The evolution of food protein-induced enterocolitis syndrome (FPIES): Global trends, emerging triggers, and natural history.

Anvari S, Gupta M, Nicolaides R et al. Ann Allergy Asthma Immunol. 2025 Sep 19:S1081-1206(25)01160-3. doi: 10.1016/j.anai.2025.09.006.

Abstract

Graphical timeline of our understanding of FPIES.

Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated food allergy characterized by delayed gastrointestinal symptoms. It is thought that immune and neuroimmune mechanisms drive FPIES pathophysiology, but this remains incompletely understood. There are no specific biomarkers to confirm the FPIES diagnosis, monitor for resolution, or assess reactivity to additional food triggers.

Social Determinants of Health in Pediatric Asthma and Allergic Diseases: A Systematic Review

Koumpagioti, D., Moriki, D., Boutopoulou, B.et al. (2025).  Epidemiologia, 6(3), 56. https://doi.org/10.3390/epidemiologia6030056

Abstract

PRISMA diagram for the study selection process.

Objectives: This study aimed to synthesize evidence of the influence of multilevel social determinants of health (SDOHs) on asthma and allergic disease outcomes and healthcare utilization in children and adolescents, with a specific focus on how these determinants generate or widen health inequities, through a systematic review of the current literature and evidence. 

Methods: A literature search was performed in the PubMed, EBSCO, and Scopus databases. The search period for all databases was from 1 January 2020 to 15 January 2025. Studies published in English that evaluated the association between at least one SDOH, as a primary exposure or effect modifier, and asthma and/or allergic disease outcomes and healthcare utilization in children and adolescents aged ≤ 18 years were included.

Artificial Intelligence Diagnostic Accuracy and Clinical Utility in Allergic Rhinitis: Systematic Review

Dana A. Alrezq, Abdulaziz M. Aldaghmani, Jana J. Alali, et al.  Authorea. September 12, 2025.

DOI: 10.22541/au.175766646.65353803/v1

Abstract

Allergic rhinitis (AR) is one of the most common outpatient conditions, diagnosed through operator-dependent and resource-intensive methodologies. Consequently, there has been a surge in the development of diagnostic strategies using artificial intelligence (AI). This review aims to explore how AI can enhance diagnostic accuracy, personalize treatment, and support clinical decisions in AR care. The review followed PRISMA guidelines and was registered in PROSPERO. PubMed, Cochrane Central, Embase, and Google Scholar were searched for studies published between 2002 and 2025. Out of 1,109 identified studies, eight studies met the inclusion criteria.

Cost-effective care in anaphylaxis prevention and management

Sanders J, Boldt C, Kumar BP, Shaker M.  Pediatr Allergy Immunol. 2025; 36:e70176. doi:10.1111/pai.70176

Abstract

Anaphylaxis is a serious hypersensitivity reaction that may be life-threatening. Data suggest that fatal anaphylaxis is a very rare event; however, anaphylaxis and fear of anaphylaxis are associated with high societal burden and cost. Cost-effectiveness analyses can facilitate a model of value-based care; in this review, we aim to highlight key health-economic analyses in anaphylaxis. Health economic evaluations suggest that screening approaches to prevent anaphylaxis have low value.

Investigating the Use of Melatonin in Children With Atopic Dermatitis: A Cross-Sectional Study

S. Lee, E. J. Kim, J. LeBovidge, et al. Pediatric Dermatology (2025): 1–7, https://doi.org/10.1111/pde.70041.

ABSTRACT

Background/Objectives

Children with atopic dermatitis (AD) frequently experience sleep disturbances. Melatonin, an over-the-counter supplement, is increasingly used in the general pediatric population; however, its prevalence and perceived effectiveness in children with AD remain unclear.

Methods

Caregivers of pediatric patients (ages 1–17 years) with physician-diagnosed AD completed surveys on melatonin use, Patient Oriented Eczema Measure (POEM), and age-appropriate sleep questionnaires.

