AM-301, a barrier-forming nasal spray, versus saline spray in seasonal allergic rhinitis: A randomized clinical trial

Becker S, Deshmukh S, De Looze F, et al. Allergy. 2024; 00: 1-10. doi:10.1111/all.16116

Abstract

Rationale

Saline nasal sprays are frequently used in the management of seasonal allergic rhinitis (SAR) for the cleansing and clearing of aeroallergens from the nasal cavity. Also using a drug-free approach, AM-301 nasal spray is forming a thin film barrier on the nasal mucosa to prevent contact with allergens, trap them, and facilitate their discharge. A clinical trial compared the efficacy, safety, and tolerability of AM-301 and saline spray in SAR.

Methods

A total of 100 patients were randomized 1:1 to self-administer AM-301 or saline 3 × daily for 2 weeks. Primary efficacy endpoint: reduction in mean daily reflective Total Nasal Symptom Score (rTNSS). Secondary efficacy endpoints: reduction in mean instantaneous TNSS and Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), global impression of efficacy.

Baricitinib Improvement Across Regions in Atopic Dermatitis Patients with Baseline Body Surface Area up to 40% and Severe Itch

Carrascosa JM, Narcisi A, Nomura T, Ständer S, Vestergaard C, Sabatino S, Grond S, Koppelhus U, Elrayes M, Chen YF, Liu C, Wollenberg A.  Dermatol Ther (Heidelb). 2024 May 22. doi: 10.1007/s13555-024-01171-7. 

Abstract

Introduction: Patients with moderate-to-severe atopic dermatitis (AD) who are most likely to respond to the Janus kinase (JAK) 1/2 inhibitor baricitinib (BARI) are known to have an impacted body surface area (BSA) ≤ 40% and severe itch (numerical rating scale [NRS] ≥ 7], collectively termed 'BARI itch-dominant' patients. Our objective is to build on our previous work by providing a body region-specific, clinical characterization of the BARI itch-dominant patient at baseline and their response to BARI 4 mg.

Methods: BREEZE-AD7 was a phase 3 trial in adults with moderate-to-severe AD receiving placebo or 2 mg or 4 mg BARI in combination with topical corticosteroids. Assessing only data from BARI itch-dominant patients, we summarized the baseline characteristics and conducted body region-specific analyses on Eczema Area and Severity Index (EASI) data in order to report the response to placebo versus BARI 4 mg within this patient subtype.

Hereditary angioedema with normal C1 esterase inhibitor: Current paradigms and clinical dilemmas

Radojicic C, Anderson J.  Allergy Asthma Proc. 2024 May 1;45(3):147-157. doi: 10.2500/aap.2024.45.240010.

Abstract

Background:

A diagnosis of hereditary angioedema (HAE) with normal C1 esterase inhibitor (HAE-nl-C1-INH) can be challenging and pharmacologic management is not well defined.

Objective:

The objective was to discuss practical considerations in the clinical management of HAE-nl-C1-INH by using illustrative clinical vignettes to highlight and/or address select challenges.

Methods:

This was a narrative review.

Results:

Practical guide for differentiating between mast cell-and bradykinin-mediated angioedema.

Symptoms of HAE-nl-C1-INH overlap with HAE types I and II; the heterogeneity of presentation and symptom burden are diagnostic challenges. A patient history, with particular attention to whether urticaria or other symptoms of mast cell mediator release are present, is important because such symptoms would strongly suggest a mast cell‐mediated pathway. A family history of angioedema is informative but a lack thereof does not rule out diagnosis.

Antihypertensive Medications and Eczematous Dermatitis in Older Adults

Ye M, Chan LN, Douglas I, Margolis DJ, Langan SM, Abuabara K. JAMA Dermatol. 2024 May 22. doi: 10.1001/jamadermatol.2024.1230. 

Key Points

• Question  Is antihypertensive drug use associated with diagnoses of eczematous dermatitis among older adults?
• Findings  This cohort study using a population-based primary care cohort of 1.5 million older adults found that antihypertensive drug use was associated with a 29% increase in the rate of eczematous dermatitis diagnoses. The hazard rate was highest for diuretic drugs and calcium channel blockers and lowest for angiotensin-converting enzyme inhibitors and β-blockers.
• Meaning  These findings indicate that physicians should consider antihypertensive treatment as part of the differential diagnoses for older patients presenting with eczematous dermatitis.

