Journal of Asthma and Allergy最新文献

{"title":"Severity-Dependent Association Between Allergic Rhinitis and Adenoid Hypertrophy in Dust Mite-Sensitized Children from Northern China: A Cross-Sectional Analysis of 170 Cases.","authors":"Bo Zhao, Yang Wang, Hongyang Zhang, Peng Jin, Tao Jia","doi":"10.2147/JAA.S598696","DOIUrl":"10.2147/JAA.S598696","url":null,"abstract":"<p><strong>Background: </strong>Allergic rhinitis (AR) and adenoid hypertrophy (AH) frequently coexist in children, yet the relationship between allergic disease severity and the extent of adenoid enlargement remains incompletely defined. This study aimed to investigate the association between AR severity, allergic inflammatory burden, and the degree of AH in dust mite-sensitized children.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis of 170 children with dust mite-sensitized AR from Northern China. AH was assessed by nasal endoscopy and classified as grade III or IV. AR severity was evaluated using the Total Nasal Symptom Score (TNSS), visual analogue scale (VAS), and Pediatric Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ-S). Allergic inflammatory markers included peripheral blood eosinophil counts (EOS), total IgE, and Dermatophagoides pteronyssinus (d1) and Dermatophagoides farinae (d2)-specific IgE. Group comparisons and Spearman correlation analyses were performed.</p><p><strong>Results: </strong>Children with grade IV AH exhibited significantly higher TNSS, VAS scores, and nasal symptom burden compared with those with grade III hypertrophy (all P < 0.001). Nasal obstruction, rhinorrhea, and nasal itching scores were also significantly increased. TNSS (r = 0.426), VAS (r = 0.458), and PRQLQ-S (r = 0.348) showed moderate positive correlations with the percentage of choanal obstruction (all P < 0.001). In addition, eosinophil counts, total IgE, and dust mite-specific IgE levels demonstrated weaker but significant correlations with adenoid obstruction.</p><p><strong>Conclusion: </strong>AR severity is positively and dose-dependently associated with AH in dust mite-sensitized children. These findings suggest that adenoid enlargement is associated with clinical and immunological markers of allergic inflammation and highlight the importance of early and effective control of allergic rhinitis to prevent progressive AH.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"598696"},"PeriodicalIF":3.3,"publicationDate":"2026-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13189079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147987586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomarker-Defined Endotypes and Clinical Phenotypes of Asthma: A Cluster-Based Analysis of Type-2 Inflammatory Patterns and Their Clinical Correlates.","authors":"Ibrahim Hamdy Elsayed Feteih, Asmaa Ali","doi":"10.2147/JAA.S591831","DOIUrl":"10.2147/JAA.S591831","url":null,"abstract":"<p><strong>Background: </strong>Asthma is a biologically heterogeneous disease characterized by diverse inflammatory mechanisms, yet the clinical translation of this heterogeneity into clearly defined, biomarker-driven endotypes remains limited in real-world populations. Although Type-2 (T2) inflammation predominates in many patients, the overlap between allergic and eosinophilic pathways and the identification of distinct endotypes with specific clinical correlates are not fully characterized. This study aimed to define biomarker-based asthma endotypes using unsupervised clustering and to explore their associated clinical and demographic features.</p><p><strong>Methods: </strong>In this cross-sectional study, asthmatic patients evaluated at a tertiary hospital were included. Demographics, body mass index (BMI), comorbidities, age of onset, disease duration, spirometry parameters, bronchodilator reversibility, allergic status, and inflammatory biomarkers; total IgE, blood eosinophil count (BEC), and fractional exhaled nitric oxide (FeNO), were retrieved from medical records. Standardized biomarker values were analyzed using hierarchical clustering to define asthma endotypes. Clinical and demographic differences between clusters were subsequently compared.