ARIA 2024–2025 systematic reviews group. Treatment Dose Increase Versus Co-Medication in Allergic Rhinitis: Systematic Review With Dose-Response Network Meta-Analysis

Sousa-Pinto B, Vieira RJ, Gil-Mata S et al.  Allergy. 2026 May 1. doi: 10.1111/all.70372. 

ABSTRACT

Background

To achieve adequate symptom control, patients with allergic rhinitis (AR) often need to increase their medication dose or add other treatments (co-medication). We aimed to perform a systematic review to compare the efficacy and safety of AR medications for increased dose versus co-medication.

Methods

We searched four bibliographic databases and three trial databases for randomised controlled trials assessing the effect of intranasal and/or oral medications in patients of all ages with seasonal or perennial AR. We performed pairwise meta-analysis based on direct evidence to compare (i) non-standard versus standard treatment doses, and (ii) co-medication strategies versus monotherapy using standard doses. Furthermore, we fitted dose–response network meta-analysis (NMA) to obtain projected estimates for comparisons involving two times the standard dose of AR medications in monotherapy versus co-medication with the standard dose of the same medications. We assessed the certainty of evidence using GRADE for NMA.

Results

Comparison between doubling the dose of the medication
on each row versus adding the medication of each column

We included 262 studies. Co-medication schemes involving oral antihistamines (OAH) + intranasal corticosteroids (INCS) resulted in higher improvements of nasal symptoms and quality of life than doubling the dose of OAH.

TNF Pathway-Mediated Tolerogenic T-Cell Trajectory Driven by Allergen Immunotherapy

H. S.Charles, A. A.Gabr, S.-H.Wang, et al. Allergy (2026): 1–14, https://doi.org/10.1111/all.70367.

ABSTRACT
Background
Allergen immunotherapy (AIT) is a therapeutic approach to restore allergen tolerance and prevent asthma progression. Previous studies have shown exhaustion of T cells and the induction of T cells expressing IL-17 and FOXP3 early in AIT, which are relevant for the clinical outcome. This study aims to investigate the dynamic transition from type-3 immunity to a regulatory state observed in the first year during allergic inflammation, as well as the subsequent dysfunction of effector cells during AIT.

Methods
Human and experimental models of allergic airway inflammation were used to assess the impact of AIT on Treg, Tr17 and Th17 cell populations using flow cytometry and proliferation assays. Additionally, human blood samples were analysed using single-cell transcriptomics to characterise transcriptional signatures associated with the transition from pro-inflammatory to regulatory states.

Graphical Abstract

Results
AIT restored balance of Tr17 and Treg populations and increased their proliferative capacity, whereas Th17 cells remained functionally impaired. Single-cell transcriptomics identified Tr17 cells as intermediate states between pro-inflammatory and regulatory T-cell programs after AIT.

Effects of Live and Heat-Treated Bifidobacterium longumCECT 7347 in Adults With Allergic Rhinitis: A Randomised, Double-Blind, Placebo-Controlled Trial

A.Cardoso, M.Naghibi, E.Climent, et al. Allergy (2026): 1–13, https://doi.org/10.1111/all.70360.

ABSTRACT

Background

Allergic rhinitis (AR) is an increasingly common chronic inflammatory condition of the nasal mucosa. While conventional anti-allergy treatments are widely used, they can come with side effects and are not always effective. As a result, AR remains a significant concern for many millions of people worldwide, affecting quality of life and social functioning.

Objective

To investigate clinical evidence for the role of probiotics and postbiotics in reducing AR symptoms.

Graphical Abstract

Methods

In this single-centre, randomized, double-blind, placebo-controlled clinical trial, 72 adults aged 18–60 years with moderate–severe AR, taking first-line medication, were studied. The primary outcome of the trial was to determine the effects of supplementation with the probiotic Bifidobacterium longum CECT 7347 (PRO) and the heat-treated postbiotic of the same strain (POST) on symptoms associated with AR as assessed using the Combined Symptom and Medication Score (CSMS).

Evaluation of Itch Intensity Scales in Atopic Dermatitis: Differential Measurement Properties and Associations with Relevant Cytokines

Witte F, Wiegmann H, Teitge E et al. J Invest Dermatol. 2026 Apr 20:S0022-202X(26)01046-8. doi: 10.1016/j.jid.2026.04.005.

Abstract

Improvement and comparison of itch intensity scales.
Worst itch intensity scales demonstrated significant improvement in itch after dupilumab
therapy in ADpatients (left: initial assessment/IA, right: follow up/FU, respectively).
The worst itch numerical rating scale/24h and visual analogue scale/4 weeks
reached significantly higher ratings than the visual analogue scale/24h at IA and FU.

