Real-life evidence in allergen immunotherapy: Moving forward with mHealth apps.

Sousa-Pinto B, Pfaar O, Bousquet J. Allergol Select. 2023 Mar 1;7:47-56. doi: 10.5414/ALX02343E.

Abstract

Aim: The efficacy and safety of allergen immunotherapy (AIT) in allergic rhinitis has been classically assessed using randomized controlled trials (RCTs). However, RCTs may have limitations in their external validity, and their evidence may be complemented with that from real-world studies. We aimed to review the mHealth apps that can be used for retrieving real-world data on AIT in allergic rhinitis. 

Materials and methods: We applied an automatic tool to identify the mHealth apps (available in the Google Play and Apple App stores) that can be used to assess patients under AIT for allergic rhinitis.

Sublingual immunotherapy (SLIT) for house dust mite - when to take a break? An unusual reaction to SLIT post-vaccinations

Gallagher A, Trujillo J.  Ann Allergy Asthma Immunol. 2023 Mar 14:S1081-1206(23)00174-6. doi: 10.1016/j.anai.2023.03.008.

Allergic conditions such as allergic rhinitis are on the rise in recent years leading to the development of many forms of immunotherapy. One such recent development is the standardized quality (SQ) house dust mite (HDM) allergen extract tablets (Acarizax), which have been proven a safe and effective management option for sublingual allergy immunotherapy (SLIT) in adults with confirmed HDM-induced allergic rhinitis or allergic asthma. Acarizax is generally well tolerated by adults with allergic rhinitis, however some experience mild to moderate allergic reactions in the mouth, which generally subside within a few days. A recent real world study published in 2021 reported mild to moderate adverse events such as oral pruritus, throat irritation, ear pruritus, mouth swelling and eye pruritus. I would like to report an interesting case of a patient with confirmed HDM allergic rhinitis, commenced on Acarizax with subsequent unusual reaction...

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Safety and Tolerability of Bilastine 0.6% Ophthalmic Solution: An 8-Weeks Phase III Study

Kuna P, Jutel M, Pulka G, Tokarski S, Arranz P, Hernández G, Fernández Hernando N. Clin Ophthalmol. 2023 Mar 4;17:735-746. doi: 10.2147/OPTH.S398168.

Purpose: The objective of this study was to assess the safety and tolerability of preservative-free bilastine 0.6% ophthalmic solution after 8 weeks of once-daily administration in patients with allergic conjunctivitis (AC).

Patients and Methods: Multi-center, international, randomized, double blind, placebo-controlled, parallel-group, phase III study of adult patients with seasonal or perennial AC. The study was conducted in 26 centers of 5 European countries. Duration of daily treatment with bilastine 0.6% ophthalmic solution or placebo was 8 weeks.

Electronic Monitoring Devices to Support Inhalation Technique in Patients with Asthma: a Narrative Review

Amber A. Eikholt MSc, 

Mechteld B. R. Wiertz MSc,MD, 

Mark Hew MBBS,PhD, 

Amy H. Y. Chan BPharm,(Hons),PhD & 

Job F. M. van Boven PharmD,PhD 

Current Treatment Options in Allergy volume 10, pages28–52 (2023)

Abstract

Purpose of Review

Improper inhaling technique is common and is associated with poor patient outcomes. However, digital e-health devices may offer novel opportunities for educational support. This narrative review provides an overview of electronic monitoring devices (EMDs) measuring patient inhalation technique. We summarise their technical features, capabilities and limitations and discuss the steps necessary for implementation in clinical practice.

Recent Findings

Six EMDs measuring inhalation were identified. The quality of published evidence varied widely. Devices differed in the inhalation technique steps measured, the feedback provided and the type of sensor employed.

Post-COVID dyspnea: prevalence, predictors, and outcomes in a longitudinal, prospective cohort

• Research
• Open Access
• 
  

• Japnam S. Grewal, 
• Christopher Carlsten, 
• James C. Johnston, 
• Aditi S. Shah, 
• Alyson W. Wong & 
• Christopher J. Ryerson 

BMC Pulmonary Medicine volume 23, Article number: 84 (2023) 

Abstract

Background

The pathophysiology, evolution, and associated outcomes of post-COVID dyspnea remain unknown. The aim of this study was to determine the prevalence, severity, and predictors of dyspnea 12 months following hospitalization for COVID-19, and to describe the respiratory, cardiac, and patient-reported outcomes in patients with post-COVID dyspnea.

Methods

We enrolled a prospective cohort of all adult patients admitted to 2 academic hospitals in Vancouver, Canada with PCR-confirmed SARS-CoV-2 during the first wave of COVID between March and June 2020.