</p><p><strong>Results: </strong>Among 162 patients, females predominated (69.1%), and overweight/obesity was common (median BMI 29.15 kg/m²). T2 inflammation was highly prevalent: 60% had IgE ≥100 IU/mL, 70% had BEC ≥300 cells/µL, and 43.8% had FeNO ≥25 ppb, with allergic rhinitis present in 71.6%. Airflow limitation was frequent, as 71% had FEV₁ <80% predicted and 86.4% lacked bronchodilator reversibility. Clustering identified four endotypes: mixed allergic-eosinophilic T2-high (35.5%), eosinophilic T2-high (24.5%), allergic T2-high (20%), and T2-low (20%). T2-high clusters showed marked female predominance and greater lung function impairment, particularly in the eosinophilic group (81.5% with FEV₁ <80%). Allergic T2-high patients had the earliest onset, whereas T2-low patients demonstrated minimal biomarker elevation and fewer allergic comorbidities. BEC correlated with IgE (r=0.29) and FeNO (r=0.43), and multivariable analysis linked biomarkers to specific clinical features.</p><p><strong>Conclusion: </strong>T2-high inflammation predominates in this cohort, comprising 80% of patients and segregating into clinically distinct allergic, eosinophilic, and mixed endotypes. Cluster-based stratification offers meaningful phenotyping that may support personalized biologic selection and precision management strategies.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"591831"},"PeriodicalIF":3.3,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13185965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147981914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In-Hospital Outcomes and Mortality of Pediatric Asthma Exacerbations in Thailand: A Nationwide Study (2015-2022).","authors":"Rattapon Uppala, Phanthila Sitthikarnkha, Sirapoom Niamsanit, Leelawadee Techasatian, Suchaorn Saengnipanthkul, Kaewjai Thepsuthammarat, Jamaree Teeratakulpisarn, Pope Kosalaraksa","doi":"10.2147/JAA.S603890","DOIUrl":"10.2147/JAA.S603890","url":null,"abstract":"<p><strong>Purpose: </strong>Asthma is a chronic respiratory disorder that is prevalent and significantly contributes to morbidity and mortality among children globally. However, national data regarding in-hospital outcomes and factors associated with complications and mortality in Thailand remain limited. This study aims to quantify in-hospital outcomes among children hospitalized due to asthma exacerbations and identify factors associated with complications and mortality.</p><p><strong>Patients and methods: </strong>We performed a nationwide retrospective study in Thailand. Pediatric patients aged under 18 years admitted due to asthma exacerbation from January 2015 to December 2022 were identified. Multivariate logistic regression models were utilized to identify factors associated with endotracheal intubation.</p><p><strong>Results: </strong>Among 283,014 pediatric patients admitted with asthma exacerbations, 62.9% were male, and 62.3% were younger than 6 years. Acute respiratory failure requiring endotracheal intubation occurred in 6,452 admissions (2.3%), predominantly among children under 6 years of age. Pneumonia, pneumothorax, and hypokalemia were frequently observed among intubated patients. Admission rates showed consistent peaks in August and September, with a notable decline in 2021 corresponding to COVID-19 pandemic-related healthcare disruptions. The overall in-hospital mortality rate was 0.1% (195 deaths among 283,014 admissions), with annual population-based mortality rates ranging from 0.11 to 0.26 per 100,000 population. Deaths occurred disproportionately among adolescents and patients treated at tertiary-level hospitals, and were commonly accompanied by severe complications including pneumonia, pneumothorax, and hypokalemia.</p><p><strong>Conclusion: </strong>This nationwide study demonstrates a substantial burden of pediatric asthma hospitalizations in Thailand, with rare but clinically significant mortality. Fatal outcomes clustered among adolescents and children experiencing severe complications, highlighting the importance of early recognition, timely escalation of care, and optimized management of high-risk patients to prevent avoidable asthma-related deaths.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"603890"},"PeriodicalIF":3.3,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13178479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147963907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Fluticasone Furoate/Vilanterol on Small Airway Function in Asthma: A Real- World Study Using Impulse Oscillometry Stratified by Eosinophilic Inflammation.","authors":"Wei-Chun Huang, Chia-Hung Chen, Chih-Yen Tu, Wu-Huei Hsu, How-Yang Tseng, Wen-Chien Cheng","doi":"10.2147/JAA.S598143","DOIUrl":"10.2147/JAA.S598143","url":null,"abstract":"<p><strong>Background: </strong>Small airway dysfunction (SAD) is a key component of asthma pathophysiology that may