Allergy, Asthma & Clinical Immunology最新文献

{"title":"Severe exacerbation of facial dermatitis with swelling following introduction of abrocitinib in a patient with atopic dermatitis","authors":"Shirui Chen, Chongtu Yang, Yonghong Lu","doi":"10.1186/s13223-024-00911-w","DOIUrl":"https://doi.org/10.1186/s13223-024-00911-w","url":null,"abstract":"Abrocitinib, an oral small-molecule Janus kinase 1 (JAK1) inhibitor, has been widely accepted for the treatment of moderate-to-severe atopic dermatitis (AD). Currently there is a paucity of data on the adverse events (AEs) after abrocitinib treatment, especially on rare events such as exacerbation of facial dermatitis, and their causal relationship and subsequent management remains poorly elucidated. A 43-year-old female patient with moderate AD received dupilumab after failure of topical treatments. Facial dermatitis persisted and became refractory after dupilumab treatment, and the patient changed treatment to oral abrocitinib. Fifteen hours after the first dose of abrocitinib, she developed exacerbation of facial dermatitis with swelling. The patient was initially diagnosed as abrocitinib-induced hypersensitivity. However, a score of 3 of the Naranjo adverse drug reaction assessment indicates week correlation between abrocitinib therapy and exacerbation of facial dermatitis, and negative results from subsequent drug provocation test further suggests no causal relationship. The present case report highlights the necessity of careful determination of abrocitinib-induced hypersensitivity, which should not be diagnosed simply based on the time sequence between drug exposure and symptom occurrence. In addition, caution should be exercised for drug withdrawal, especially when confirmative evidence is absent. Drug provocation test can be helpful and effective treatments could be continued unless severe AEs occur.","PeriodicalId":501611,"journal":{"name":"Allergy, Asthma & Clinical Immunology","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142266095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review protocol: health economic evaluations of immunotherapy and biologics for food allergy management","authors":"Andrew T. Fong, Joshua Jacob, Jennifer L. P. Protudjer, Melanie Lloyd, Liz Thyer, Peter S. Hsu, Lei Si","doi":"10.1186/s13223-024-00909-4","DOIUrl":"https://doi.org/10.1186/s13223-024-00909-4","url":null,"abstract":"<p>To the Editor,</p><p>Food allergy is a significant public health concern, that currently affects an estimated 4–10% of people worldwide and the prevalence is thought to be increasing [1]. Food allergy typically demands that those affected avoid consumption of known allergens, which contributes to requisite dietary and behavioural changes. In turn, such changes and the potential for severe reactions, contributes to substantial economic costs, including the cost of treatment, healthcare service utilisation, carers’ time and so on. These economic costs of food allergy are spread throughout families, communities, and society at large. With novel approaches to therapies and evolving discussions on allergy management, there are multiple knowledge gaps on the economic burden of food allergies and the cost-effectiveness of the various treatments available [2].</p><p>Over the last couple of years, food allergen immunotherapy has shown promise in the management of food allergies, reducing the incidence of serious allergic reactions and potentially inducing sustained unresponsiveness (remission of food allergy) in a subset of patients [3, 4]. Commerical forms of food allergen immunotherapy are now available in some countries with additional products in the pipeline. In addition, multiple protocols for clinician-led immunotherapy have been proposed. Despite this, the economic viability and cost-effectiveness of these products have been varied [5]. A previous systematic review broadly exploring the cost-effectiveness of food allergy interventions in children, identified only three articles related to immunotherapy with no studies identified on biologics. However, this is an area with increased interest and a timely update is warranted due to the rapidly evolving evidence base [5].</p><p>For biological therapies, Wood et al. (2024) recently highlighted that a well-established monoclonal anti-Immunoglobulin E (IgE) antibody, Omalizumab, has clinical efficacy compared to a placebo in increasing the reaction threshold for peanut and other common food allergens in children and adults [6]. The varying models of care for administration and monitoring in international health systems add difficulty for assessment of cost-effectiveness for this novel food allergy treatment modality.</p><p>We will undertake a systematic review with the aim to synthesise health economic evaluation studies on the use of immunotherapy and biologics in food allergy management.