The association between different regimens of glucocorticoid and antifungal treatment with the prognosis of allergic bronchopulmonary aspergillosis: a retrospective cohort study

Background Optimal management of allergic bronchopulmonary aspergillosis (ABPA) remains debated, particularly regarding glucocorticoid (GC) dosage, duration, antifungal selection, and combination therapy. This study evaluated the impact of different regimens on ABPA prognosis.Methods A total of 76 ABPA patients at Zhongshan Hospital, Fudan University from March 2009 to June 2018 were enrolled and stratified by one-year relapse status. Demographics, treatment details (GC dosage, GC duration, antifungal type), and outcomes (GC dependence, acute exacerbations, lesion resolution, recurrence) were analyzed. Multivariate logistic regression analysis was utilized.Results No significant difference were observed between the relapse group (n = 20) and non-relapse group (n = 56) in baseline demographics, clinical characteristics, or use of GC duration/dosage or antifungals. The mean follow-up time for the relapse and non-relapse groups were 23.95 vs 24.91 months. The former had higher long-term GC use (>3 months) than the non-relapse group (80% vs. 30.36%, p < 0.001). Long-term GC was an independent risk factor for relapse (OR 6.85, 95%CI 1.51–31.51), GC dependence (OR 5.92, 95%CI 1.29–27.11), and acute exacerbations (OR 9.41, 95%CI 2.76–32.06). Conversely, low-dose GC (