persist despite adequate treatment. Impulse oscillometry (IOS) provides sensitive detection of peripheral airway abnormalities beyond conventional spirometry. Fluticasone furoate/vilanterol (FF/VI) is a widely used once-daily inhaled corticosteroid/long-acting β₂-agonist (ICS/LABA) combination that has been shown to improve lung function and reduce exacerbation risk in patients with asthma. However, the effects of FF/VI on small airway function have not been well explored, particularly using IOS and in relation to inflammatory phenotypes. Therefore, this study evaluated the effects of once-daily FF/VI on spirometry and IOS parameters and examined whether blood eosinophil levels influence these responses.</p><p><strong>Methods: </strong>Patients with asthma who received FF/VI for 12 months were retrospectively reviewed. Pulmonary function tests, including forced expiratory volume in one second (FEV₁) and forced vital capacity (FVC), and IOS indices-resistance at 5 Hz (R5), resistance at 20 Hz (R20), the difference between R5 and R20 (R5-R20, kPa/L/s), reactance area (AX, kPa/L), and resonant frequency (Fres, Hz)-were compared before and after treatment. Patients were stratified according to blood eosinophil count (<300 or ≥300 cells per microliter).</p><p><strong>Results: </strong>After one year of treatment, mean FEV₁ increased from 2.51 to 2.65 liters (<i>p</i> < 0.001) and mean FVC increased from 3.16 to 3.23 liters (<i>p</i> < 0.001). Total and central airway resistance decreased, with mean R5 declining from 148 to 131% of predicted (<i>p</i> < 0.001) and mean R20 from 145 to 134% of predicted (<i>p</i> < 0.001). The AX improved from 0.90 to 0.69 kPa/L (<i>p</i> = 0.044). However, significant improvements in R5-R20 and Fres were observed only among patients with blood eosinophil counts below 300 cells/µL.</p><p><strong>Conclusion: </strong>FF/VI 92/22 μg delivered via the Ellipta device significantly improved spirometric indices and central airway resistance. Improvements in small-airway mechanics were observed in patients with lower eosinophilic inflammation, suggesting that eosinophilic inflammation may be associated with attenuated small airway response. Further prospective studies are warranted to better define the role of inflammatory status in small airway dysfunction and to validate these findings.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"598143"},"PeriodicalIF":3.3,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13172617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147963899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of Misdiagnosis Factors in Allergic Bronchopulmonary Mycosis Using Explainable Machine Learning.","authors":"Xuemei Chen, Zekai Yu, Xiaoxiao Gong, Runjin Cai, Huan Ge, Yunbing Jia, Jiale Tang, Leng Huang, Xiaozhao Li, Juntao Feng","doi":"10.2147/JAA.S605864","DOIUrl":"10.2147/JAA.S605864","url":null,"abstract":"<p><strong>Background: </strong>Allergic bronchopulmonary aspergillosis/mycosis (ABPA/ABPM) is frequently misdiagnosed as pulmonary tuberculosis due to overlapping clinical and radiological features.</p><p><strong>Methods: </strong>In a retrospective cohort of 89 multidisciplinary team (MDT)-confirmed ABPA/ABPM patients, we investigated determinants of misdiagnosis and disentangled causal drivers from spurious associations. Machine learning models with SHAP interpretation were utilized alongside a Double Machine Learning framework to estimate the average treatment effects of five key features while adjusting for major confounders.</p><p><strong>Results: </strong>Immunological markers were identified as the dominant contributors to misdiagnosis. Total serum IgE showed the strongest protective causal effect against misdiagnosis, followed by <i>Aspergillus fumigatus</i>-specific IgE. Bronchiectasis demonstrated a modest protective effect. These findings were robust across covariate balance, overlap, and placebo analyses.</p><p><strong>Conclusion: </strong>Our results indicate that ABPA/ABPM misdiagnosis is driven primarily by underrecognition of immunological features rather than imaging findings, underscoring the importance of systematic immunologic assessment to reduce diagnostic delay and unnecessary anti-tuberculosis treatment, particularly in tuberculosis-endemic settings.