GAtherton

💬 What Would Help You Consider Taking Part in a Clinical Trial?

As part of the aspergillosis community — whether you're a patient, carer, or supporter — your voice matters. We’d like to ask:

What would make you feel more confident or willing to consider taking part in a clinical trial?

We’re not asking you to sign up.
We’re asking you to help us understand what matters — so we can make trials feel safer, clearer, and more patient-friendly for everyone.

🧠 We Understand the Hesitations

Over the years, we’ve heard a range of understandable concerns:

  • “Will I be safe?”

  • “Will this interfere with my current treatment?”

  • “What if it’s a waste of time?”

  • “I don’t want to be pressured or used.”

Some of this worry comes from the way trials have been presented in the past, or from media coverage about vaccines or experimental drugs. And we get it — it’s not easy to agree to something unknown, especially when your health is already fragile.

🧭 But Trials Can’t Happen Without You — and in Aspergillosis, It’s Especially Difficult

The reality is:

It’s harder than ever to find people willing to take part in clinical trials.

And for a condition like aspergillosis, that challenge is even greater.

Why?

  • It’s a rare condition, so there are fewer eligible patients

  • It’s a complex condition, often involving other lung diseases, steroid use, or immunosuppression

  • People living with aspergillosis often deal with unpredictable flare-ups, fatigue, or long-term medication side effects, which can make the idea of extra appointments or uncertainty even harder

Even when promising new treatments (like biologics or inhaled antifungals) are ready to be tested, many trials can’t go ahead — or finish — because not enough people can or are willing to volunteer.

This means slower progress, longer waits for new treatment options, and missed opportunities for care to improve.

🙏 So We’re Asking You:

If you’ve ever taken part in a trial — what helped you say yes?

If you haven’t — what would you need in order to even consider it?

Would it help to:

  • Know more about your rights and safety?

  • Speak to someone who’s done it before?

  • Read a simple explanation of what the trial involves?

  • Have the option to talk it through without pressure?

Whatever your answer — it matters.

💡 Would a "Patients for Clinical Trials" Page on Aspergillosis.org Help?

We’re thinking of creating a page that would:

  • Explain what clinical trials are (and aren’t) — in plain English

  • Share real stories from patients who’ve taken part

  • Offer clear information about trial opportunities — without pressure

  • Answer your most common questions honestly

  • Give you a place to register interest or ask questions — even anonymously

Would something like that make a difference for you?
What would it need to include to feel useful, safe, and respectful?

💬 Help Us Get This Right

We’re not asking you to sign up.
We’re asking for your input.

Because the biggest thing holding back better treatment for aspergillosis is not the science — it’s how hard it is to find people willing or able to take part.

That’s no one’s fault. But we’d like your help to improve it.

You can reply in the support group, message us privately, or fill out an anonymous form (coming soon).

🧩 Together, We Can Make Trials More Patient-Centred

Your feedback could:

  • Help new patients feel less afraid

  • Improve how trials are explained

  • Make the process more flexible, respectful, and supportive

Because better treatments for aspergillosis start with listening — and they start with you.

Click here to add your comments or suggestions

by GAtherton

🦠 Understanding Antibiotic Use in Aspergillosis: A Guide to Antimicrobial Stewardship (AMS)

This information is provided to help you understand your treatment. Always follow your medical team's advice. They will make the best decision for your care based on your individual health needs.

⚖️ What is Antimicrobial Stewardship (AMS)?

Antimicrobial stewardship means using antibiotics responsibly — only when needed, and choosing the most appropriate one for each infection. This helps protect patients from side effects and helps ensure antibiotics remain effective in the future.

For people with chronic lung conditions like chronic pulmonary aspergillosis (CPA), ABPA, or aspergillus bronchitis, this balance is especially important.

🔍 Why Is This Important for Aspergillosis Patients?

  • Antibiotics don’t work for fungal infections, but they may be prescribed if a bacterial infection is also present.

  • Using unnecessary antibiotics can lead to side effects, gut upset, or drug interactions (especially with antifungal medicines).

  • Overuse of broad-spectrum antibiotics can make future infections harder to treat.

Your clinical team carefully considers all of this when prescribing.

🔴 Broad-Spectrum Antibiotics

Broad-spectrum antibiotics target a wide range of bacteria, including helpful ones in your body. They are sometimes necessary, but their use is carefully monitored.

Examples Common Uses
Co-amoxiclav Chest infections, dental issues
Ciprofloxacin, Levofloxacin Serious or hospital infections
Doxycycline Chest infections, acne
Azithromycin Atypical pneumonia
Meropenem Resistant or hospital-acquired infections

🧠 These antibiotics may be used only if clearly needed. Doctors will often review and adjust the treatment after tests.

