Achieving clinical outcomes with benralizumab in severe eosinophilic asthma patients in a real-world setting: orbe II study

Padilla-Galo, A., Moya Carmona, I., Ausín, P. et al. Respir Res 24, 235 (2023). https://doi.org/10.1186/s12931-023-02539-7

Abstract

Background

The ORBE II study aimed to describe the characteristics and clinical outcomes of adult patients with severe eosinophilic asthma (SEA) treated with benralizumab in a real-world setting in Spain.

Methods

ORBE II (NCT04648839) was an observational, retrospective cohort study in adult SEA patients who had been prescribed benralizumab. Demographic and clinical data of 204 SEA patients were collected 12 months prior to benralizumab initiation (baseline) and at follow-up. Exacerbation rate, asthma symptoms, maintenance oral corticosteroid (OCS) use and lung function were evaluated, among other variables.

Results

Change in the number of exacerbations over 1-year follow-up. 

A total of 204 SEA patients were evaluated. Mean (standard deviation, SD) age of the study population was 56.4 (12.4) years, 62.3% were women and mean (SD) duration of asthma was 15.1 (12.7) years. Median (Q1–Q3) follow-up duration was 19.5 (14.2–24.2) months.

The immunology of long COVID

Altmann, D.M., Whettlock, E.M., Liu, S. et al. Nat Rev Immunol 23, 618–634 (2023). https://doi.org/10.1038/s41577-023-00904-7

Abstract

Weekly estimates of prevalence of COVID-19 and long COVID in England,
 according to the Office of National Statistics infection survey.

Long COVID is the patient-coined term for the disease entity whereby persistent symptoms ensue in a significant proportion of those who have had COVID-19, whether asymptomatic, mild or severe. Estimated numbers vary but the assumption is that, of all those who had COVID-19 globally, at least 10% have long COVID. The disease burden spans from mild symptoms to profound disability, the scale making this a huge, new health-care challenge. Long COVID will likely be stratified into several more or less discrete entities with potentially distinct pathogenic pathways. The evolving symptom list is extensive, multi-organ, multisystem and relapsing–remitting, including fatigue, breathlessness, neurocognitive effects and dysautonomia.

Don't we overestimate drug allergies in children?

Podlecka D, Jerzyńska J, Brzozowska A.  Int J Occup Med Environ Health. 2023 Sep 25:169848. 

ABSTRACT

Objectives: On average about 10% of parents report hypersensitivity to at least 1 drug in their children. After diagnosis process a few of these reactions are being confirmed as drug hypersensitivity reactions. The aim of the study was to assess the real-life prevalence of drug hypersensitivity in children based on drug provocation tests. Material and Methods: The authors included 113 children, aged 4–18 years, referred to Pediatrics and Allergy Clinic in Łódź, Poland, due to incidence of adverse reaction during treatment. Medical history regarding allergies to drugs was taken in accordance to the form developed by the United States Food and Drug Administration Adverse Event Reporting System. Skin prick tests, intradermal test and drug provocation test were performed in all patients.

Clinical standards for diagnosis, treatment and prevention of post-COVID-19 lung disease

Visca D, Centis R, Pontali E et aI. Int J Tuberc Lung Dis. 2023 Oct 1;27(10):729-741. doi: 10.5588/ijtld.23.0248.

BACKGROUND: The aim of these clinical standards is to provide guidance on ‘best practice’ care for the diagnosis, treatment and prevention of post-COVID-19 lung disease.

METHODS: A panel of international experts representing scientific societies, associations and groups active in post-COVID-19 lung disease was identified; 45 completed a Delphi process. A 5-point Likert scale indicated level of agreement with the draft standards. The final version was approved by consensus (with 100% agreement).

RESULTS: Four clinical standards were agreed for patients with a previous history of COVID-19: Standard 1, Patients with sequelae not explained by an alternative diagnosis should be evaluated for possible post-COVID-19 lung disease;

Modeled small airways lung deposition of two fixed-dose triple therapy combinations assessed with in silico functional respiratory imaging

Usmani, O., Li, G., De Backer, J. et al. Respir Res 24, 226 (2023). https://doi.org/10.1186/s12931-023-02534-y

Abstract

Background

Small airways disease plays a key role in the pathogenesis of chronic obstructive pulmonary disease (COPD) and is a major cause of obstruction; therefore, it is a critical pharmacotherapy target. This study evaluated lung deposition of two inhaled corticosteroid (ICS)/long-acting β2-agonist/long-acting muscarinic antagonist single-inhaler triple therapies using in silico functional respiratory imaging (FRI). Deposition was assessed using real-world inhalation profiles simulating everyday use where optimal inhalation may be compromised.

Methods

Three-dimensional airway models were produced from 20 patients with moderate-to-very severe COPD. Total, central, and regional small airways deposition as a percentage of delivered dose of budesonide/glycopyrronium/formoterol fumarate dihydrate (BGF) 160/7.2/5 µg per actuation and fluticasone furoate/umeclidinium/vilanterol (FF/UM/VI) 100/62.5/25 µg were evaluated using in silico FRI based on in vitro aerodynamic particle size distributions of each device.

A concept for integrated care pathways for atopic dermatitis-A GA2 LEN ADCARE initiative.

Zuberbier T, Abdul Latiff A, Aggelidis X,et al. Clin Transl Allergy. 2023 Sep;13(9):e12299. 

Abstract

Introduction

The integrated care pathways for atopic dermatitis (AD-ICPs) aim to bridge the gap between existing AD treatment evidence-based guidelines and expert opinion based on daily practice by offering a structured multidisciplinary plan for patient management of AD. ICPs have the potential to enhance guideline recommendations by combining interventions and aspects from different guidelines, integrating quality assurance, and describing co-ordination of care. Most importantly, patients can enter the ICPs at any level depending on AD severity, resources available in their country, and economic factors such as differences in insurance reimbursement systems.

Real-world physician practices on the diagnosis and management of allergic rhinitis in the Philippine setting

Balotro-Torres MCV, Tan FM, Navarro-Locsin CG et al. Asia Pac Allergy. 2023 Sep;13(3):105-113. 

Abstract

Background:

Physician awareness and adherence to guidelines varies among countries and between types of physician practice. Identifying the needs of the physician and patient is essential to improve patient outcome. Data on physician diagnosis and management of allergic rhinitis (AR) in the Philippines is currently limited.

Objective:

Study objectives are to assess awareness and use of guidelines, practices on diagnosis and management of intermittent and persistent AR, reasons for choice of therapy, and familiarity with immunotherapy.

Impact of Digital Media on the Patient Journey and Patient-Physician Relationship Among Dermatologists and Adult Patients With Skin Diseases: Qualitative Interview Study

Schick T, Höllerl L, Biedermann T, Zink A, Ziehfreund S. J Med Internet Res 2023;25:e44129

Abstract

Background:

Digital media are easily accessible without time restrictions and are widely used for health- or disease-related purposes. However, their influence on the patient journey and the patient-physician relationship has not yet been sufficiently investigated.

Objective:

This qualitative interview study was designed to explore dermatologists’ and patients’ experiences with digital media for medical purposes in the context of patient journeys and patient-physician relationships.

Methods:

Twenty-eight semistructured video conference–based interviews were conducted and audiorecorded by experienced interviewers between November 2021 and June 2022 in Germany.