Systemic Therapy for Atopic Dermatitis: Choosing Biologics or Janus Kinase Inhibitors for Children and Adults

Scholl IM, Drucker AM, Flohr C, Gerbens LAA.  J Allergy Clin Immunol Pract. 2026 Feb;14(2):344-359. doi: 10.1016/j.jaip.2025.10.052.

Abstract

Mechanism of action of biologics and Janus kinase (JAK) inhibitors

Atopic dermatitis is a highly prevalent chronic inflammatory skin disease worldwide, with a significant burden on patients’ quality of life. Although most patients with atopic dermatitis are effectively managed with topical treatments, a significant minority requires systemic therapy. In recent years, the therapeutic landscape for this patient population has expanded beyond conventional treatments, introducing novel targeted therapies such as biologic agents and Janus kinase inhibitors.

Estimated Effectiveness of 2024-2025 COVID-19 Vaccination Against Severe COVID-19

Ma KC, Webber A, Lauring AS et al.   JAMA Netw Open. 2026 Feb 2;9(2):e2557415. doi: 10.1001/jamanetworkopen.2025.57415. 

Key Points

Question  What was the estimated vaccine effectiveness (VE) of the 2024-2025 COVID-19 vaccines against severe COVID-19, and did it vary by SARS-CoV-2 lineage or spike protein mutations?

Findings  In this case-control study of 1888 adults with COVID-19 and 6605 adults without COVID-19, estimated VE was 40% against hospitalization and 79% against invasive mechanical ventilation or death. The estimated VE was similar for KP.3.1.1 and XEC lineages, as well as for spike protein mutations potentially associated with immune evasion (S31 deletion, T22N and F59S substitutions).

Meaning  These findings suggest that COVID-19 vaccines offered protection against hospitalization and severe in-hospital outcomes during the 2024-2025 season, in which multiple JN.1 lineages evolved and circulated.

Abstract

Importance  As SARS-CoV-2 JN.1 lineage descendants continue to evolve, evaluating COVID-19 vaccine effectiveness (VE) against severe COVID-19 remains important to guide vaccination strategies.

Allergy to Cats: Current Perspectives and Therapeutic Options

Demoly P, Zakariya M, Dávila I et al. Clin Transl Allergy. 2026 Mar;16(3):e70152. doi: 10.1002/clt2.70152.

ABSTRACT

Allergic rhinitis (AR) and asthma caused by cat dander have a highly variable prevalence across countries, which can reach 30% of the population in some regions. Cat allergens are widely distributed in the environment, making exposure nearly unavoidable, even in non-cat-owning households. Eight cat allergens have been identified, with Fel d 1 and Fel d 4 being particularly associated with the development and severity of asthma. 

Cat allergens

Symptoms can range from mild nasal and eye symptoms to severe asthma exacerbations, with many patients experiencing polysensitization to other allergens.

RSV Detection and Antibiotic Prescribing Decisions for Pediatric Respiratory Tract Infections

Boracchini R, Brigadoi G, Salvadori S, et al. JAMA Netw Open. 2026;9(3):e260409. doi:10.1001/jamanetworkopen.2026.0409

Key Points

Question  Are respiratory syncytial virus (RSV) antigen rapid diagnostic tests (Ag-RDTs) in primary care associated with reduced inappropriate antibiotic prescribing in children with suspected viral lower respiratory tract infections (VLRTIs), including bronchiolitis?

Findings  In this cohort study of 256 children aged 9 to 36 months in Italy, implementing RSV Ag-RDTs in clinical practice was associated with a reduction in unnecessary antibiotic use. Overall, RSV Ag-RDTs were associated with a mean reduction in antibiotic prescribing for VLRTIs and bronchiolitis compared with clinically diagnosed cohorts.

Meaning  The findings suggest incorporating RSV Ag-RDTs into pediatric care may support more appropriate antibiotic prescribing and could help reduce antibiotic overuse.

Abstract

Importance  Respiratory syncytial virus (RSV) is a leading cause of pediatric viral lower respiratory tract infections (VLRTIs), often leading to inappropriate antibiotic use. Although rapid antigen diagnostic tests (Ag-RDTs) support clinical diagnosis, their effect on antibiotic prescribing in community settings remains uncertain.

Efficacy and safety of oral antihistamines for allergic rhinitis: Network meta-analysis

Vieira RJ, Gil-Mata S, Ferreira A et al.  ARIA 2024-2025 guideline panel.  J Allergy Clin Immunol Pract. 2026 Feb 16:S2213-2198(26)00140-6. doi: 10.1016/j.jaip.2025.12.034. 