🟢 Narrow-Spectrum Antibiotics

These target specific bacteria and are usually first choice when the infection source is known.

Examples Common Uses
Penicillin V Sore throats, dental infections
Flucloxacillin Skin infections (e.g. infected eczema)
Nitrofurantoin Urinary tract infections
Vancomycin (IV) Resistant bacterial infections
Fosfomycin Resistant urinary infections

✅ These are often preferred because they reduce the risk of resistance and protect your body’s healthy bacteria.

🤝 What You Can Do

  • Trust your clinical team’s decisions — they are based on guidelines, test results, and your health history.

  • Tell your doctor or pharmacist about all medications you are taking — especially antifungals like itraconazole or voriconazole.

  • Report any side effects or concerns, especially if you notice gut problems or unexpected symptoms.

⚠️ A Note on Drug Interactions

Some antibiotics (like clarithromycin or rifampicin) can reduce how well azole antifungals work. Your doctor will avoid these combinations or adjust treatment accordingly.

✅ Final Reminder

This article is for general understanding only.
Your doctors are trained to choose the safest and most effective treatments for your condition. If you’re ever unsure about why a medication has been prescribed, ask — they’ll be happy to explain.

by GAtherton

💡 Dupilumab for ABPA: What You Need to Know Now the Trial Is Complete

A large Phase III trial—called LIBERTY‑ABPA AIRED—has recently completed studying dupilumab in people with ABPA and asthma who frequently exacerbate despite other treatments. Let’s break down what that means and what’s still missing 📌

🗓️ Trial Timeline & Scope

📋 What Was Measured?

The trial assessed:

  • Severe respiratory exacerbations (requiring steroids or hospital admission)

  • Lung function changes (e.g. FEV₁)

  • ABPA-related symptoms, quality of life, asthma control

  • Biomarkers including IgE and FeNO

  • Safety and tolerability, including antibody formation to dupilumab Wikipedia+15Clinical Trials+15trialsummaries.com+15

🧬 Why Results Matter

Dupilumab blocks both IL‑4 and IL‑13 pathways, which drive inflammation, mucus, and elevated IgE in ABPA. Early case reports and small series have shown promising benefits, especially in reducing exacerbations and steroid use, but until now, no large randomized trial data were available ScienceDirect+1PMC+1.

❓ What’s Available Now?

  • ✅ The trial has finished, but official results have not yet been published or released publicly.

  • 🕒 Regulators and sponsors previously estimated publication around late 2023, with actual report likely still under review or preparation ctv.veeva.com+3ScienceDirect+3Clinical Trials+3.

  • 📡 Until these results are public, dupilumab remains not officially approved for ABPA, though individual clinicians may consider off‑label use in select cases.

🧾 Summary Table: Where Things Stand

Status Current Position
Trial status Completed Feb 2024
Official results Pending publication
Based on early data Case reports show improvement in exacerbations and steroid reduction
Regulatory status Not yet licensed for ABPA treatment
Clinical use now Only as part of research or off‑label under specialist review

💬 What Should Patients Do Now?

If you’re managing ABPA and considering biologic options:

  • ✅ Ask if longstanding biologics like dupilumab are being considered for your individual case.

  • 💬 Be clear that formal approval for ABPA is still pending, pending public release of the trial results.

  • 🩺 Consult with your specialist or asthma/respiratory team about possible off‑label use—they can explain access options, benefits, and risks.

🧭 Final Thoughts

The LIBERTY‑ABPA AIRED trial has now completed, marking a major milestone for potential new treatment in ABPA. But until results are published and reviewed, dupilumab remains off-label for this condition.

You may still hear about its use in ABPA from case reports showing positive outcomes—but wider clinical acceptance awaits published study data. If it becomes available, it could offer meaningful benefits—but only if confirmed in research.

by GAtherton

🤐 Why It's Important Not to Share Your Clinical Trial Experience — Until It’s Over

If you have chronic pulmonary aspergillosis (CPA), you may be invited to take part in a clinical trial for a new antifungal medication like rezafungin. That’s exciting — and could help improve treatment for many people in future.

Naturally, people want to support each other by sharing experiences, especially in online support groups. But when it comes to clinical trials, there’s a really important reason why we shouldn’t talk about how we’re feeling while we’re still in the trial.

Here’s why.

🧪 What Are Clinical Trials For?

Clinical trials help doctors and researchers answer important questions like:

  • Does this new treatment work?

  • Is it better than the current treatment?

  • What side effects might it cause?

To get accurate answers, the trial needs to be fair and unbiased — meaning that personal expectations and outside influences shouldn’t affect how people report their symptoms or progress.

