Effect of tezepelumab on asthma exacerbations co-occurring with infection-attributed acute respiratory illnesses

Feleszko W, Caminati M, Gern JE et al.  Ann Allergy Asthma Immunol. 2025 Oct 8:S1081-1206(25)01201-3. doi: 10.1016/j.anai.2025.09.015. 

Abstract

Background

Tezepelumab, a human monoclonal antibody, blocks the activity of thymic stromal lymphopoietin (TSLP). In the phase 2b PATHWAY (NCT02054130) and phase 3 NAVIGATOR (NCT03347279) studies, tezepelumab reduced exacerbations and improved lung function, asthma control, and health-related quality of life versus placebo in patients with severe, uncontrolled asthma.

Objective

This post hoc analysis of PATHWAY and NAVIGATOR evaluated the incidence of asthma exacerbations co-occurring with documented acute respiratory illnesses attributed to infections.

Methods

Patients were randomized 1:1 to receive tezepelumab 210 mg subcutaneously or placebo every 4 weeks for 52 weeks. The incidence of asthma exacerbations co-occurring with respiratory illness-related adverse events (AEs) was assessed. Co-occurrence was defined as at least 1 day of overlap between a respiratory illness-related AE and the asthma exacerbation period beginning 7 days before the start of the exacerbation until the end of the asthma exacerbation.

Results

Respiratory illness-related AEs occurred at an incidence of
 ≥ 1 per 100 patient-years in either treatment group

Of the 1334 patients (tezepelumab, n = 665; placebo, n = 669) included, 312 experienced at least one asthma exacerbation co-occurring with a respiratory illness-related AE attributed to an infection.

Allergic Rhinitis and its Impact on Asthma (ARIA) Classes in MASK-air Users

Sousa-Pinto B, Savouré M, Vieira RJ et al. J Investig Allergol Clin Immunol. 2025 Oct 15;35(5):373-383. doi: 10.18176/jiaci.1047. 

Abstract: 

Background: The Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines classify rhinitis as "intermittent" or "persistent" and "mild" or "moderate-severe".

Objectives: To assess ARIA classes in a real-world study in terms of phenotypic differences and their association with asthma.

Methods: We performed a cross-sectional real-world study based on users of the MASK-air® app who reported data for at least 3 different months. We assessed the frequency of users according to the ARIA classes and compared these classes in terms of rhinitis symptoms, use of comedication, frequency of comorbid asthma, and the association between comorbid asthma and rhinitis control.

Maximum (A) and median (B) values of rhinitis visual analog scales (VAS)
in patients with no evidence of asthma (R) and in patients with probable asthma (R+A)
across the different Allergic Rhinitis and its Impact on Asthma (ARIA) classes. 

Results: A total of 2273 users (180 796 days) were assessed. Most users had moderate-severe rhinitis (n=2003; 88.1%) and persistent rhinitis (n=1144; 50.3%). The frequency of patients with probable asthma was 35.7% (95%CI, 34.5%-37.0%) for intermittent rhinitis and 48.5% (95%CI, 47.1%-49.9%) for persistent rhinitis.

Efficacy of 5-Grass Pollen Liquid Sublingual Allergen Immunotherapy for Seasonal Allergic Rhinoconjunctivitis: A Systematic Review and Meta-analysis

Di Bona D, Paoletti G, Cognet-Sicé J et al. J Investig Allergol Clin Immunol 2025; Vol 35(5) : 341-352 doi: 10.18176/jiaci.1076

Abstract:

Subgroup analyses of symptom score by age and sensitization
status of sublingual immunotherapy vs placebo.

The efficacy and safety of allergen immunotherapy (AIT) have been demonstrated in randomized controlled trials (RCTs). However, differences in study protocols, populations, and AIT products lead to variability in outcomes. The World Allergy Organization and the European Academy of Allergy and Clinical Immunology advise assessing individual AIT products rather than assuming a universal class effect. We conducted a meta-analysis on the efficacy and safety of 5–grass pollen liquid sublingual immunotherapy (SLIT) (5-grass SLIT liquid) in patients affected by allergic rhinoconjunctivitis (ARC) with and without asthma. We searched computerized databases (MEDLINE, ISI Web of Science, LILACS, the Cochrane Library, ClinicalTrial.gov) up to June 2023, supplemented our approach with manual literature searches, and included RCTs comparing 5-grass SLIT-liquid to placebo, irrespective of primary endpoints or treatment duration.

