{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T07:55:51Z","timestamp":1789631751825,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,3,5]],"date-time":"2020-03-05T00:00:00Z","timestamp":1583366400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Respiratory J"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Chronic pulmonary aspergillosis (CPA) is a fungal disease with high mortality and morbidity. Guidelines suggest treatment with azoles as first\u2010line therapy. However, patients often develop treatment intolerance or increasingly azole resistance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>This retrospective review assesses outcomes in azole resistant or intolerant patients with CPA treated with cyclical echinocandin therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively examined records of 25 patients with CPA treated with cyclical caspofungin, 6 of whom were either azole\u2010resistant or azole intolerant. Baseline characteristics, high\u2010resolution computed tomography severity scores, forced expiratory volume after 1 minute (FEV1), forced vital capacity (FVC), body mass index and serology (<jats:italic>Aspergillus fumigatus\u2010<\/jats:italic>specific IgG, <jats:italic>Aspergillus fumigatus\u2010<\/jats:italic>specific IgE, total IgE and CRP) were assessed before and after caspofungin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the six patients, four (66%) started caspofungin due to intolerance and two (33%) due to pan\u2010azole resistance. On treatment, there was stability in FEV1 with an overall mortality of 33% during the follow\u2010up period with a median survival of 875.5\u00a0days (IQR 529\u20101024). No significant change in serology (<jats:italic>A. fumigatus<\/jats:italic>\u2010specific IgG and CRP was seen.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>With pulsed echinocandin therapy, azole\u2010intolerant or pan\u2010resistant CPA patients have similar mortality rates to azole\u2010na\u00efve CPA patients. Pulsed echinocandin therapy may present a strategy to stabilize CPA in patients with pan resistance or intolerance to, azole therapy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/crj.13171","type":"journal-article","created":{"date-parts":[[2020,2,20]],"date-time":"2020-02-20T06:58:22Z","timestamp":1582181902000},"page":"571-577","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Pulsed echinocandin therapy in azole intolerant or multiresistant chronic pulmonary aspergillosis: A retrospective review at a UK tertiary centre"],"prefix":"10.1111","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3564-1441","authenticated-orcid":false,"given":"William","family":"Osborne","sequence":"first","affiliation":[{"name":"Royal Brompton and Harefield NHS Foundation Trust London 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