</p><p>This systematic review protocol was developed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement published and updated in 2020 [7]. A PRISMA checklist and PRISMA flow diagram will be completed with reporting. The review is registered (registration number: CRD42024531663) on the International Prospective Register of Systematic Reviews (PROSPERO) prior to commencement.</p><p>Three routes of food allergen immunotherapy will be included in the review: oral immunothe","PeriodicalId":501611,"journal":{"name":"Allergy, Asthma & Clinical Immunology","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142266096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"fSCIG 10% in pediatric primary immunodeficiency diseases: a European post-authorization safety study","authors":"Peter Čižnár, Marion Roderick, Helen Schneiderova, Miloš Jeseňák, Gergely Kriván, Nicholas Brodszki, Stephen Jolles, Charles Atisso, Katharina Fielhauer, Shumyla Saeed-Khawaja, Barbara McCoy, Leman Yel","doi":"10.1186/s13223-024-00904-9","DOIUrl":"https://doi.org/10.1186/s13223-024-00904-9","url":null,"abstract":"The safety, tolerability, and immunogenicity of hyaluronidase-facilitated subcutaneous immunoglobulin (fSCIG) 10% (dual-vial unit of human immunoglobulin 10% and recombinant human hyaluronidase [rHuPH20]) were assessed in children with primary immunodeficiency diseases (PIDs). This phase 4, post-authorization, prospective, interventional, multicenter study (NCT03116347) conducted in the European Economic Area, enrolled patients aged 2 to < 18 years with a documented PID diagnosis who had received immunoglobulin therapy for ≥ 3 months before enrollment. New fSCIG 10% starters underwent fSCIG 10% dose ramp-up for ≤ 6 weeks (epoch 1) before receiving fSCIG 10% for ≤ 3 years (epoch 2); patients pretreated with fSCIG 10% entered epoch 2 directly. The primary outcome was the number and rate (per infusion) of all noninfectious treatment-related serious and severe adverse events (AEs). In total, 42 patients were enrolled and dosed (median [range] age: 11.5 [3–17] years; 81% male; 23 new starters; 19 pretreated). Overall, 49 related noninfectious, treatment-emergent AEs (TEAEs) were reported in 15 patients; most were mild in severity (87.8%). No treatment-related serious TEAEs were reported. Two TEAEs (infusion site pain and emotional distress) were reported as severe and treatment-related in a single new fSCIG 10% starter. The rate of local TEAEs was lower in pretreated patients (0.1 event/patient-year) versus new starters (1.3 events/patient-year). No patients tested positive for binding anti-rHuPH20 antibodies (titer of ≥ 1:160). No safety signals were identified, and the incidence of local AEs declined over the duration of fSCIG 10% treatment. This study supports fSCIG 10% long-term safety in children with PIDs. NCT03116347.","PeriodicalId":501611,"journal":{"name":"Allergy, Asthma & Clinical Immunology","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142266101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic links between atopy, allergy, and alopecia areata: insights from a Mendelian randomization study","authors":"Wen Xu, Hongyan Zhang, Sheng Wan, Bo Xie, Xiuzu Song","doi":"10.1186/s13223-024-00892-w","DOIUrl":"https://doi.org/10.1186/s13223-024-00892-w","url":null,"abstract":"Alopecia areata (AA), a prevalent form of autoimmune hair loss, has a not well-defined relationship with atopic and allergic disorders, including eczema, hay fever, and asthma. This study aims to elucidate the genetic relationship between atopy, allergies, and alopecia areata (AA) using Mendelian randomization. We hypothesize that atopic and allergic conditions contribute to the genetic predisposition of AA. We analyzed extensive genetic data from Genome-wide Association Studies (GWAS) involving over one million individuals. This analysis focused on assessing the genetic correlation between AA and various allergic conditions, including hay fever, eczema, asthma, and allergies to pollen, dust, and cats. The inverse variance weighted method served as our primary analytical tool, complemented by sensitivity analyses to verify the robustness of our results. Our findings reveal a significant genetic correlation between atopy/allergies and an increased risk of AA. Notably, strong associations were observed for hay fever, eczema, asthma, and specific allergies (pollen, dust, and cats). The sensitivity analyses corroborated these associations, reinforcing the reliability of our primary results. This study provides compelling genetic evidence of an association between atopic and allergic conditions and the development of AA. These findings suggest that individuals with such conditions may benefit from enhanced surveillance for early signs of AA.","PeriodicalId":501611,"journal":{"name":"Allergy, Asthma & Clinical Immunology","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140798218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A survey of severe asthma in Canada: results from the CASCADE practice reflective program","authors":"Krystelle Godbout, Harold Kim, Irvin Mayers, James Paterson, Charles K. N. Chan","doi":"10.1186/s13223-024-00891-x","DOIUrl":"https://doi.org/10.1186/s13223-024-00891-x","url":null,"abstract":"Since