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"605864"},"PeriodicalIF":3.3,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13170601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147941701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of FF/UMEC/VI versus ICS/LABA in Patients with Uncontrolled Asthma Treated in Routine Clinical Practice (PERFORM): A Pragmatic Randomized Controlled Trial.","authors":"Erika Penz, Stephen G Noorduyn, Alison C Moore, Hiroyuki Nagase, Jodie Crawford, Mary Woessner, Lydia Demetriou, Nicola Brown, David Slade, Gabriel Garcia, Alan P Baptist, John J Oppenheimer","doi":"10.2147/JAA.S599766","DOIUrl":"10.2147/JAA.S599766","url":null,"abstract":"<p><strong>Purpose: </strong>Asthma guidelines recommend stepwise escalation of inhaled corticosteroid/long-acting β₂-agonist (ICS/LABA) therapy, yet many patients remain uncontrolled. Randomized controlled trials (RCTs) show that single-inhaler triple therapy improves lung function, with varying effects on symptoms and exacerbations. However, highly controlled explanatory RCTs with selective populations may not reflect real-world care. PERFORM evaluated the effectiveness and safety of initiating once-daily fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) ELLIPTA versus usual care non-ELLIPTA ICS/LABA in routine clinical practice.</p><p><strong>Methods: </strong>PERFORM (GSK219912/NCT06372496) is a randomized, open-label, active-controlled, 52-week, global pragmatic trial including adults (18-75 years) with uncontrolled, infrequently exacerbating asthma, previously untreated or treated with non-ELLIPTA ICS or ICS/LABA in the 3-months pre-randomization. Powered primary and secondary endpoints were change from baseline in trough forced expiratory volume in 1 second (FEV₁) and asthma control (Asthma Control Questionnaire [ACQ]-7 responder analysis) at Week 24 (W24). Safety was assessed throughout the trial.</p><p><strong>Results: </strong>Overall, 1236 patients (mean age: 48.9 years; 68.6% female) were included in this W24 primary analysis (FF/UMEC/VI: N=619; ICS/LABA: N=617). At baseline mean FEV₁%predicted was 85.7; mean ACQ-7 score was 2.46. At W24, FF/UMEC/VI statistically significantly improved trough FEV₁ from baseline versus ICS/LABA (least squares mean difference [95% confidence interval]: +68mL [36-99], <i>P</i><0.001). FEV₁ improvement from baseline was 178mL (139-217) with FF/UMEC/VI and 110mL (72-149) with ICS/LABA. Odds of a clinically meaningful response in ACQ-7 score (≥0.5-point improvement from baseline) were significantly greater with FF/UMEC/VI versus ICS/LABA (odds ratio [95% confidence interval]: 1.47 [1.13-1.92], <i>P</i><0.004); 79.0% of patients achieved a response with FF/UMEC/VI and 71.8% with ICS/LABA. Safety profile to W24 aligned with previous studies.</p><p><strong>Conclusion: </strong>This pragmatic RCT demonstrated significant improvements in lung function and asthma control with FF/UMEC/VI versus ICS/LABA in uncontrolled and infrequently exacerbating patients treated in a routine practice setting. These findings further inform the evidence base for optimized use of FF/UMEC/VI.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"599766"},"PeriodicalIF":3.3,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13159957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147929771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality Among Adults with Subspecialist-Treated Severe Asthma: A Descriptive Analysis from the Observational CHRONICLE Study.","authors":"Njira L Lugogo, Jennifer Trevor, Joseph D Spahn, Reynold A Panettieri, Donna D Carstens, Christopher S Ambrose","doi":"10.2147/JAA.S588118","DOIUrl":"10.2147/JAA.S588118","url":null,"abstract":"<p><strong>Purpose: </strong>There are limited recent data assessing all-cause mortality for US patients with severe asthma. This descriptive analysis evaluated all-cause mortality in a real-world cohort of US adults with subspecialist-treated severe asthma, examining patient characteristics among those who died, physician-reported primary causes of death, and associations with treatment class.</p><p><strong>Patients and methods: </strong>CHRONICLE (NCT03373045) was an observational study of US adults (aged ≥18 years) with subspecialist-treated severe asthma, enrolled from February 2018 to October 2024. Patients met at least one of the following criteria: ongoing FDA-approved monoclonal antibody therapy, maintenance systemic corticosteroids (mSCS) for ≥50% of the prior year, or persistently uncontrolled asthma despite high-dosage inhaled corticosteroids and additional controllers. All-cause mortality was assessed descriptively, overall and by treatment class at time of death. Investigators reported primary causes of death and COVID-19 involvement. Treatment class exposure was calculated by the cumulative days on biologics and/or mSCS.