Treating allergic bronchopulmonary aspergillosis with hormone therapy: natural disease course, regimens, compliance, and outcomes.

Objective: Current guidelines lack information on the natural course and prognosis of allergic bronchopulmonary aspergillosis (ABPA). In this retrospective study, the natural course of ABPA was evaluated in patients treated with hormone therapy. Materials and methods: 25 ABPA patients were given standardized hormone therapy at stage 1 (acute) and stage 3 (exacerbation) of the natural course of disease. Total 47 sessions were divided into 2 groups according to stages, including 25 for stage 1 and 22 for stage 3 ABPA. Followed up once every 2 weeks during the first 8 weeks of treatment. Changes in eosinophils (Δeosinophils) and total serum immunoglobulin E (ΔIgE) were recorded. The correlation between ΔIgE and Δeosinophils at 2 and 4 weeks after treatment was calculated using Kendall's tau-b (K) correlation analysis. Results: Some patients did not receive standardized hormone therapy after 4 weeks. After 6 weeks, only 31.91% sessions adhered to standardized hormone therapy. Serum IgE differed between stage 1 and stage 3 patients under the same hormone therapy. Overall, 90.90% of the first ABPA exacerbations occurred within 2 years of diagnosis. The correlation coefficients between ΔIgE and Δeosinophils during treatment were 0.193 and 0.074 at 2 and 4 weeks of treatment, respectively. Conclusion: The compliance of patients with ABPA to hormone therapy is poor after 4 weeks of treatment. Repeated exacerbations can occur within 2 years of hormone therapy, and ΔIgE should be noted during this period. More evidence is needed to determine whether hormone therapy regimens should be distinguished between stage 1 and stage 3 ABPA.