Itraconazole as “bridge therapy” to anti-IgE in patients with severe asthma with fungal sensitization

Background Sensitization to fungi has been reported to play an important role in a particular phenotype of severe asthma, the so called severe asthma with fungal sensitization (SAFS), characterized by high levels of total IgE, which may be an obstacle to anti-IgE therapy. A few studies showed the benefit of antifungal therapy in improving the quality of life of patients with SAFS associated to a decrease of total IgE serum concentration. We describe here the role of antifungal therapy as “bridge therapy”, which provided us the opportunity to start anti IgE therapy in one polysensitized patient with severe asthma, who had very high levels of total IgE, beyond the upper limits recommended for proper prescription of omalizumab.