Allergic Rhinitis—Underrepresented Populations and Barriers to Healthcare Access

Peifer, S.J., Helmen, Z.M., Duffield, S., Shields, C., Mehra, S., Lerner, D.K. and Gadkaree, S.K. (2025), The Laryngoscope. https://doi.org/10.1002/lary.32165

ABSTRACT

Objective

To establish the prevalence of allergic rhinitis (AR), categorized by demographics and barriers to healthcare, and the prevalence of antihistamine and nasal steroid use in these subgroups.

Methods

We performed a retrospective, cross-sectional study utilizing the All of Us Database. Sociodemographic factors among AR patients were compared via Chi-Square analysis and multivariable logistic regression (MLR). Subgroups of AR patients with or without nasal steroid spray or oral antihistamine listed in the electronic health record (EHR) were compared via chi-square analysis and MLR.

Results

Demographic description of all patients vs. allergic rhinitis patients (AR)
in the All of Us database

47,224 participants were identified with AR, an 11.6% estimated prevalence. AR patients were more commonly White (12.8% vs. 10.6%, p < 0.001), female (13.1% vs. 9.1%, p < 0.001), and older than 65 (14.7% vs. 7.6% vs. 11.6%, p < 0.001). MLR identified older age (OR 1.018, CI: 1.017–1.018), income > $35,000 (OR 1.035, CI: 1.021–1.049), finishing high school/college (OR 1.140, CI: 1.113–1.167; OR 1.113, CI: 1.085, 1.142), and health insurance coverage (OR 2.003, CI: 1.924–2.087) as predictive factors for AR.

Risk Factors for Severe Disease Among Children Hospitalized With Respiratory Syncytial Virus

Kirolos N, Mtaweh H, Datta RR, et al. JAMA Netw Open. 2025;8(4):e254666. doi:10.1001/jamanetworkopen.2025.4666

Key Points

Question  What are the current risk factors for severe respiratory syncytial virus (RSV) infection given the changing epidemiologic characteristics after the COVID-19 pandemic?

Findings  In this cohort study that included 709 cases of RSV-associated acute respiratory tract infection, severe disease was more likely among children aged 2 years or older with pulmonary and neurologic, neuromuscular, or developmental conditions; children younger than 2 years with a history of prematurity; or children younger than 6 months.

From Urticaria to Correct Diagnosis: A Case Report of Cryopyrin-Associated Periodic Syndromes

Wang X, Zhou N, Zhi Y. J Asthma Allergy. 2025;18:539-544

https://doi.org/10.2147/JAA.S509939

 (A) and (B) Urticaria-like rash on legs and right arm

Abstract: Cryopyrin-associated periodic syndrome (CAPS) is a rare autoinflammatory disorder often misdiagnosed as urticaria or urticarial vasculitis, thereby delaying treatment for patients. This report presents a large CAPS pedigree. The proband was a 57-year-old man with recurrent urticaria-like rash, fever, and arthralgia for more than 50 years and hearing loss for 28 years.

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.