Immunotherapy: Current indications and recommendations in the management of ocular allergy

Mahesh, Padukudru Anand; Samajdar, Shambo Samrat; Nagarajan, Sowmya Arudi; Murthy, Greeshma Mandya Venkatesh; Moitra, Saibal.  Indian Journal of Ophthalmology 73(4):p 526-536, April 2025. | DOI: 10.4103/IJO.IJO_2853_23

Abstract

Allergic diseases, including allergic conjunctivitis (AC), pose a significant health burden, affecting both developed and developing nations. Despite its importance, AC is often underreported, leading to underestimated incidence and prevalence. The coexistence of AC with allergic rhinitis and its comorbidity with asthma underscore its clinical relevance. The prevalence of nasal symptoms with eye symptoms related to eye allergy varies among different age groups and regions worldwide. Climatic factors, aeroallergens, and environmental exposure play significant roles in the prevalence of ocular allergies. Allergen immunotherapy (AIT) represents the only disease-modifying treatment for IgE-mediated allergic diseases. This review provides a comprehensive overview of the history, mechanisms, and evidence of AIT for ocular allergies, with a focus on AC.

Dual biological treatments in immune-mediated disorders: a single center experience

Shamriz, O., Parnasa, E., Rubin, L. et al.  BMC Immunol 26, 29 (2025). https://doi.org/10.1186/s12865-025-00705-8

Abstract

Background

Physicians may encounter situations where they need to co-administer omalizumab with non–IgE-targeting monoclonal antibodies. In this study, we share our experience with these dual biologic treatments.

Objective

To evaluate the efficacy and safety of dual biological therapy using omalizumab and non-IgE-targeting monoclonal antibodies at a single center.

Infection risk in atopic dermatitis patients treated with biologics and JAK inhibitors: BioDay results

van der Gang LF, Atash K, Zuithoff NPA, Haeck I, Boesjes CM, Bacoş-Cosma OI, et al. J Eur Acad Dermatol Venereol. 2025; 00: 1–13. https://doi.org/10.1111/jdv.20674

Abstract

Background

Limited data exist on the comparative risk of infections during biologic and Janus kinase inhibitor (JAKi) treatment for atopic dermatitis (AD) in daily practice.

Objective

To assess the differential infection risk of biologic and JAKi treatment in patients with moderate-to-severe AD in a real-world setting.

Methods

This prospective, multicentre study evaluated treatment-emergent infections in patients (age ≥ 12 years) using biologics or JAKi from the BioDay registry from October 2017 to July 2024. Crude incidence rates were calculated per 100 patient-years (PY) per treatment. Cox regression for recurrent events, adjusted for potential confounders, was used to estimate hazard ratios (HR) for the rate of infections, with subgroup and sensitivity analyses in bio-/JAKi-naïve patients.

Results

Graphical Abstract

In total 1793 patients were included (4044.1 PY; 1886 biologic treatment episodes (TEs); 480 JAKi), with 794 infections. JAKi showed higher infection rates (58.4–65.5/100 PY) compared to biologics (13.6–22.0), especially for herpes infections (n = 195, 24.6%; JAKi 13.6–19.8 vs. biologicals 3.0–3.6).

Medication-related perceptions of children and adolescents with severe asthma and moderate-to-severe atopic dermatitis: a non-interventional exploratory study

Herzig, M., vom Hove, M., Bertsche, A. et al.  Allergy Asthma Clin Immunol 21, 16 (2025). https://doi.org/10.1186/s13223-025-00961-8

Abstract

Background

Severe asthma and moderate-to-severe atopic dermatitis can significantly impact the lives of children and adolescents. However, real-world data on pediatric patients’ perceptions of their medication are limited.

Methods

This non-interventional cross-sectional study at a university hospital explored patients’ perceptions. We included patients aged between 6 and 17 with severe asthma and/or moderate-to-severe atopic dermatitis. For patients treated with dupilumab, a minimum dupilumab treatment duration of 16 weeks was required. We conducted one structured interview per patient, based on a questionnaire consisting of open questions and ratings on 6-point Likert scales (response scale range: “0: not at all” to “5: very strongly”).

Results

Participants’ perceptions of their diseases before and during
dupilumab therapy 

The study included 57 participants (severe asthma: n = 31; moderate-to-severe atopic dermatitis: n = 21; both: n = 5) who reported a “rather moderate” burden of asthma (median: 2; Q25/Q75: 0.3/2.8) or atopic dermatitis (3; 1.5/3.5).

Stapokibart for moderate-to-severe seasonal allergic rhinitis: a randomized phase 3 trial

Zhang, Y., Li, J., Wang, M. et al. Nat Med (2025). https://doi.org/10.1038/s41591-025-03651-5

Abstract

Seasonal allergic rhinitis (SAR) places a significant socioeconomic burden, particularly on individuals with poorly managed recurrent and severe symptoms despite standard-of-care treatment. Stapokibart, a humanized monoclonal antibody that targets the interleukin (IL)-4 receptor subunit alpha, inhibits its interaction with both IL-4 and IL-13 in type 2 inflammation.