the last guidance was published by the Canadian Thoracic Society, there have been several advances in the clinical management of severe asthma. To gain a better understanding of the current standards of care and treatment patterns of patients, the CASCADE practice reflective program was established to conduct a real-world analysis of severe asthma management among specialists in Canada with a goal of identifying areas of opportunity to enhance patient management and outcomes. The CASCADE program was a two-part practice reflective and assessment program delivered through an on-line portal for selected specialists (Respirologists and Allergists) in Canada. The program consisted of a one-time overview survey of physician practice to establish overall practice parameters, followed by a review of at least 5 severe asthma patients to establish the current landscape of severe asthma management. The program collected practice overview surveys from 78 specialists (52 Respirologists, 24 Allergists, and 2 General practice physicians with an interest in respiratory disease) in 8 provinces. Practices included a variety of types in both large metropolitan centres and smaller regional settings. There were 503 patients reviewed and included in the program. Most (65%) patients were currently using a biologic treatment, 30% were biologic naive, and 5% had used a biologic treatment in the past. Most patients (53%) were reported to have mixed allergic and eosinophilic phenotypes, despite a perception that allergic, eosinophilic and mixed phenotypes were evenly balanced in the physician practice. Overall, patients currently treated with biologic agents had parameters suggesting higher control and were more satisfied with treatment. However, there was less than optimal treatment satisfaction for more than half of all patients, particularly for those patients not treated with a biologic agent. Phenotyping is hampered by poor availability for several assessments, and the full range of treatments are not currently fully utilized, partly due to physician familiarity with the agents and partly due to prescribing restrictions. Even when treated with biologic agents, patient satisfaction can still be improved.","PeriodicalId":501611,"journal":{"name":"Allergy, Asthma & Clinical Immunology","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140617084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of immunoglobulin replacement therapy in preventing infections in patients with chronic obstructive pulmonary disease: a systematic review","authors":"Justin J. Y. Kim, Liz Dennett, Maria B. Ospina, Anne Hicks, Harissios Vliagoftis, Adil Adatia","doi":"10.1186/s13223-024-00886-8","DOIUrl":"https://doi.org/10.1186/s13223-024-00886-8","url":null,"abstract":"Immunoglobulin replacement therapy is a standard treatment for patients with antibody production deficiencies, which is of interest in patients with chronic obstructive pulmonary disease (COPD). This systematic review, registered with PROSPERO (CRD42021281118), assessed the current literature regarding immunoglobulin replacement therapy on COPD clinical outcomes in patients with low immunoglobulin G (IgG) serum concentrations. Literature searches conducted from inception to August 23, 2021, in databases including MEDLINE, EMBASE, and CINAHL. Population (sex, age, comorbidities), baseline clinical characteristics (pulmonary function testing results, IgG levels), and outcome (hospitalizations, emergency department visits) were extracted after title/abstract and full text screening. The Cochrane risk of bias assessment form was used for risk of bias assessment of randomized controlled trials and the National Heart, Lung, and Blood Institute (NHLBI) assessment was used for pre and post studies. A total of 1381 studies were identified in the preliminary search, and 874 records were screened after duplicates were removed. Screening 77 full texts yielded four studies that were included in the review. It is unclear whether immune globulin replacement therapy reduces acute exacerbation frequency and severity in COPD. Current evidence suggests that it is worth considering, but better developed protocols for administration of immune globulin supplementation is required for future randomized controlled trials.","PeriodicalId":501611,"journal":{"name":"Allergy, Asthma & Clinical Immunology","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140602397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of adherence to guideline-directed therapy and risk factors for exacerbation in mild asthma: a retrospective chart review","authors":"Beth A. Zerr, Jacklyn M. Kruse, Jon J. Glover","doi":"10.1186/s13223-024-00888-6","DOIUrl":"https://doi.org/10.1186/s13223-024-00888-6","url":null,"abstract":"A significant update was made to both the Global Initiative for Asthma (GINA) in 2019 and the National Heart Lung and Blood Institute (NHLBI) asthma guidelines in 2020 for mild asthma. These groups no longer