📣 The Problem With Sharing During a Trial

If you’re taking part in a trial and say something like:

“I feel great — this new drug is working for me!”
or
“This is making me feel worse than ever — don’t join!”

...other people may change how they think and feel based on your comment.

This is called bias. It can:

  • Make others expect the same good (or bad) result

  • Affect how people rate their own symptoms

  • Cause people to drop out or not join at all

  • Make the trial results less accurate or even unusable

Even well-meaning comments can damage the study, especially if the trial is small (like most CPA studies are).

🕵️‍♀️ What If It’s a Blinded Trial?

Some trials are "blinded", meaning you don’t know whether you're getting the new treatment or a standard one (or placebo).

But if people start guessing or posting:

“I’m sure I’m on the real drug — I feel amazing!”

...then other people might also guess, or feel disappointed — which again, affects how results are reported.

🚦When Is It Safe to Share?

💬 After the trial is over and the results are published, you can talk freely about your experience.

In fact, patient voices are vital at that stage — they help others understand what it’s like to be part of a trial and whether new treatments are helpful in real life.

💡 What You Can Say During the Trial

You can still help raise awareness without compromising the study. For example:

  • ✅ “I’m taking part in a CPA trial – ask your doctor if you might be eligible.”

  • ✅ “There’s a study on a new antifungal — here’s the link to the official trial page: clinicaltrials.gov/study/NCT06794554”

  • ✅ “I’m proud to be contributing to research — happy to share my experience once the trial ends.”

Just don’t talk about how the treatment is affecting you until the trial is complete.

🙏 Why This Matters

By keeping quiet during the trial, you're:

  • Protecting the integrity of the study

  • Helping future patients get trustworthy answers

  • Supporting the research team who need clear, unbiased data

You’re not just taking part in a trial — you’re helping build evidence that others will depend on for years to come.

🧭 Summary

✅ Do ❌ Don’t
Tell people a trial exists Share how the treatment is affecting you
Encourage others to talk to their doctor Post guesses about which drug you’re on
Wait until the trial ends to share experiences Influence others to join based on your results

If you're ever unsure, ask your clinical trial team or group moderator — they'll be glad to help. Your role in research is important, and your silence now is a powerful act of support for science, fairness, and future care.

by GAtherton

🧾 Rezafungin: A New Antifungal Being Trialled for CPA

Some people with chronic pulmonary aspergillosis (CPA) have trouble tolerating standard antifungal medications. Commonly used drugs like voriconazole and posaconazole can cause serious side effects such as hallucinations, liver enzyme disturbances, or gut problems. When these medications can’t be used, options become limited.

A new antifungal, rezafungin, is now being studied as a possible treatment for CPA — especially in people who can't tolerate azoles. It is not yet approved for aspergillosis, but a major clinical trial is under way.

🧬 What Is Rezafungin?

Rezafungin is part of a newer group of antifungal drugs called echinocandins. These work by weakening the fungal cell wall — a very different mechanism to azole drugs like itraconazole or voriconazole.

Key features:

  • Given as a weekly intravenous (IV) drip

  • Long-acting: stays in the body for days after each dose

  • Designed to provide high drug levels in the lungs and bloodstream

  • Early studies show less frequent side effects than with some older antifungals

It is already licensed for treatment of Candida bloodstream infections but is being studied now for CPA.

🧪 Current Research: Trial for CPA

A clinical trial is currently recruiting people with CPA who:

  • Cannot take azole antifungals because of side effects or resistance

  • Need alternative or combination therapy

This trial (called REZAFUNGin Efficacy and Safety for Aspergillus – CPA) is being conducted in the UK and internationally. The goal is to test whether rezafungin is safe and effective in CPA patients who have few remaining options.

🔗 View the clinical trial (NCT06794554)

📊 What Have Previous Studies Found?

While studies in CPA are just beginning, previous trials in other fungal infections provide important clues:

✅ Phase 2 & 3 Studies (Candida Infections)

  • Rezafungin was found to be as effective as daily echinocandins (like caspofungin)

  • Once-weekly dosing worked just as well as daily treatment

  • Side effects were mild, and liver toxicity was rare

  • No CNS side effects (like hallucinations) were reported

🧫 Laboratory Evidence

  • Rezafungin is active against Aspergillus fumigatus, including some azole-resistant strains

  • It reaches good levels in lung tissue — an important feature for CPA

  • May be used alone or with another antifungal in complex cases

🩺 Case Example

A recent case report described successful treatment of chronic pulmonary aspergillosis using rezafungin plus voriconazole in a patient with resistant infection (Oxford University Press, 2024).

⚠️ Is Rezafungin Available Now?

Not yet. Rezafungin is only available for CPA:

  • Through a clinical trial, or

  • By special approval for compassionate use in selected cases

It is not currently licensed for aspergillosis in the UK or elsewhere.