Medical ID use by international patients with Aspirin-Exacerbated Respiratory Disease

• Short report
• Open Access
• 
  

• Mohammed Alqabasani, 
• Andrea Lasso & 
• Shaun Kilty 

Allergy, Asthma & Clinical Immunology volume 19, Article number: 22 (2023) 

Abstract

Background

Patients widely use medical identification (ID) to indicate their food and drug allergies, and chronic medical conditions. One chronic condition for which patients are recommended to use a form of medical ID is Aspirin-Exacerbated Respiratory Disease (AERD), a disease characterized by the presence of asthma, chronic rhinosinusitis with nasal polyps and sensitivity to aspirin and other COX-1 inhibitors, including nonsteroidal anti-inflammatory drugs (NSAIDs).

Long-term efficacy of HDM-SCIT in pediatric and adult patients with allergic rhinitis

• Research
• Open Access
• 
  

• Lei Ren, 
• Chengshuo Wang, 
• Lin Xi, 
• Yunbo Gao, 
• Yuan Zhang & 
• Luo Zhang 

Allergy, Asthma & Clinical Immunology volume 19, Article number: 20 (2023) 

• details

Abstract

Background

Subcutaneous immunotherapy (SCIT) is a well-validated and effective disease modification treatment for house dust mites (HDM)-induced allergic rhinitis (AR). Long-term post-treatment comparisons in children and adults treated with SCIT have rarely been published. This study aimed to evaluate the long-term efficacy of HDM-SCIT administered under a cluster schedule in children compared to adults.

Stepping Down Treatment in Chronic Spontaneous Urticaria: What We Know and What We Don’t Know

• Review Article
• Open Access
• 
  

• Dorothea Terhorst-Molawi, 
• Lena Fox, 
• Frank Siebenhaar, 
• Martin Metz & 
• Marcus Maurer 

American Journal of Clinical Dermatology (2023)

• details

Abstract

In chronic spontaneous urticaria (CSU), wheals, angioedema, or both appear spontaneously for > 6 weeks. Current recommended treatment options for urticaria target mast cell mediators such as histamine, or activators, such as autoantibodies. The goal of CSU treatment is to treat the disease until it is gone as effectively and safely as possible. As no cure is available for CSU as of now, the treatment is aimed at continuously suppressing disease activity, with complete control of the disease and a normalization of quality of life. To achieve this, pharmacological treatment should be continued until no longer needed.

Childhood asthma diagnoses declined during the COVID-19 pandemic in the United States

• Correspondence
• Open Access
• 
  

• Daniel B. Horton, 
• Amanda L. Neikirk, 
• Yiling Yang, 
• Cecilia Huang, 
• Reynold A. Panettieri Jr, 
• Stephen Crystal, 
• Brian L. Strom & 
• Lauren E. Parlett 

Respiratory Research volume 24, Article number: 72 (2023) 

• details

Abstract

Background

Prior studies have documented declines in pediatric asthma exacerbations and asthma-related health care utilization during the COVID-19 pandemic, but less is known about the incidence of asthma during the pandemic.

Methods

We conducted a retrospective cohort study of children under age 18 without a prior diagnosis of asthma within a large US commercial claims database. Incident asthma was defined using a combination of diagnosis codes, location of services, and medication dispensing.

Evaluation of Plasmapheresis vs Immunoglobulin as First Treatment After Ineffective Systemic Corticosteroid Therapy for Patients With Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

Yuki Miyamoto, MD, MPH1,2; Hiroyuki Ohbe, MD, MPH2; Ryosuke Kumazawa, DPH2; et al

JAMA Dermatol. Published online March 8, 2023. doi:10.1001/jamadermatol.2023.0035

Key Points

Question Are the clinical outcomes of administering plasmapheresis therapy first better than those of administering intravenous immunoglobulin (IVIG) therapy first after ineffective systemic corticosteroid therapy in patients with Stevens-Johnson syndrome or toxic epidermal necrolysis (SJS/TEN)?

Findings This retrospective cohort study of 266 inpatients with SJS/TEN found no significant difference in mortality rates between the plasmapheresis-first and the IVIG-first groups. Patients who received plasmapheresis therapy first had longer hospitalization stays and incurred higher expenses.

Calprotectin in nasal secretion: a new biomarker of non-type 2 inflammation in CRSwNP

Eugenio De Corso Silvia Baroni Maria Elisabetta Onori Laura Tricarico Stefano Settimi Giacomo Moretti Eliana Troiani Rodolfo Francesco Mastrapasqua Daniela Furno Fabrizio Crudo Andrea Urbani Jacopo Galli.

