New BTS Clinical Statement Published on Aspergillus

The British Thoracic Society (BTS) is pleased to announce the publication of the new BTS Clinical Statement on Aspergillus-related chronic lung disease, now available in Thorax.  

Chronic lung diseases caused by Aspergillus spp. continue to present challenges for clinicians due to the range of potential clinical presentations of these diseases, each of which have different diagnostic criteria and treatment approaches.   

This Clinical Statement provides comprehensive guidance for healthcare professionals on the classification, diagnosis, and management of chronic lung diseases caused by Aspergillus spp. The aim is to improve the diagnosis and management of chronic Aspergillus-related lung diseases, reducing the significant morbidity and mortality caused by these diseases. 

The guidance outlines a number of clinical practice points which: 

• Describe the main forms of Aspergillus-related chronic lung disease and providing for each of them clear diagnostic criteria based on clinical, radiological, microbiological, and serological data. 
  
  
• Provide clear guidance on the management of different types of Aspergillus-related chronic lung disease, including defining:
  -  the role of surgery and anti-fungal therapy for active infective forms 
  -  the role of corticosteroids, antifungal therapy, and biological agents for allergic bronchopulmonary     aspergillosis 
  -  when aspergillomas may require surgery or antifungal therapy 
  
  
• Provide advice on using antifungal therapy, including which agents should be used for the different clinical presentations of Aspergillus-related chronic lung disease, what tests are required before and after initiation of therapy, how the response to therapy should be assessed, and information on the common side-effects and interactions of the common anti-fungal agents. 
  
  
• Define when subspecialty expertise is required, such as in cases when there is diagnostic uncertainty, complex presentations, or suspected antifungal resistance. 

Dr Richard Russell, British Thoracic Society Chair, said: 

“The BTS Clinical Statement on the management of Aspergillosis is long overdue and will be welcomed by clinicians and researchers. This statement provides a much-needed update on how to diagnose and manage this difficult condition, which can progress to cause significant lung damage and harm to patients.  

Being suspicious about Aspergillus is key, and the statement provides clarity as to which tests to do and which treatments are effective. This BTS statement joins a pantheon of others providing practical evidence-based direction for the management of lung disease.” 

Read the full Clinical Statement in Thorax