💬 What Should I Discuss with My Doctor?

If you're considering participation in a clinical trial or if standard treatments have failed, you might ask:

  • Am I eligible for the rezafungin CPA trial?

  • What are the benefits and risks of trying this treatment?

  • Will I still need other antifungals (e.g. azoles or amphotericin)?

  • How often will I need blood tests and hospital visits?

  • Will this help if I have azole resistance or liver side effects?

📌 Summary

Rezafungin is a new antifungal drug being tested for people with chronic pulmonary aspergillosis who cannot take older treatments. It offers once-weekly dosing and early signs suggest a favourable safety profile, including in patients with liver concerns or those who had side effects from azoles.

Although not yet widely available, it may offer hope for people with limited options. If you or someone you know is struggling with antifungal intolerance, you may wish to speak to your medical team about the CPA clinical trial or explore compassionate access routes.

👉 Learn more or check trial sites:
🔗 https://clinicaltrials.gov/study/NCT06794554

by GAtherton

Cyber Safety for Aspergillosis Patients: Supplement to UK NCSC Advice

This guide builds on the official UK Government cybersecurity advice for families and individuals (www.ncsc.gov.uk/section/advice-guidance/you-your-family) and adds patient-specific tips for people with aspergillosis.

Feeling overwhelmed?

You're not alone. The internet and phone landscape can feel like a minefield, especially when you're trying to manage your health too. No one expects you to become an expert in cybersecurity overnight. The aim of this guide isn’t to scare you — it’s to help you take small, realistic steps to protect yourself.

Just like with your health, doing the basics well goes a long way. You don’t need to memorise everything — focus on:

  • Using strong passwords (or a password manager)
  • Being cautious with texts, links, and phone calls
  • Asking for help when something doesn’t feel right
  • Always accept updates on your phone, browser, or computer when offered — these often fix known security problems and help keep you protected.

It's okay to stop and ask: “Does this sound right?” If in doubt, check with someone you trust.

Top Scam Red Flags

Watch out for these common signs that something could be a scam:

  • You’re told to act urgently or keep it secret
  • You’re offered money, discounts, prizes or help out of the blue
  • You’re asked to click a link or open an attachment in a message
  • A caller claims to be from the bank, NHS, government, or police, but something feels off
  • You’re told the second part of a message will come from a different number or address
  • You’re asked to confirm personal, financial or password information
  • You’re asked to download software or apps to “fix” your device
  • You’re pressured to stay on the phone or not call anyone else

If in doubt, hang up, delete, or double check with someone you trust.

1. Protecting Your NHS and Medical Accounts

  • Use strong, unique passwords for your NHS login, GP apps (e.g. Patient Access, myGP), or hospital portals.
  • Enable two-factor authentication (2FA) wherever it’s offered.
  • Never share your NHS login or codes with anyone.
  • Always go directly to the official app or website, not through links in emails or texts.

2. Beware of Scams

  • Scams can take many forms — phone calls, emails, texts, or fake websites.
  • Be especially wary of anyone offering money, discounts, prizes, or urgent deals.
  • Criminals may pose as trusted organisations like your bank, utility provider, government, or even the NHS.
  • As a general principle: if something seems too good to be true — such as offers of free money, major discounts, prizes, or miracle cures — it almost certainly isn't real. Be suspicious of anything that promises unusually high benefits for little or no effort.
  • If in doubt, forward suspicious messages to [email protected] (Link) or speak to someone you trust before taking action.

3. Using Online Support Groups Safely

  • Facebook groups and forums can be great for connection, but don’t post:
    • Your address, phone number, or full date of birth
    • Photos of prescriptions or test results
  • Don’t click links shared by strangers, even if they seem friendly.
  • Moderators or admins should never ask for sensitive personal details.

4. Shopping and Donations

  • Be cautious when buying medical supplies or donating online.
  • Stick to trusted UK pharmacies and charities.
  • Watch for copycat sites that look like legitimate health organisations.

5. Email, Phone & Text Safety

  • Don’t click on links or open attachments in messages claiming to be from the NHS, unless you were expecting them.
  • Never share passwords or bank details over email or text.
  • Never give out your account numbers or passwords, especially if someone is trying to rush or pressure you.
  • Scam texts can fake NHS or GOV.UK addresses — check official sites if unsure.
  • Even texts or emails that appear to come from your bank can be faked. A common red flag is a message saying that a second text or email will come from a different number or sender — ask yourself why a genuine organisation would do this. Real authorities go to great lengths to be verifiable.
  • If someone calls and tries to rush or scare you, hang up and call back using an official number from the NHS or your GP’s website.
  • If in doubt — or even as a general principle — hang up and call a number you can verify yourself, such as:
    • The number printed on the back of your bank card
    • The official website of a company or authority (searched independently)
  • Avoid using any contact information provided by the caller or in a suspicious message — treat it as untrustworthy until confirmed.
  • To check a suspicious link in a text, don’t click — instead, search for the organisation’s website directly or ask someone you trust.