Results

Among 102 total respondents, 27.5% reported a history of melatonin use, with 10.8% using it in the past 30 days. Gummies were the most common formulation (85.7%), though brands and dosages varied widely (0.5–10 mg; median: 3 mg).

Comparative Efficacy of Montelukast-Levocetirizine Combination Therapy versus Monotherapy in Allergic Rhinitis: A Systematic Review and Meta-Analysis

Kim JS, Stybayeva G, Hwang SH.  Int Arch Allergy Immunol. 2025 Jul 15:1-14. doi: 10.1159/000547410.

Abstract

Introduction: Combination therapy with antihistamines and leukotriene receptor antagonists (LTRAs) is frequently used in allergic rhinitis (AR), particularly in patients with persistent or inadequately controlled symptoms. However, supporting evidence has been inconsistent. This meta-analysis assessed the efficacy of montelukast combined with levocetirizine in patients with AR by directly comparing the combination therapy with each monotherapy and evaluating individual symptom domains. 

Methods: A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted, with database searches performed through March 2025. Outcomes included daytime and nighttime total symptom scores, individual nasal symptoms, rhinoconjunctivitis-related quality of life (RQLQ), and treatment-emergent adverse events (TEAEs). Pooled effects were calculated using standardized mean differences (SMDs) and odds ratios (ORs) with 95% confidence intervals (CIs). 

Forest plots comparing changes in daytime total symptom score (a),
nighttime total symptom score (b), and rhinoconjunctivitis quality of
lifequestionnaire (RQLQ) scores (c) between combination therapy
(montelukast-levocetirizine) and monotherapy.

Results: Seven RCTs (n = 887) were included. Combination therapy resulted in greater improvement in daytime symptoms (SMD [95% CI]: −0.42 [–0.64 to −0.20]), rhinorrhea (SMD [95% CI]: −0.69 [–1.09 to −0.30]), and nasal congestion (SMD [95% CI]: −0.64 [–1.05 to −0.24]) compared to monotherapy.

Expert Perspectives on Next Generation Health Guidelines: How to Integrate RWE in EBM

Del Giacco S, Canonica GW, Agache I et al.  Pragmat Obs Res. 2025 Sep 11;16:169-177. doi: 10.2147/POR.S487342.

Abstract: 

Integrating real-world evidence (RWE) into evidence-based medicine (EBM) enhances healthcare decision-making. RWE provides insights into the real-world effectiveness and safety of therapies and health technologies, filling gaps that clinical trials may leave. EBM, which concentrates on therapeutic issues, depends on rigorous evaluation of evidence, including data from randomized controlled trials (RCTs) and RWE. Combining evidence from RCTs and RWE when forming recommendations offers a comprehensive understanding of benefits and risks by considering their strengths, limitations, and standardized methods. The 2nd European Academy of Allergy & Clinical Immunology/Respiratory Effectiveness Group (EAACI/REG) Workshop, held in Rome, Italy, on October 4th, 2023, discussed integrating RWE and EBM. The goals were to develop recommendations for high-quality RWE and its inclusion in evidence syntheses, with a particular focus on airway diseases.

Subcutaneous Allergen Immunotherapy in Adults Allergic to House Dust Mites: A Phase 3 Randomized Controlled Trial

C. Bachert, H. Hoogeveen, R. ten Have, et al.  Allergy (2025): 1–10, https://doi.org/10.1111/all.70063.

ABSTRACT

Background

Subcutaneous allergen immunotherapy (SCIT) has a longstanding history as a safe and effective treatment. Nevertheless, to meet the European Medicines Agency's regulatory requirements for continued market authorization, its efficacy and safety must be confirmed in a pivotal Phase III trial.

Graphical Abstract

Objective

Based on a successful Phase II dose-finding study, the aim was to confirm the safety and efficacy of a subcutaneous house dust mites (HDM) preparation in a randomized controlled trial using an optimal higher dose than the current maintenance dose.

Method

Seven hundred sixty-seven subjects were randomized in a 1:1 ratio to 1-year treatment with SCIT-product at a dose of 50,000 AUeq/mL or placebo.