An alternative to the 'one-size-fits-all' approach to treating fungal lung infections

21 July 2023

A new research study aims to investigate which treatments work best on patients with allergic bronchopulmonary aspergillosis (ABPA), the most common form of chronic fungal lung infection in patients with long-term lung disease.

Thanks to funding from the National Institute for Health and Care Research, Lisa Nwankwo, specialist pharmacist in antimicrobials at Royal Brompton and Harefield hospitals, will be undertaking a doctoral clinical and practitioner academic fellowship, which will enable her to conduct the study.

Notably, Lisa was the only pharmacist awarded the fellowship nationally, and 3 out of the 6 fellowships awarded in London were to staff at Guy’s and St Thomas’ NHS Foundation Trust.

What is ABPA?

ABPA is form of lung disease caused by an allergic reaction to the fungus, Aspergillus fumigatus. Symptoms include cough (sometimes coughing up blood), fatigue, shortness of breath and weight loss. The disease causes progressive lung damage and leads to increased infections, which means patients are admitted to the hospital more frequently.

ABPA affects approximately 175,000 people with asthma in the UK, 19% of people with Cystic fibrosis, and 1-3% of people with chronic obstructive pulmonary disease (COPD).

The current standard of care treatment for ABPA involves oral corticosteroids and antifungal treatment.  However, these are not very good at treating ABPA and also have many side effects.

Newer treatments for ABPA have been developed which work better and are well tolerated by patients. However, there are very few trials on their effectiveness for patients with ABPA.

Additionally, there is also a need to find new ways to check how the patient is feeling and if they are getting better or worse with the treatment. Since the disease is long-term, it is important that patients feel comfortable with the tests used to track their symptoms.  

The research

Previous research conducted by Lisa has shown posaconazole is an antifungal treatment which improves lung function more than corticosteroids or itraconazole.

Her new study is an observational study which aims to follow patients over time to find out which treatments should be used to improve health and quality of life, determine when a treatment is working well or not, and be sensitive to early signs of bad outcomes so that steps can be taken sooner.

Her research will also lead to the development of a new disease-specific tool to improve symptom monitoring.  

Lisa expressed her gratitude in receiving the award and said:

“I am ecstatic to receive this award as it allows me to fulfil a long-standing aspiration of dedicating time to develop my academic skills. This achievement holds a special significance for me as I follow in the footsteps of my father, who was an exceptional professor and academic.

“The opportunities to collaborate with leading experts in the field of infectious diseases is an added bonus that I am truly grateful for. With this opportunity to develop my research skills, I am confident that I can engage in high-quality research that will positively impact those living with ABPA.”

The study is expected to begin in September 2023.

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