皮质类固醇的治疗方法。本综述中总结的替代疗法均导致临床改善，随后停用或减少口服皮质类固醇的剂量。报道的药物不良反应最小。
■尽管皮质类固醇是ABPA管理的基石，在已经高风险的患者群体中,毒性可能是显著的局限性.患者可能对指南推荐的治疗失败或变得不耐受，需要替代治疗方法。
■CF患者ABPA的替代治疗方式，包括唑类抗真菌药,脉冲静脉内糖皮质激素，奥马珠单抗，美波利单抗，吸入两性霉素，似乎是有效的和良好的耐受性。药理学特性，包括给药途径，储存和稳定性，超越使用约会，在为患者选择切实可行的护理计划时，必须考虑各种治疗方式的不利影响。