Acta Otorhinolaryngol Ital. 2022 Aug;42(4):355-363. doi: 10.14639/0392-100X-N1800.

Abstract

Objective. We analysed calprotectin in sinonasal secretions of different chronic rhinosinusitis with nasal polyps (CRSwNP) endotypes to assess its role as a biomarker of non-type 2 inflammation.

Methods. We included primary diffuse CRSwNP patients (n = 41) and three different control groups [non-allergic rhinitis (NAR) (n = 13), non-allergic eosinophilic syndrome (NARES) (n = 10) and healthy subjects (n = 12)].

Phenotypes of persistent hen`s egg allergy in children and adolescents

Hilal Ünsal 1 ,Sevda Tüten Dal 1 ,Ayşegül Akarsu 1 ,Ümit Murat Şahiner 1 ,Özge Soyer 1 ,Bülent Enis Şekerel 1

1 Division of Pediatric Allergy, Hacettepe University Faculty of Medicine, Ankara, Türkiye

DOI : 10.24953/turkjped.2021.5417

Background. Optimum management of food allergy (FA) includes consideration of co-allergies and multimorbidities and tolerance assessment. Documentation of FA practices may pave the way for better practice.

Methods. Patients aged 3-18 years, with persistent IgE-mediated hen`s egg allergy were reviewed.

Results. A total of 102 children with a median age of 59 months (IQR= 40-84) (72.2% males) were included. All were diagnosed during infancy and the initial symptoms were atopic dermatitis (65.6%), urticaria (18.6%), and anaphylaxis (5.9%).

Asthma occurrence in children and early life systemic antibiotic use: an incidence density study

• Research
• Open Access
• 
  

• Hayat Bentouhami, 
• Milcah Kahkelam Bungwa, 
• Lidia Casas, 
• Samuel Coenen & 
• Joost Weyler 

Allergy, Asthma & Clinical Immunology volume 19, Article number: 18 (2023) 

Abstract

Background

Results of studies evaluating the relationship between asthma occurrence and early life antibiotic use have been conflicting. The aim of this study was to investigate the relationship between occurrence of asthma in children and systemic antibiotic use in the first year of life based on an incidence density study with careful consideration of the temporal aspects of the determinant-outcome relationship.

Methods

We conducted an incidence density study nested in a data collection project with information on 1128 mother–child pairs. Systemic antibiotic use in the first year of life was defined as excessive (≥ 4 courses) vs. non-excessive (< 4 courses) use based on information from weekly diaries.

IgE sensitization to Blo t 21 and Blo t 5 is associated with asthma in the tropics: a case-control study

Zakzuk J1, Donado K1, Mondol E1, Marrugo V1, Regino R1, López JF1, Hernández K1, Mercado D1, Dennis R2, Puerta L1, Caraballo L1

1Institute for Immunological Research, University of Cartagena, Cartagena, Colombia
2Fundación Cardioinfantil, Bogotá, Colombia

J Investig Allergol Clin Immunol 2024; Vol. 34(3) doi: 10.18176/jiaci.0892

Abstract

Background: Blomia tropicalis sensitization is associated with asthma in different tropical and sub-tropical countries; however, information about the specific molecular components associated with this disease is scarce.
Objective: Using molecular diagnosis, we sought to identify B. tropicalis allergens associated with asthma in Colombia.
Methods: Specific IgE (sIgE) to eight B. tropicalis recombinant allergens (Blo t 2/5/7/8/10/12/13 and 21) was determined using an in-house developed ELISA system in asthmatic patients (n=272) and control subjects (n=298) recruited in a national prevalencestudy performed in Colombian cities (Barranquilla, Bogotá, Medellín, Cali and San Andrés). Sample study included children and adults (mean age: 28±SD 17 years old). Cross-reactivity between Blot 5 and Blo t 21 was evaluated by ELISA-inhibition.

Exhaled biomarkers in adults with non-productive cough

• Correspondence
• Open Access
• 
  

• Össur Ingi Emilsson, 
• Spela Kokelj, 
• Jörgen Östling & 
• Anna-Carin Olin 

Respiratory Research volume 24, Article number: 65 (2023) 

Abstract

Background

Chronic cough is a common condition but disease mechanisms are not fully understood. Our aim was to study respiratory biomarkers from the small airways in individuals with non-productive cough.

Methods

A cohort of 107 participants answered detailed questionnaires, performed spirometry, exhaled NO measurement, impulse oscillometry, gave blood samples and particles in exhaled air (PEx) samples. Current smokers (N = 38) were excluded. A total of 14 participants reported non-productive cough (cases).