6. If You're Shielding or Vulnerable

  • You may be more targeted by scams pretending to offer:
    • COVID-19 test kits, antifungal treatments, or priority delivery slots
    • Access to urgent medical appointments or services
  • Verify any offer with your NHS care team before taking action.

7. Keeping Your Devices Safe

  • Install antivirus and keep your phone/tablet/computer updated.
  • Always accept software updates — they patch security flaws that criminals may try to exploit.
  • Set devices to auto-lock and use a passcode or fingerprint.
  • Avoid using public Wi-Fi for medical logins or financial information.

Do You Still Need Antivirus?

  • Windows PCs: Yes — always install antivirus. Microsoft Defender (built-in) is good and free. You can also consider free versions of AVG, Avast, or Bitdefender.
  • Mac computers: Less targeted, but still recommended. Free options include Avira or Sophos Home.
  • Android phones: A good idea, especially if you install apps outside the Play Store. Try Bitdefender or AVG.
  • iPhones/iPads: Antivirus apps aren’t usually needed if you keep iOS updated and install apps only from the App Store.

Whichever device you use, updates and cautious browsing are just as important as antivirus software.

8. Best Ways to Use Strong Passwords

Cyber security can be time-consuming and even irritating — but as malicious activity becomes more sophisticated, it’s worth the effort. Consider using different levels of passwords for different kinds of accounts:

  • Low-level passwords for things like newsletters or forums
  • High-level, strong passwords for NHS, banking, or health-related logins

Make Passwords Long and Unique

  • Use at least 12 characters, mixing letters, numbers, and symbols
  • Avoid personal info like names or birthdates

Use a Password Manager

  • Tools like Bitwarden, 1Password, or Apple Keychain securely store passwords
  • You only need to remember one master password

Use Passphrases for Important Accounts

  • Combine random words to create a memorable but strong password, like:
    • Correct!Horse-Battery!Staple99

Turn On Two-Factor Authentication (2FA)

  • Adds a second layer of protection, such as a code from your phone
  • 2FA ties your account to a specific device (like your phone), meaning a criminal would need access to that device as well as your password to break in

Use a Unique Password for Every Account

  • Never reuse passwords

Avoid These Mistakes

Mistake Better Option
Reusing passwords Use a password manager
Writing them down Use encrypted storage
Adding "123" to a word Use unrelated, random words/symbols

When to Change Passwords

  • If your account may have been hacked
  • If the same password is used elsewhere

Is It Safe to Use Chrome or Other Browser Autofill?

Using Chrome, Firefox, Safari, or Edge to autofill logins can be safe with the right precautions:

  • Your device should be private and locked with a passcode or fingerprint
  • Your browser and operating system should be kept fully up to date
  • You should avoid storing logins for sensitive accounts (e.g. banking, NHS login)

Risks to consider:

  • Passwords stored in browsers can be accessed by malware or rogue extensions
  • If someone gets access to your device, they may access saved logins

Safer Alternative:

  • Use a dedicated password manager (like Bitwarden, 1Password, or Dashlane)
  • These offer stronger security and are harder for malware or hackers to access

If you do use browser autofill, protect your device and account with:

  • Two-factor authentication for your Google, Apple, or Microsoft account
  • A strong device password or biometric lock

9. Finding the Happy Medium

Cybersecurity doesn’t have to take over your life — the key is to find a realistic balance between staying safe and staying sane:

  • Focus on protecting your most important accounts first — especially NHS, email, banking, and anything medical
  • Don’t ignore warning signs, but don’t feel you have to be perfect with every app or device
  • Use automation where possible (e.g. password managers, browser autofill, device lock)
  • Ask for help if you’re unsure — carers, family members, or digital support charities can assist

Think of it like seatbelts — you hope you never need them, but they’re worth the hassle when something goes wrong.

Useful Links

Remember: Your health is private and valuable. Treat your medical and personal information like you would your bank details. Stay cautious, ask questions, and when in doubt, ask a trusted health professional or carer.

by GAtherton

🫁 Is It an ABPA Flare or a Bronchiectasis Flare? How to Tell the Difference

If you have aspergillosis, especially ABPA (Allergic Bronchopulmonary Aspergillosis) and bronchiectasis, it can be hard to know which one is flaring up when your lungs feel worse. They often overlap — but there are some clues that can help.