Highlights

• What is already known about this topic? Oral antihistamines are one of the mainstays of the pharmacological management of allergic rhinitis, being widely available and affordable.

• What does this article add to our knowledge? Oral antihistamines are effective in improving rhinitis symptoms and quality-of-life. Cetirizine, ebastine, bilastine and rupatadine were among the individual medications associated with the highest efficacy for improving nasal symptoms.

• How does this study impact current management guidelines? This systematic review will inform the Allergic Rhinitis and its Impact on Asthma (2024-2025) guidelines. In particular, it will provide evidence on the efficacy and safety of individual oral antihistamines.

Abstract

Background

Oral H1-antihistamines (OAH) are among the most frequently used medications for the treatment of allergic rhinitis (AR).

Objective

To perform a systematic review and network meta-analysis comparing the efficacy and safety of individual OAH in patients with AR.

Methods

We searched four electronic bibliographic databases and three clinical trial databases for randomized controlled trials assessing adults with perennial or seasonal AR, and comparing (i) OAH versus placebo or (ii) different individual OAH. We performed a network meta-analysis on the Total Nasal Symptom Score, Total Ocular Symptom Score, Rhinoconjunctivitis Quality-of-Life Questionnaire, development of adverse events, and withdrawals due to adverse events. Certainty of evidence for comparisons involving the most clinically relevant second-generation OAH was assessed using GRADE-NMA.

Results

Summary of the network meta-analysis results of
the comparisons between each main oral
antihistaminewith placebo

We included 74 randomized controlled trials (21 on perennial AR and 53 on seasonal AR). Cetirizine, ebastine, bilastine and rupatadine were among the individual medications associated with the highest efficacy for improving nasal symptoms. For other efficacy outcomes, the most efficacious interventions varied.

Regulation of allergies across the body by microbial metabolites

Kim, C.H., Baker, J.R.  Exp Mol Med (2026). https://doi.org/10.1038/s12276-026-01642-1

Abstract

General impact of microbial metabolite dysbiosis on allergic pathogenesis.

Allergies are adverse immune responses to typically harmless substances, known as allergens. While allergies can involve diverse immune responses, type 2 immune responses that induce acute hypersensitivity mediated by mast cells, eosinophils and basophils are the major mechanisms underlying allergic disorders. Allergic diseases include atopic dermatitis, allergic rhinitis, food allergies and asthma. The onset and persistence of allergic disorders are influenced by genetic factors, pre-existing illnesses, age, environmental conditions and other lifestyle factors.

Beyond Algorithms: Clinical Judgement in the Management of Allergic Rhinitis

Di Lorenzo G, Melluso M, Seidita A. Clin Exp Allergy. 2026 Feb 17. doi: 10.1111/cea.70254.

From disease to illness in allergic rhinitis

Allergic rhinitis affects 10%–40% of the global population and represents one of the most frequently managed conditions in allergy and internal medicine practice. International guidelines, particularly ARIA (Allergic Rhinitis and its Impact on Asthma), have successfully standardised diagnosis and treatment through evidence-based algorithms that constitute an undeniable scientific advance. However, after 40 years of outpatient allergy practice, it becomes clear that daily clinical reality reveals a complexity that transcends standardised recommendations. This patient-centred perspective is not new—it echoes the Hippocratic emphasis on studying the patient rather than the disease, on careful observation and on allowing sufficient time to combine contradictory findings.

Artificial light at night extends pollen season and elevates allergen exposure

Brandt Geist, Lin Meng, Daniel S W Katz et al. PNAS Nexus, Volume 5, Issue 1, January 2026, pgaf405, https://doi.org/10.1093/pnasnexus/pgaf405

Abstract

Proportion of days in the pollen season under four exposure
severity levels for “No ALAN” and “ALAN” conditions.

Artificial light at night (ALAN), a growing environmental stressor in urban ecosystems, disrupts natural light–dark cycles and alters plant phenological events such as leaf-out and flowering. However, the extent to which ALAN influences airborne pollen season timing and exacerbates allergy-related health risks remains largely understudied. This study investigates how ALAN influences the timing and duration of the airborne pollen season across the Northeastern United States from 2012 to 2023 and the consequences of allergenic pollen exposure. Using daily pollen concentrations from the National Allergy Bureau, ALAN data from the Visible Infrared Imaging Radiometer Suite product, and gridded Daymet climate data, we derived three key pollen season metrics: start of season, end of season, and season length, and examined their relationship with environmental conditions.