Itch is the cardinal symptom contributing to patient burden in atopic dermatitis (AD). Multiple validated itch scales are used in clinical trials, generating heterogeneous data sets. In addition, recent studies suggest an association between cytokine levels and disease severity in AD. This study aimed to compare the performance of different validated itch instruments and their relationship to blood cytokine profiles. 49 adults with severe AD and severe itch were treated with dupilumab 300mg for 16 weeks. At initial assessment and after treatment, itch intensity and quality of life were evaluated using various assessment tools.

Biomarkers in Bronchiectasis - Infographic

Biomarkers are important to describe inflammatory and molecular endotypes that pave the way for individualized therapeutic targets. This infographic from the Bronchiectasis Section of the CHEST Airways Disorders Network describes biomarkers in bronchiectasis.

Learn more: https://hubs.la/Q04drBQf0

Long-Term Dupilumab Treatment Is Not Associated with an Increased Overall Risk of Infections in Adults with Moderate-to-Severe Atopic Dermatitis: Results from an Open-Label 5-Year Extension Study

Beck, L.A., Simpson, E.L., Thaçi, D. et al.  Adv Ther (2026). https://doi.org/10.1007/s12325-026-03582-8

Abstract

Introduction

Patients with atopic dermatitis (AD) are at an increased risk for infections. Here, we report a confirmatory follow-up study analyzing the incidence of infections in adults with moderate-to-severe AD treated with dupilumab for up to 5 years.

Methods

Infections in adults with moderate-to-severe AD treated with dupilumab 300 mg weekly (qw) or every 2 weeks (q2w; approved regimen) were assessed for up to 5 years in the open-label extension study, LIBERTY AD OLE. Topical corticosteroids (TCS) and calcineurin inhibitors (TCI) were permitted. Exposure-adjusted incidence rates [number of patients with at least one event per 100 patient-years (nP/100 PY)] are reported. Since the OLE had no control arm, safety results from the placebo + TCS arm of the 1-year LIBERTY AD CHRONOS study are included for comparisons.

Results

Of the 2677 patients included, 2207 (82.4%) completed up to week 52, 557 (20.8%) up to week 148, and 334 (12.5%) up to week 260; 226 patients (8.4%) switched from qw to q2w during the trial due to a protocol amendment.

Asthma Impairment and Risk Questionnaire predicts short- and long-term exacerbation occurrence across asthma severities

McCann WA, Chipps BE, Beuther DA et al. Ann Allergy Asthma Immunol. 2026 Mar 22:S1081-1206(26)00120-1. doi: 10.1016/j.anai.2026.03.014. 

Abstract

Background

The Asthma Impairment and Risk Questionnaire (AIRQ) predicts 12-month exacerbation occurrence for patients aged ≥12 years.

Objective

To assess the short- and long-term exacerbation prediction ability of the AIRQ in patients with mild-to-moderate and severe asthma.

Methods

This post hoc analysis from the AIRQ longitudinal study classified patients with asthma aged ≥12 years as having mild-to-moderate or severe disease based on prescribed pharmacotherapy. Participant-reported severe asthma exacerbations were assessed monthly over 12 months. For both severity groups and relative to baseline AIRQ control category, exacerbation occurrence was assessed via logistic regression and Kaplan–Meier time-to-first event analyses for the overall 12-month period, months 0-3 (short-term), and months 4-12 (long-term) post-enrollment.

Results

Proportion of patients in the total population (A), with mild-to-moderate
(B) and severe asthma (C) who experienced ≥1 exacerbation over the
short-term (months 0-3) and long-term (months 4-12) follow-up periods
relative to AIRQ control category. AIRQ,
Asthma Impairment and Risk Questionnaire;
NWC, not well-controlled; VPC, very poorly controlled;
WC, well-controlled.

Of 1070 patients who completed ≥1 follow-up assessment, 374 (35.0%) had mild-to-moderate and 696 (65.0%) had severe asthma.

Enhanced Early Detection of Allergic Rhinitis: A Prospective Study on a Symptom-Based Predictive Model

K.-Z.Zhu, C.He, S.-Z.Zhu et al. World Journal of Otorhinolaryngology - Head and Neck Surgery 0 (2026): 1–12. https://doi.org/10.1002/wjo2.70109.

ABSTRACT

Introduction

Allergic rhinitis (AR) and non-allergic rhinitis (NAR) share overlapping symptoms but differ in pathophysiology and treatment. Current AR diagnosis relies on skin prick testing (SPT) and serum IgE quantification, both of which are complex. This study aimed to develop a symptom-based model for early AR detection, explore allergen-symptom relationships, and evaluate its performance.

Material and Methods

A prospective cohort study was conducted at Wuhan Tongji Hospital between June 2024 and October 2024, enrolling 1150 patients with clinically suspected AR. Participants completed a visual analogue scale (VAS) questionnaire evaluating nasal symptoms (itching, congestion, sneezing, rhinorrhea), ocular symptoms, and overall discomfort, and the final diagnosis of AR was confirmed by SPT.