🔍 How the Two Conditions Are Different

Feature ABPA Flare (Allergic Reaction to Aspergillus) Bronchiectasis Flare (Infection in Damaged Airways)
Main cause Your immune system reacting to Aspergillus Infection in widened, inflamed airways
Symptoms you may notice - Chest tightness or wheezing
- Thick, sticky mucus
- Feeling more tired
- Occasional low-grade fever		 - Wet cough with more sputum
- Sputum changes colour (green/yellow)
- Fever, chills, or general unwell feeling
How it starts May come on gradually or after exposure to damp/mould Often starts after a cold or virus
What helps most Steroids (inhaled or oral), sometimes biologics Antibiotics and chest physiotherapy
What tests may show - Raised IgE or eosinophils
- CT may show mucus plugs		 - Raised CRP or white cells
- Sputum may grow bacteria or fungus
What to ask your doctor “Is my IgE or eosinophil count up?” “Do I need a sputum test or antibiotics?”

🧭 What Can You Do as a Patient?

  • 📝 Keep a symptom diary – especially note changes in:

    • Sputum colour or amount

    • Wheezing or chest tightness

    • Tiredness or sleep quality

  • 🧪 Ask for the right tests:

    • Blood tests like IgE and eosinophils for ABPA

    • CRP, white blood count, and sputum tests for bronchiectasis

  • 🩺 Don’t guess or self-treat – steroids and antibiotics work in different ways, and using the wrong one can make things worse or mask important signs.

💬 Final Thought

It's very common for people with aspergillosis to feel confused by flare-ups — you're not alone. Learning to spot your own patterns, and getting support from your specialist team, can make a real difference.

by GAtherton

Asthma & Lung: 5 tips to help you breathe better and stay well

Dr Andy offers five tips to help you breathe better and stay well.

We know that things like hay fever, air pollution and hot weather can make breathing more difficult and stop you doing the things you love. Our clinical lead, Dr Andy, offers five tips to help you breathe better and stay well. Head to our website to find more easy-to-follow tips and advice to improve your breathing during the warmer months: https://orlo.uk/v9JT2

by GAtherton

🔬 Emerging Research for Aspergillosis

Aspergillosis is a complex group of diseases caused by the Aspergillus fungus. Ongoing research is uncovering new ways to diagnose, treat, and prevent these conditions—offering hope for improved care and long-term outcomes. This page outlines current areas of promising research relevant to patients, carers, and healthcare professionals.

⏱️ Has Research Accelerated Over Time?

Yes. Over the last 40 years, research into aspergillosis and fungal infections has significantly accelerated due to:

  • Rising awareness of fungal diseases in immunocompromised patients
  • Improved diagnostic technology (e.g. PCR, lateral flow tests, next-gen sequencing)
  • New drug development in response to growing azole resistance
  • Greater investment from both academic institutions and industry
  • Dedicated centres like the UK National Aspergillosis Centre driving specialist research
  • Fungal infections gaining WHO recognition as emerging public health threats

In the 1980s and 1990s, progress was relatively slow. Since the early 2000s—and especially after the COVID-19 pandemic revealed the risks of fungal co-infection—momentum has increased markedly.

1. 🧪 Antifungal Drug Development

Resistance to azole antifungals is a growing concern. Several new antifungal agents are in development:

🔸 Olorofim (F2G)

  • First-in-class orotomide antifungal
  • Shows activity against Aspergillus, including azole-resistant strains
  • Currently in phase III trials for invasive and chronic pulmonary aspergillosis

🔸 Ibrexafungerp and Fosmanogepix

  • New antifungals with different mechanisms of action
  • Potentially effective in combination or for resistant cases

🔸 Inhaled Antifungals

  • Trials of inhaled itraconazole, posaconazole, and PC945 (opelconazole) for direct delivery to the lungs
  • Aim: higher local drug concentrations with fewer side effects

2. 🧬 Biologics and Immune Modulation

🧭 What's Next in Biologic Therapies for Severe Asthma?

Several next-generation biologics are under development, aiming to:

  • Broaden coverage for patients who don't respond to existing biologics
  • Target upstream pathways (beyond IL‑5, IL‑4/13, or IgE)
  • Offer once-yearly dosing or dual-target activity

Examples include:

  • Depemokimab: A long-acting anti-IL‑5 antibody in phase 3 trials (GSK)
  • CSJ117: An inhaled anti-TSLP monoclonal antibody fragment (Novartis)
  • RG6354: Targeting IL-33 pathway, an upstream trigger in type 2 and non-type 2 asthma
  • Dual Biologics: Exploratory research combining two targets (e.g., IL‑5 + IL‑4 or TSLP + IL‑13)

These developments may also benefit subsets of aspergillosis patients with severe asthma or ABPA who have not fully responded to current biologics. Research is exploring biologic therapies that reduce allergic inflammation or modulate immune response, particularly for ABPA (Allergic Bronchopulmonary Aspergillosis) and overlapping asthma subtypes.