recommend short-acting beta-agonists (SABA) as monotherapy for mild (GINA) or mild-persistent (NHLBI) asthma. With the lag that can occur between guideline or evidence updates and changes in practice, this study sought to evaluate whether guideline adoption had occurred. In this retrospective chart review, patient electronic medical records from a large healthcare system were evaluated from July 1 of 2021 to July 1 of 2022 to determine how many patients with mild asthma were prescribed as needed or daily inhaled corticosteroids (ICS) in addition to as needed SABA. The secondary outcome was to evaluate the incidence of exacerbations in patients with mild asthma, comparing those on guideline-directed therapy or not. In addition, we evaluated other patient factors increasing exacerbation risk in mild asthma. For the primary outcome, of the 1,107 patients meeting inclusion criteria, 284 patients (26%) did not have documentation of guideline-directed therapy for mild asthma during the study period, while 823 (74%) were on guideline-directed therapy (Diff:48.7%; 95% CI:45.1 to 52.3%, p < 0.001). For the secondary objective, 161 patients had an exacerbation (12% on guideline-directed therapy, 15.4% not on guideline-directed therapy). This difference in incidence of exacerbation between the two treatment groups was not statistically significant (Diff: -3.4%; 95% CI: -8 to 1.1%; p = 0.133). In addition, being female, having GERD, and being obese were all statistically significant factors associated with having asthma exacerbations among our patient population. Nearly one-fourth of patients with mild persistent asthma were not on guideline-directed therapy, despite updates in asthma guidelines (GINA 2019, NHLBI 2020). Factors such as being female, having GERD, and being obese were all statistically significant factors associated with having asthma exacerbations among patients with mild persistent asthma.","PeriodicalId":501611,"journal":{"name":"Allergy, Asthma & Clinical Immunology","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140316118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introduction of a penicillin allergy de-labelling program with direct oral challenge and its effects on utilization of beta-lactam antimicrobials: a multicenter retrospective parallel cohort study","authors":"Adhora Mir, Derek Lanoue, Veronica Zanichelli, Carl van Walraven, Timothy Olynych, Caroline Nott, Derek MacFadden","doi":"10.1186/s13223-024-00877-9","DOIUrl":"https://doi.org/10.1186/s13223-024-00877-9","url":null,"abstract":"Self-reported penicillin allergy labels are common and often inaccurate after assessment. These labels can lead to reduced use of first-line beta-lactam antibiotics and worse outcomes. We measured the impact of a previously performed inpatient proactive systematic penicillin allergy de-labelling program on subsequent antibiotic use. This prior program included assessment, risk-stratification, and low risk direct oral amoxicillin challenge. We performed a retrospective comparison of parallel cohorts from two separate tertiary care hospital campuses in Ottawa, Canada across two penicillin de-labelling intervention periods across April 15th to April 30th, 2021, and February 15th to March 8th, 2022. Outcomes, including penicillin allergy labelling and antibiotic use, were collected for the index admission and the subsequent 6-month period. Descriptive statistics and multivariate regression analyses were performed. A total of 368 patients with penicillin allergy label were included across two campuses and study periods. 24 (13.8%) patients in the intervention groups had sustained penicillin allergy label removal at 30 days from admission vs. 3 (1.5%) in the non-intervention group (p < 0.001). In the 6-months following admission, beta-lactams were prescribed more frequently in the intervention groups vs. the non-intervention groups for all patients (28 [16.1%] vs.15 [7.7%], p = 0.04) and were prescribed more frequently amongst those who received at least one antibiotic (28/46 [60.9%] vs.15/40 [37.5%], p = 0.097). In a multivariate regression analysis, the intervention groups were found to be associated with an increased odds of beta-lactam prescribing in all patients (OR 2.49, 95%CI 1.29–5.02) and in those prescribed at least one antibiotic (OR 2.44, 95%CI 1.00–6.15). No drug-related adverse events were reported. Proactive penicillin allergy de-labelling for inpatients was associated with a reduction in penicillin allergy labels and increased utilization of beta-lactams in the subsequent 6-months.","PeriodicalId":501611,"journal":{"name":"Allergy, Asthma & Clinical Immunology","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140037037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eosinophilic gastritis and gluten-sensitive enteropathy manifested as hypoproteinemia and treated with omalizumab: a case report","authors":"Zhirong Du, Zixi Wang, Weixun Zhou, Jia Yin, Yuxiang Zhi","doi":"10.1186/s13223-024-00878-8","DOIUrl":"https://doi.org/10.1186/s13223-024-00878-8","url":null,"abstract":"Eosinophilic