Abstract

Importance  Rates of physician-diagnosed eczema have been increasing among older adults, but little is known regarding the pathophysiologic processes and best treatments in this subgroup. Preliminary data suggest that medications—antihypertensive medications in particular—may contribute to eczematous dermatitis; however, there are limited population-based data on the proportion of eczematous dermatitis diagnoses among older adults that may be attributed to antihypertensive drugs.

Allergen specific immunotherapy regulates macrophage property in the airways

Liu J, Xiao X, Liao Y, Xu X, Liu Y, Tang A, Zeng X, Yang P. Arch Biochem Biophys. 2024 May;755:109984. doi: 10.1016/j.abb.2024.109984.

Highlights

• •

  Better absorption of allergen in airway macrophages was observed in airway vaccination.

• •

  Better production of IL-10 by macrophages after the airway vaccination.

• •

  Better immune suppressive functions in macrophages in mice received airway vaccination.

Abstract

Background

Allergen specific immunotherapy (AIT) has been widely used in allergy clinics. The therapeutic effects of it are to be improved. Macrophages occupy the largest proportion of airway immune cells. The aim of this study is to measure the effects of nasal instillation AIT (nAIT) on airway allergy by regulating macrophage functions.

Long-Term Outcomes Associated With β-Lactam Allergies

Gray MP, Kellum JA, Kirisci L, Boyce RD, Kane-Gill SL.  JAMA Netw Open. 2024;7(5):e2412313. doi:10.1001/jamanetworkopen.2024.12313

Key Points

Question  What are the long-term clinical outcomes of patients with β-lactam allergies?

Findings  In this cohort study following 20 092 adult patients for up to 12 years, a generalized estimating equation analysis model found that the presence of a documented β-lactam allergy was not associated with a statistically significant increase in the odds of all-cause mortality but was associated with an increase in antibiotic-resistant infections.

Meaning  These findings suggest that documented β-lactam allergies are associated with substantial long-term clinical detriment, and health systems should prioritize initiatives to maximize the use of first-line antimicrobials and reduce unnecessary β-lactam avoidance.

Abstract

Importance  β-lactam (BL) allergies are the most common drug allergy worldwide, but most are reported in error. BL allergies are also well-established risk factors for adverse drug events and antibiotic-resistant infections during inpatient health care encounters, but the understanding of the long-term outcomes of patients with BL allergies remains limited.

Pathological Findings of Post-Viral Olfactory Dysfunction: A Systematic Review

Hacksell F, Saber A. Eur J Rhinol Allergy 2024; 7: 21-28 DOI: 10.5152/ejra.2024.24128

Abstract: The coronavirus disease 2019 pandemic has shed light on the post-viral olfactory dysfunction (PVOD). Post-viral olfactory dysfunction is temporary for most people and usually subsides when the common cold symptoms ameliorate. However, in some patients, this condition can persist for several weeks or months. The exact pathological mechanisms of persistent olfactory loss secondary to upper respiratory tract infection (URTI) is unknown, and there is a lack of efective treatment. An increased understanding of pathology could possibly translate into new therapeutic regimens. The aim of this systematic review is to synthesize primary data regarding histopathological and neuropathological fndings in patients with PVOD secondary to URTI. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was followed. Databases PubMed and Web of Science were searched with keywords and mesh terms to identify relevant articles.

Publication Trends and Hot Spots of ChatGPT’s Application in the Medicine

Li, Zq., Wang, Xf. & Liu, Jp. J Med Syst 48, 52 (2024). https://doi.org/10.1007/s10916-024-02074-y

Abstract

This study aimed to analyze the current landscape of ChatGPT application in the medical field, assessing the current collaboration patterns and research topic hotspots to understand the impact and trends. By conducting a search in the Web of Science, we collected literature related to the applications of ChatGPT in medicine, covering the period from January 1, 2000 up to January 16, 2024. Bibliometric analyses were performed using CiteSpace (V6.2., Drexel University, PA, USA) and Microsoft Excel (Microsoft Corp.,WA, USA) to map the collaboration among countries/regions, the distribution of institutions and authors, and clustering of keywords. A total of 574 eligible articles were included, with 97.74% published in 2023.