</p><p><strong>Results: </strong>Among 4366 enrolled patients, mean age was 54.7 years; 69.7% were female, 73.1% were White, and 18.6% were Black. Over 14,758 person-years of observation, 130 deaths occurred (3.0%), yielding a mortality of 8.8 (95% confidence interval: 7.4, 10.5) per 1000 person-years. Cardiovascular disease was the leading cause of death (25.4%), followed by cancer (13.1%) and asthma (1.5%). COVID-19 contributed to 8.5% of deaths. Observed associations for all-cause mortality ranged from 6.8 per 1000 person-years in patients who were receiving biologics without mSCS to 31.6 per 1000 person-years in those receiving mSCS without biologics.</p><p><strong>Conclusion: </strong>US adults with subspecialist-treated severe asthma have an increased risk of all-cause mortality, especially those patients receiving mSCS. These findings highlight the importance of identifying mortality risks and limiting the use of mSCS whenever possible while supporting further research into the relationship between severe asthma and cardiovascular disease.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"588118"},"PeriodicalIF":3.3,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13157347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147874164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistence and Reasons for Discontinuation of Subcutaneous Immunotherapy in Children with Dust Mite Allergy: A Real-World Cohort from Hangzhou, China.","authors":"Zhenghong Song, Jing He, Shuxian Li, Kaiyi Lu, Hanqing Shao, Jinling Liu, Lei Wu, Hongzhen Xu, Zhimin Chen","doi":"10.2147/JAA.S558029","DOIUrl":"10.2147/JAA.S558029","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the present state of adherence to subcutaneous specific immunotherapy (SCIT) in children sensitized to dust mites, explore the factors contributing to the cessation of SCIT in this demographic, and provide scientific evidence aimed at improving compliance and efficacy of SCIT in pediatric patients.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on clinical data of pediatric patients who received treatment at our desensitization center between January 2017 and December 2023. These children exhibited sensitivity to dust mites and were diagnosed with allergic asthma, allergic rhinitis, or other allergic diseases, subsequently undergoing SCIT therapy. The fulfillment of the SCIT regimen was evaluated, and the factors contributing to treatment cessation were analyzed.</p><p><strong>Results: </strong>A total of 680 children were included in the study. Of these, 424 children (62.35%) successfully completed the entire treatment regimen (total course ≥3 years), whereas 256 children (37.65%) chose to discontinue the treatment prematurely (total course <3 years). The reasons for the cessation of SCIT, ranked from most to least common, included efficacy issues (54.69%), drug intolerance (18.75%), family-related factors (10.94%), the repercussions of the COVID-19 pandemic (6.64%), influence from other diseases (6.25%) and various other reasons. The primary reason for discontinuation within the first month was family factors (46.15%), while within six months, it was drug intolerance (40.82%), and after 6 months, efficacy issues (68.04%) became the leading cause.</p><p><strong>Conclusion: </strong>The uncertain efficacy and intolerance to the medication predominantly hinder compliance with SCIT in children, while family factors serve as the main reason for discontinuation within the first month. By enhancing parental comprehension and awareness of SCIT, standardizing operational protocols, and promptly addressing any adverse reactions, compliance with SCIT could be significantly improved.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"558029"},"PeriodicalIF":3.3,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13155399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147868288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug Patterns and Economic Costs Among Patients with Hereditary Angioedema.","authors":"Emily Kutrieb, Derek Weycker, Montserrat Vera-Llonch, Arthur Zbrozek, Kevin Ottino, William R Lumry","doi":"10.2147/JAA.S565239","DOIUrl":"10.2147/JAA.S565239","url":null,"abstract":"<p><strong>Background/objectives: </strong>This study explored real-world patterns of subcutaneous (SC) long-term prophylaxis (LTP), prescriptions for on-demand treatment (ODT), and treatment-related expenditures among patients with hereditary angioedema (HAE).