Change from baseline over time in daily rTNSS during the 4-week treatment period.

Here we aim to assess the efficacy and safety of stapokibart as an add-on therapy in adults with moderate-to-severe SAR. The study was a phase 3 multicenter, randomized, double-blind, placebo-controlled clinical trial with 108 patients diagnosed with moderate-to-severe SAR and having baseline blood eosinophil counts ≥300 cells μl−1. Participants were randomized (1:1) to receive 600 mg (loading dose) to 300 mg stapokibart subcutaneously or a placebo every 2 weeks for 4 weeks. The primary endpoint was mean change from baseline in daily reflective total nasal symptom score (rTNSS) over the first 2 weeks.

Diagnostic performance of a doppler radar-based sleep apnoea testing device

Röcken, J., Darie, A.M., Grize, L. et al. BMC Pulm Med 25, 150 (2025). https://doi.org/10.1186/s12890-025-03618-9

Abstract

Background

Inpatient polysomnography (PSG) is the gold standard for the diagnosis of obstructive sleep apnoea (OSA), however, both complexity and costs limit the availability of this examination. Home sleep apnoea testing devices are a diagnostic alternative in patients with increased risk of OSA. We evaluated the diagnostic performance of a Doppler radar technology based, contactless sleep apnoea testing device (CSATD) in a cohort of patients with a clinically increased risk of OSA.

Methods

Monocentric prospective study. Sleep monitoring with the CSATD SleepizOne + without pulse oximetry (Sleepiz AG, Switzerland) was performed simultaneously with elective inpatient PSG. PSG was analysed blinded to the CSATD results and according to AASM 2012 criteria by certified sleep physicians. The CSATD data were analysed automatically and independently by a dedicated software.

Bibliometric and visual analysis of drug-specific immunotherapy from 1990 to 2024

Cui, Z., Chen, X., Zhai, S. et al.  Naunyn-Schmiedeberg's Arch Pharmacol (2025). https://doi.org/10.1007/s00210-025-04073-3

Abstract

Specific immunotherapy (SIT) is key in allergic diseases, tumor immunity, and autoimmune regulation. In recent years, the mechanism of action of drugs in SIT has attracted much attention, including the induction of hypersensitivity responses and modulation of immune tolerance. However, scientific challenges remain regarding their mechanism of action and optimization strategies. Studies on pharmacological SIT have been accumulated in the past, and there is an urgent need for bibliometric analyses to review and prospect these results for future academic development. Strict search criteria were developed to screen and download literature information from the Web of Science Core Collection.

Impact of allergic symptoms on work productivity in allergic rhinitis: A MASK-air direct patient data study

Vieira RJ, Pereira AM, Kupczyk M, Regateiro FS, Larenas-Linnemann DE, Toppila-Salmi S, Iinuma T, Kuna P, Cruz AA, Brussino L, Gemicioglu B, Samolinski B, Taborda-Barata L, Ventura MT, Kvedariene V, Klimek L, Pfaar O, Zuberbier T, Azevedo LF, Fonseca JA, Bousquet J, Sousa-Pinto B; MASK-air think tank. Allergol Int. 2025 Apr 1:S1323-8930(25)00002-4. doi: 10.1016/j.alit.2024.12.007. 

Abstract

Background: Allergic rhinitis may impair work productivity. This study aimed to assess (i) the differential impact of allergic rhinitis symptoms on work performance, assessed by means of Visual Analogue Scale (VAS) work; and (ii) the effect of asthma comorbidity on work productivity.

Methods: We assessed data from the MASK-air mHealth app of patients with allergic rhinitis. We identified factors associated with the impact of allergic symptoms on work productivity through multivariable linear mixed effects models.

Results: We studied 260,378 days from 20,724 patients. In multivariable regression models, nasal symptoms showed the strongest association with VAS work (regression coefficient = 0.38 [95%CI = 0.38; 0.38]). Poor rhinitis control, measured by the combined symptom-medication score, was associated with worse VAS work (regression coefficient = 0.96 [95%CI = 0.96; 0.97]). The median VAS work in patients with probable or possible asthma (median = 9, interquartile range = 22 for probable and 23 for possible asthma) was greater than for patients with no evidence of asthma (median = 3, interquartile range = 12) (Cohen's d = 0.60). In patients with probable asthma, nasal and asthma symptoms showed a similar impact on work productivity (regression coefficient for VAS nose = 0.32 [95%CI = 0.31; 0.32]; regression coefficient for VAS asthma = 0.30 [95%CI = 0.29; 0.31]).

Conclusions: Allergy symptoms, especially nasal symptoms, are associated with worse work productivity. In addition, patients with allergic rhinitis and asthma display more impairment in work productivity than patients with allergic rhinitis alone.

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