24290286
BACKGROUND	IgE sensitization to Aspergillus fumigatus and a positive sputum fungal culture result are common in patients with refractory asthma .
BACKGROUND	It is not clear whether these patients would benefit from antifungal treatment .
OBJECTIVE	We sought to determine whether a 3-month course of voriconazole improved asthma-related outcomes in patients with asthma who are IgE sensitized to A fumigatus .
METHODS	Asthmatic patients who were IgE sensitized to A fumigatus with a history of at least 2 severe exacerbations in the previous 12 months were treated for 3 months with 200 mg of voriconazole twice daily , followed by observation for 9 months , in a double-blind , placebo-controlled , randomized design .
METHODS	Primary outcomes were improvement in quality of life at the end of the treatment period and a reduction in the number of severe exacerbations over the 12 months of the study .
RESULTS	Sixty-five patients were randomized .
RESULTS	Fifty-nine patients started treatment ( 32 receiving voriconazole and 27 receiving placebo ) and were included in an intention-to-treat analysis .
RESULTS	Fifty-six patients took the full 3 months of medication .
RESULTS	Between the voriconazole and placebo groups , there were no significant differences in the number of severe exacerbations ( 1.16 vs 1.41 per patient per year , respectively ; mean difference , 0.25 ; 95 % CI , 0.19-0 .31 ) , quality of life ( change in Asthma Quality of Life Questionnaire score , 0.68 vs 0.88 ; mean difference between groups , 0.2 ; 95 % CI , -0.05 to -0.11 ) , or any of our secondary outcome measures .
CONCLUSIONS	We were unable to show a beneficial effect of 3 months of treatment with voriconazole in patients with moderate-to-severe asthma who were IgE sensitized to A fumigatus on either the rate of severe exacerbations , quality of life , or other markers of asthma control .

