May 28, 2024

Factors Affecting Usage of a Digital Asthma Monitoring Application by Old-Age Asthmatics Living in Inner Central Portugal

Abreu MIT, Santos AF, Gama JMR, Valente S, Valente MJ, Pereira H, Regateiro F, Sousa-Pinto B, Ventura MT, Bousquet J, Taborda-Barata L. Clin Interv Aging. 2024;19:971-979

Purpose: To analyse factors affecting the ability to use the digital asthma monitoring application Mask-Air® in old-age individuals living in inland Portugal.

Patients and Methods: In this observational study, patients with medically confirmed asthma who agreed to participate were interviewed and subdivided into Non-users Group: those who could not use the application and Users Group: those who could. Sociodemographic and psychological data, comorbidities, and asthma status were compared between groups. Assessment of reasons for refusal was based on a 6-item questionnaire.

Reasons for not using MASK-Air App by Non-users Group asthmatics.
Most frequent reasons given by Non-users Group (44 patients) for not using
MASK-air;these results show lack of possibility to use the 
App versus not
wanting to use the 
App (A).
Venn diagram showing specific reasons and combinations of reasons
given by Non-users Group (44 patients) for not using MASK-Air 
App (B)
Results: Among the 72 sequentially recruited patients (mean age±SD 73.26± 5.43 yrs; 61 women; 11 men), 44 (61.1%; mean age±SD 74.64± 5.68 yrs; 38 women; 6 men)) were included in Non-users Group and 28 (38.9%; mean age±SD 71.11± 4.26 yrs; 23 women; 5 men) in Users Group. Non-users Group patients were significantly older, had lower socioeconomic level, and more frequently had severe asthma (25% vs 3.6%; Odds ratio=0.08 (95% CI=0.01– 0.81; p=0.033)) and diabetes (32.6% vs 7.4%; Odds ratio=0.17 (95% CI=0.03– 0.80; p=0.025)) than Users Group.

May 27, 2024

Immunotherapy and biologics in the management of IgE-mediated food allergy: Systematic review and meta-analyses of efficacy and safety

Riggioni C, Oton T, Carmona L, Du Toit G, Skypala I, Santos AF, the EAACI Food Allergy Guidelines Expert Group and the EAACI Research and Outreach Committee FA Group  Allergy. 2024; 00: 1-31. doi:10.1111/all.16129

Abstract

Food allergy (FA) is a potentially life-threatening chronic condition that is becoming an increasing public health problem worldwide. This systematic review (SR) was carried out to inform the development of clinical recommendations on the treatment of IgE-mediated FA with biologics and/or IT for the update of the EAACI guidelines. A SR of randomized-controlled trials or quasi-controlled trials was carried out. Studies were identified via comprehensive search strategies in Medline, Embase, and Cochrane Library, up to April 2022. Population: Human adults, children, and adolescents with IgE-mediated FA. Intervention: IT and/or biologics. Comparator: Placebo or standard-of-care (allergen avoidance).

Metanalysis of omalizumab versus placebo in IgE-mediated food allergies:
Primary outcome (Desensitization)
Outcome: Efficacy (desensitization, sustained unresponsiveness (SU), remission), quality of life, and safety (systemic and local adverse reactions (AR)). The Cochrane RoB tool was used to assess the risk of bias. It was reported according to PRISMA and registered in PROSPERO CRD4202229828.

May 25, 2024

The Multiple Trajectories of the Allergic March.

 

de Las Vecillas L, Quirce S.  J Investig Allergol Clin Immunol. 2024 Apr 12;34(2):75-84. doi: 10.18176/jiaci.0983.



Abstract

Etiologic features and risk factors related to the development of the allergic march and preventive
interventions to impact its course. TH2 indicates type 2 helper T cell; AIT, allergen immunotherapy
The allergic march comprises the sequential appearance of a series of allergic comorbidities. However, variability in the onset and progression of allergic diseases generates a heterogeneous scenario that does not follow a linear and single trajectory.

Almost half of the pediatric population presents at least 1 allergy symptom. However, only 4%-6% present multimorbidity, with several allergic diseases co-occurring. It has recently been shown that although they share etiological mechanisms and risk factors, allergic diseases arise independently. In most cases, progression is not consecutive, or at least not the same in all patients.

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.

May 24, 2024

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.

May 23, 2024

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.

May 22, 2024

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.