</p><p><strong>Methods: </strong>This study was conducted using a retrospective cohort design and US healthcare claims database (02/23/18-06/30/22). Study population included patients aged ≥12 years who initiated SC LTP with C1-esterase inhibitor (C1-INH-SC) or lanadelumab for HAE management. Study measures were evaluated from the date of LTP initiation through the last date of health plan enrollment or the study period. Study measures included LTP adherence (medication possession ratio [MPR]), LTP discontinuation (gap in drug supply ≥60 days), annualized number of ODT prescriptions, and annualized treatment-related expenditures (ie., ODT prescriptions and emergent care [all-cause hospitalizations and emergency department (ED) visits]). Measures were summarized using means, percentages, and 95% confidence intervals (CI).</p><p><strong>Results: </strong>Study population included 196 patients (C1-INH-SC: N=65; lanadelumab: N=131); mean age was 39 years and 69% were female. During a mean follow-up of 19 months, MPR for LTP was 73% (CI: 68-77) and LTP discontinuation was 48% (41-55). Mean annualized number of ODT prescriptions was 3.8 (3.6-4.1) per patient, and mean annualized treatment-related expenditures totaled $209,547 (133,460-325,453) per patient, including $200,886 (124,792-317,983) for ODT prescriptions, $7,299 (3,408-12,214) for hospitalizations and $1,363 (859-1,959) for ED visits.</p><p><strong>Conclusion: </strong>Despite the availability of SC LTP for the management of HAE, adherence was suboptimal, almost 50% of patients discontinued prophylaxis, and treatment-related expenditures were high. Notably, annualized expenditures for ODT prescriptions, hospitalizations, and ED visits averaged >$200,000, even after initiation of SC LTP.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"565239"},"PeriodicalIF":3.3,"publicationDate":"2026-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13151981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147868264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Predictors of Bronchial Thermoplasty for Symptom Control in Severe Asthma.","authors":"Jia Pan, Ming-Lu Zhong, Xiao-Yi Pan, Sha-Sha He, Ying-Bo Wu, Shi-Yue Li, Zhu-Quan Su","doi":"10.2147/JAA.S585639","DOIUrl":"10.2147/JAA.S585639","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the clinical biomarkers that predict therapeutic response to bronchial thermoplasty (BT) in severe asthma.</p><p><strong>Patients and methods: </strong>We prospectively recruited patients with severe asthma who completed three sessions of bronchial thermoplasty. Baseline demographics, Asthma Control Questionnaire-5 (ACQ5) scores, eosinophil counts, fractional exhaled nitric oxide (FeNO), spirometry, impulse oscillometry (IOS), endobronchial optical coherence tomography (EB-OCT), and BT activation counts were recorded. All subjects were followed for two years and classified as responders or non-responders according to ACQ5 improvement ≥0.5 points.</p><p><strong>Results: </strong>Thirty patients were included (22 responders, 8 non-responders). Compared with non-responders, responders had lower body weight, BMI, and triglycerides, along with more negative X₅ values, higher RV/TLC ratios, greater Collagen Type III (COL3) expression, and larger airway luminal areas with thinner airway walls on EB-OCT. Receiver operating characteristic (ROC) analysis demonstrated that body weight (AUC = 0.759), BMI (AUC = 0.733), triglycerides (AUC = 0.694), X₅ (AUC = 0.938), RV/TLC (AUC = 0.756), COL3 (AUC = 0.846), and EB-OCT indices including airway luminal area from the 3^rd to 6^th generation (Ai3-6), 7^th to 9^th generation (Ai7-9), and airway wall area percentage from the 3^rd to 6^th generation (Aw%3-6) showed moderate-to-good discriminatory power (AUC range: 0.761-0.830). Multivariable logistic model integrating BMI, X₅, and Ai3-6 achieved better discrimination (AUC = 0.988) in predicting response to BT.</p><p><strong>Conclusion: </strong>More negative baseline X₅, lower triglyceride levels, EB-OCT-derived thinner airway walls and larger luminal areas, and higher COL3 expression, but not BT activation number, may help identify asthma patients most likely to benefit from BT and serve as potential predictors of its long-term efficacy.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"585639"},"PeriodicalIF":3.3,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13134572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}