✅ Biologics Currently in Use for ABPA

Omalizumab (Xolair) – Anti-IgE

  • Target: IgE antibody—blocks allergic immune response to Aspergillus antigens.
  • Evidence: Studies show significant reductions in exacerbations, IgE, steroid use, and improved lung function.
  • Clinical Use: Widely used off-label in ABPA patients with raised IgE and asthma features.

Mepolizumab (Nucala) – Anti–IL‑5

  • Target: IL‑5 cytokine—reduces eosinophil inflammation.
  • Use: Steroid-sparing and symptom control in eosinophilic ABPA.

Benralizumab (Fasenra) – Anti–IL‑5 Receptor

  • Target: IL‑5Rα—causes rapid eosinophil depletion.
  • Use: Clearing mucus plugs and reducing flares; often used after mepolizumab failure.

Dupilumab (Dupixent) – Anti–IL‑4Ra

  • Target: IL‑4/IL‑13 pathway—type 2 inflammation.
  • Use: Shown to reduce IgE levels and ABPA exacerbations.

Tezepelumab (Tezspire) – Anti‑TSLP

  • Target: TSLP—broadly suppresses upstream allergic inflammation.
  • Evidence: Early reports suggest benefit in ABPA patients, though data are limited.

📊 Real-World Effectiveness

UK-based retrospective study (2014–2022):

  • 74 ABPA patients treated with biologics
  • 65% showed ≥50% reduction in steroid use after 12 months
  • 35% switched due to lack of effect or side effects

📌 Summary Table of Biologics

Biologic Target Use in Aspergillosis Key Benefits
Omalizumab IgE ABPA with raised IgE ↓ Exacerbations, ↓ steroids, ↑ FEV₁
Mepolizumab IL‑5 Eosinophilic ABPA Steroid-sparing, symptom control
Benralizumab IL‑5Rα Refractory cases Mucus clearance, eosinophil depletion
Dupilumab IL‑4/IL‑13 Mixed allergic/eosinophilic ABPA ↓ IgE, ↓ flares
Tezepelumab TSLP Emerging, broad asthma-ABPA Broad inflammation control

3. 🧫 Diagnostic Advances

Improved diagnostics aim to detect disease earlier and more accurately:

  • Lateral flow tests (e.g., Aspergillus-specific LFD) for rapid diagnosis
  • PCR testing and galactomannan assays in blood, sputum, or BAL
  • Aspergillus-specific IgG and IgE testing to distinguish CPA, ABPA, and colonisation
  • Next-generation sequencing (NGS) for strain typing and resistance detection

4. 🌡️ Non-Pharmacological Research

🌀 Airway Clearance and Physiotherapy

  • Trials assessing flutter devices, oscillating PEP, and manual physiotherapy in chronic aspergillosis and bronchiectasis

🥦 Nutrition and Gut-Lung Health

  • Increasing interest in the role of dietary fibre, gut microbiome, and short-chain fatty acids in immune defence and lung inflammation

💨 Air Quality and Exposure

  • Home-based studies evaluating the impact of HEPA filters, spore counts, and environmental remediation

5. 🛡️ Preventative Strategies

🫁 Lung/Nasal Coatings (Experimental)

  • Early research into coating the lungs or nasal passages to prevent infection
  • Not yet in human trials for aspergillosis, but promising in animals for viral and bacterial prevention

💉 Vaccines

  • No approved vaccines yet, but exploratory work is underway for high-risk populations

6. 🧫 Clinical Trials in Aspergillosis

A wide range of clinical trials are currently underway or recently completed, focusing on new antifungals, biologics, and non-pharmacological interventions:

🧪 Antifungal Trials

  • Rezafungin – A long-acting echinocandin administered once weekly, currently in trials for prevention and treatment of invasive fungal infections, including those caused by Aspergillus species
  • Olorofim (F2G) – Phase III trials for CPA and invasive aspergillosis
  • PC945 (Opelconazole) – Inhaled triazole for CPA and prophylaxis in immunocompromised patients
  • Fosmanogepix and Ibrexafungerp – Investigated in resistant and invasive fungal disease

🧬 Biologic Trials

  • Tezepelumab and Dupilumab – Trials involving patients with ABPA and severe asthma
  • Depemokimab (GSK) – Phase III trials for long-acting IL‑5 blockade

🌡️ Other Trials

  • Airway clearance studies – Use of physiotherapy and flutter/PEP devices in chronic pulmonary aspergillosis
  • Gut microbiome and fibre supplementation – Exploring anti-inflammatory potential in lung disease

These trials often recruit patients from UK centres including the National Aspergillosis Centre, and are registered on databases such as ClinicalTrials.gov.