gastritis (EoG) has rarely been reported in conjunction with gluten-sensitive enteropathy (GSE). When this does occur, patients typically present with gastrointestinal symptoms. To our knowledge, hypoproteinemia has not been reported as the primary manifestation. Anti-IgE therapy, such as omalizumab, lowers eosinophil counts in the blood, lungs, and gut. Its efficiency in treating active EoG remain unknown. We report a 33-month-old boy with a history of food allergy and atopic dermatitis who developed recurrent edema, hypoproteinemia, and eosinophilia at the age of 14 months. The diagnoses of EoG and GSE were confirmed based on the clinical presentation and results of gastrointestinal biopsies and serological testing. Although prednisone and dietary intervention were initially effective, the boy developed prednisone-related facial swelling. After stopping prednisone, his symptoms relapsed. Subsequent treatment with omalizumab, combined with dietary intervention, showed good efficacy and safety. To our knowledge, this is the first case of concurrent EoG and GSE that presented primarily with hypoproteinemia. We highlight the rare manifestations of these two diseases to raise clinical suspicion and prevent missed and delayed diagnoses. The pathogenesis of EoG is heterogeneous and complex. Omalizumab showed good efficacy, indicating that IgE-mediated processes may be involved in the pathogenesis of this patient’s diseases.","PeriodicalId":501611,"journal":{"name":"Allergy, Asthma & Clinical Immunology","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140037206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2023 CSACI annual scientific meeting book of abstracts","authors":"","doi":"10.1186/s13223-023-00866-4","DOIUrl":"https://doi.org/10.1186/s13223-023-00866-4","url":null,"abstract":"<h3>\u0000<u>Felix Chan</u>\u0000¹, Victor Nguyen¹, Susan Tarlo^1,2\u0000</h3><h4>\u0000¹Department of Medicine, University of Toronto, Toronto, ON; ²Toronto Western Hospital, University Health Network, Toronto, ON</h4><h5>Correspondence: Felix Chan</h5><p><i>Allergy, Asthma &amp; Clinical Immunology</i> 2024, <b>20(Suppl 1):</b>1</p><p><b>Background:</b> Occupational asthma accounts for nearly 18% of cases of adult-onset asthma, but prevalence rates vary between men and women. This may be due to sex distributions in industries and occupations associated with developing occupational asthma. The purpose of our study was to assess sex differences in occupational and clinical characteristics of patients with occupational asthma.</p><p><b>Methods:</b> We conducted a retrospective analysis of occupational and clinical data (including respiratory and allergy investigations) from patients with occupational asthma assessed at two tertiary care hospitals in Toronto, Canada, between 2000 to 2022. Our research questions were to elucidate sex differences in time to onset and diagnosis of occupational asthma and severity of occupational asthma, measured by spirometry and methacholine challenge testing.</p><p><b>Results:</b> Our study population included 255 patients with occupational asthma (159 males [62%] and 96 females [38%]). Males were more likely to work in the automotive industry (22% vs 4%, P &lt; 0.05) and have had their employment terminated due to occupational symptoms (24% vs 3%, P &lt; 0.05). Females predominated in healthcare (15% vs 1%, P &lt; 0.001) and were more likely to have never smoked cigarettes (65% vs 47%, P &lt; 0.05). Males tended to report a longer latency period between occupational exposure and development of asthmatic symptoms (36 months vs 18 months, P = 0.11) and a longer time to diagnosis (24 months vs 14 months, P = 0.08). In never-smokers, the mean FEV1/FVC ratio was significantly greater in females compared to males (75.90 vs 68.75, P &lt; 0.001). There were no significant differences in PEF work variability, severity of airway hyperresponsiveness by methacholine challenge testing, and positivity to allergy skin tests.</p><p><b>Conclusions:</b> Though some limitations exist, our findings substantiate historical sex difference trends in occupational asthma distribution and exposures and suggest a longer time to diagnosis and increased disease severity in men compared to women.</p><h3>\u0000<u>Mariam Eldaba</u>, Hoang Pham</h3><h4>University of Ottawa, Ottawa, ON</h4><h5>\u0000<b>Correspondence:</b> Mariam Eldaba</h5><p><i>Allergy, Asthma &amp; Clinical Immunology</i> 2024, <b>20(Suppl 1):</b>2</p><p><b>Background:</b> Asthma is a heterogeneous disease with a plethora of phenotypes [1]. An estimated 30% of Type 2 high (T2-High) asthma is uncontrolled despite demonstrated effectiveness of multiple downstream biologic medications [2]. However, novel tezepelumab offered a new approach with more upstream b","PeriodicalId":501611,"journal":{"name":"Allergy, Asthma & Clinical Immunology","volume":"63 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140037379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}