Risk factor analysis of iodinated contrast medium-related hypersensitivity reactions

Beiner, L., Boehm, I.  Insights Imaging 16, 216 (2025). https://doi.org/10.1186/s13244-025-02099-y

Abstract

Graphical Abstract

Hypersensitivity reactions caused by iodinated contrast media (ICM) are by definition type B adverse reactions and therefore, they are not predictable. To partially limit this uncertainty, since the 1980s, risk factors have been defined and published. Currently, there are so many risks that any patient undergoing a contrast-enhanced imaging examination would have at least one risk. This is not helpful and instead leads to uncertainty again. From both studies and clinical experience, we know that only a small percentage of patients develop hypersensitivity reactions after ICM administration. Therefore, we subjected the risks published to a critical analysis. Based on 126 publications, we identified 43 risks, which were divided into three categories (patient-related, contrast agent-related and management-related risks).

Correlation Between Allergic Rhinitis, Asthma, and Laryngopharyngeal Reflux Disease: A Systematic Review

Awad BI, Aldokhail LS, Alotaibi EMet al. Ear Nose Throat J. 2025 Oct 5:1455613251378726. doi: 10.1177/01455613251378726. 

Abstract

Background:

Laryngopharyngeal reflux (LPR), allergic rhinitis (AR), and asthma are common airway disorders that often coexist, suggesting shared inflammatory mechanisms. LPR involves gastric reflux into the laryngopharynx, while AR and asthma are linked by the “united airway” hypothesis. Evidence indicates LPR may contribute to AR and asthma exacerbation, yet their interactions remain unclear. Understanding their interaction may enhance clinical outcomes.

Objective:

This systematic review aimed to evaluate the associations between LPR, AR, and asthma by analyzing studies that examined these conditions in various patient populations.

Methodology:

A comprehensive search of electronic databases, including PubMed, Scopus, and Google Scholar, was conducted for studies published up until 2024.

ARIA webinar sessions (6 & 7 October 2025)

Jean Bousquet:

• ARIA: Past, present and future
• ARIA and MASK-air: Novel findings
• ARIA 2024-2025: Concept and sources of information

Bernardo Sousa-Pinto:

• Presentation of the recommendations of intranasal treatments for the ARIA 2024-2025 guidelines
• What's new in ARIA 2024-2025 in terms of rhinitis management with intranasal treatments?

Long-Term, Real-World Effectiveness of Allergen Immunotherapy in Children and Adolescents With Allergic Rhinitis and Asthma

C. Woehlk, T. Stranzl, M. Contoli, et al. Allergy (2025): 1–11, https://doi.org/10.1111/all.70085.

ABSTRACT

Background
Respiratory allergies often begin in childhood and can progress over time, leading to increased disease burden. Allergen immunotherapy (AIT) is the only causal treatment for allergic respiratory diseases with disease-modifying potential. While randomised trials support its efficacy in controlling allergic rhinitis (AR) and asthma symptoms, long-term real-world data in children remain limited.

Methods
This paediatric study (n = 11,036) was conducted within the pre-defined framework of the REACT study, based on protocol-specified objectives. Children (< 18 years) with physician-diagnosed AR, with or without pre-existing asthma, were included. AIT-treated patients were matched 1:1 to non-AIT controls.

Digital Monitoring of Symptoms and Lung Function During Birch Pollen Season in Pediatric Patients

Tanninen TH, Reiterä PH, Saarto A et al. Clin Transl Allergy. 2025 Oct;15(10):e70101. doi: 10.1002/clt2.70101. 

ABSTRACT

Background

Mobile health (mHealth) applications for asthma and allergic rhinitis (AR) may guide patients in following medication use, symptoms, and lung function supporting self-management.

Objective

The primary study objective was to investigate the objective effect of birch pollen on asthma and AR symptoms and medicine use in pediatric patients with varying levels of birch-specific immunoglobulin E (IgE) during the 2022 birch pollen season using digital tools. The secondary objectives were to determine the effect of birch pollen on Asthma Control Test scores, and to record the subjective benefits in self-management while using the application.

Methods

Altogether, 48 pediatric participants were categorized into three groups based on their birch-specific IgE levels.