7. 🤝 Patient Support and Outcomes Research

📊 Real-World Evidence

  • Registries and observational studies (e.g., LIFE, FungiScope) gathering long-term data on patients with CPA, ABPA, SAFS, and invasive disease

👥 Quality of Life and Patient-Reported Outcomes

  • Surveys and tools to measure impact of fatigue, breathlessness, mental health, and medication side effects
  • Aim: improve personalised care and support services

🧭 Where to Find Updates

  • ClinicalTrials.gov – searchable by "aspergillosis"
  • Aspergillosis.org – for patient-friendly research summaries
  • National Aspergillosis Centre (UK) – involved in many UK-based studies
  • Journal of Fungi, Medical Mycology, Clinical Infectious Diseases – leading sources of peer-reviewed studies

📢 Final Word

Research into aspergillosis is accelerating across drug development, diagnostics, prevention, and patient support. While not all options are available yet, many are in trials or early clinical use. Staying informed and involved—whether through trial participation or feedback—helps shape better care for all.

Updated July 2025 – suitable for patients, clinicians, and advocacy groups.

 

by GAtherton

🫁 Could Lung or Nasal Coatings Help Prevent Aspergillosis?

As research into new ways of preventing lung infections advances, some patients with aspergillosis are asking whether coating the lungs or airways—with a protective spray, gel, or surfactant—might one day protect them from fungal disease.

Here’s what the science says so far.

🔬 What Is Being Researched?

Scientists are currently studying ways to coat the lungs or nasal passages with a protective substance designed to:

  • Trap or neutralise viruses, bacteria, or fungal spores
  • Stabilise the lung or airway lining
  • Prevent inflammation or infection from taking hold

These coatings may come in the form of:

  • Dry powder aerosols (inhaled)
  • Drug-free nasal gels or sprays

Importantly, these are being developed as preventative measures, not as treatments for people already ill.

🧪 Current Research: Early-Stage, Not Yet for Aspergillosis

1. Dry Powder Lung Surfactants

  • These are based on natural surfactants that coat the lungs and keep the air sacs (alveoli) open.
  • Tested in animals (e.g., lambs, rabbits) with good results in preventing respiratory distress or injury.
  • Used mostly in neonatal care for premature babies.
  • Not yet tested for fungal infections or chronic diseases like aspergillosis.

2. Nasal Gel-Coating Sprays

  • These sprays form a temporary coating in the nose and upper airways, shown in mice to block viruses like flu or COVID-19.
  • Protective effect may last several hours.
  • Still in animal testing—no human trials or approvals yet.
  • No evidence yet that they can prevent fungal infections like Aspergillus.

📌 Are These Coatings Available Yet?

No. As of now:

  • There are no licensed lung or nasal sprays designed to prevent aspergillosis or other fungal lung infections.
  • Most studies are in pre-clinical stages (animal research only).
  • It may be several years before any human trials begin.

🛡️ Who Might Receive These Preventatives in the Future?

If future research proves these coatings are safe and effective, likely priority groups would include:

🎯 High-risk populations:

  • People with chronic aspergillosis (CPA) or ABPA
  • Patients on long-term steroids or immunosuppressants
  • Individuals with bronchiectasis, COPD, or cystic fibrosis
  • Transplant recipients or those with cancer or immune deficiencies
  • Elderly people, especially in care homes
  • Healthcare or construction workers exposed to dust, spores, or mould
  • Hospitalised or ventilated patients (e.g. risk of CAPA in ICU)

❗ What Aspergillosis Patients Should Know

  • These technologies are not available yet and remain in the research phase.
  • They are being explored as preventative tools, not as treatment for existing fungal infections.
  • There is no evidence yet they can prevent Aspergillus infections—but the research is promising.

✅ What You Can Do Now

Until better preventatives are developed, people with aspergillosis can reduce risk by:

  • Avoiding high-risk environments (e.g., compost, renovation dust, decaying vegetation)
  • Using prescribed antifungals or steroids correctly
  • Supporting immune health (e.g., good nutrition, rest, fibre-rich diet)
  • Asking doctors about biologics or ongoing research trials if relevant

📘 Final Word

While the idea of coating the lungs or nose to stop infections sounds futuristic, it’s grounded in real science. For people vulnerable to fungal lung disease, this kind of innovation may one day offer protection—especially for those on immunosuppressive treatments or with fragile lungs.

But for now, the best defence remains personalised treatment, avoidance strategies, and good communication between specialists and GPs. We’ll keep watching this space closely as research develops.

by GAtherton