Annals of Allergy Asthma & Immunology最新文献

{"title":"Evaluation of the PEN-FAST Clinical Decision Rule in Non-Beta-Lactam Antibiotic Allergy Assessment.","authors":"Deniz Göcebe, Elham Khatamzas, Alexander Enk, Knut Schäkel","doi":"10.1016/j.anai.2025.06.019","DOIUrl":"https://doi.org/10.1016/j.anai.2025.06.019","url":null,"abstract":"<p><strong>Background: </strong>False antibiotic allergy labels lead to the unnecessary use of broad-spectrum agents, contributing to antimicrobial resistance and poorer clinical outcomes. Penicillin allergy delabeling initiatives have been supported by validated clinical decision rules such as PEN-FAST. However, there are currently no available standardized approaches for non-beta-lactam allergies, for which standardized and validated skin tests are also lacking.</p><p><strong>Objective: </strong>We first aimed to validate the safety and negative predictive value (NPV) of PEN-FAST for penicillin allergies. Next, we evaluated whether the performance of PEN-FAST could be replicated for non-beta-lactam antibiotic allergy labels.</p><p><strong>Methods: </strong>This retrospective single-center comparative cohort study analyzed adult patients with penicillin or non-beta-lactam allergy labels referred to our allergy division at the Department of Dermatology, Heidelberg, Germany. Allergy assessment included skin tests and subsequent drug challenge. The performance of the previously published PEN-FAST criteria was evaluated for both cohorts.</p><p><strong>Results: </strong>102 penicillin allergy and 191 non-beta-lactam labels were analyzed. Confirmed allergies were more prevalent among non-beta-lactams (50.3% vs. 37.3%). PEN-FAST demonstrated high sensitivity for both penicillin (97.4%) and non-beta-lactams (94.8%), with an NPV of 95.8% and 82.8%, respectively. Misclassifications were limited to mild cutaneous reactions. Excluding clindamycin labels increased the NPV for non-beta-lactams to 95%.</p><p><strong>Conclusion: </strong>Despite lower NPV for non-beta-lactam labels and varying performance across antibiotic classes, our results indicate that PEN-FAST may serve as a safe risk-stratification tool for non-beta-lactam allergy labels. Prospective studies with direct drug challenges are required to assess its utility in the delabeling of non-beta-lactam allergies.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Phenotype of Food Allergy in Children with Cystic Fibrosis.","authors":"Hang P Nguyen, Veronika Shabanova, Sarah McCollum, Brooke Polk, Tricia Lee, Kyle Whittington, Priscila Cunha, Emanuela M Bruscia, Marie E Egan, Marc Emmenegger, Stephanie Leeds","doi":"10.1016/j.anai.2025.06.024","DOIUrl":"https://doi.org/10.1016/j.anai.2025.06.024","url":null,"abstract":"<p><strong>Background: </strong>Nonspecific gastrointestinal symptoms associated with cystic fibrosis (CF) may be misdiagnosed as food allergy (FA). There is a paucity of data regarding prevalence and phenotype of IgE-mediated FA in CF.</p><p><strong>Objective: </strong>We aimed to determine the prevalence and characteristics of pediatric FA in CF.</p><p><strong>Methods: </strong>We conducted a retrospective pediatric cohort study using the Cystic Fibrosis Foundation Registries and electronic medical records from [redacted names A and B]. Demographic, biometric, and medical information were collected, and individuals suspected of having FA were identified through multiple inclusion criteria. A convincing FA diagnosis was established based on a priori criteria including medical history, testing results, and management. Estimated prevalence was calculated as a percentage and compared to the most recently reported pediatric FA prevalence in the United States (US).</p><p><strong>Results: </strong>Among 289 patients (51.21% male, median age=12.40 years), 11 (3.81%, 95% confidence interval [CI] 1.91-6.71) had at least one convincing FA, yielding a smaller prevalence than the most recent estimate in the US pediatric population (7.60%, 95% CI 7.10-8.10, p=0.015). Male CF patients (6.08% versus 1.42%, p=0.038) and patients without pancreatic enzyme replacement (9.09% versus 2.25%, p=0.020) had higher prevalence of convincing FA.</p><p><strong>Conclusion: </strong>Our study of pediatric CF patients found a lower prevalence of FA compared to the general pediatric population in the US. Stringent criteria should be used when labeling CF patients with FA to minimize overdiagnosis. Further studies are needed to investigate if CF could potentially be protective against the development of FA.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased Likelihood of COVID-19-Related Asthma Exacerbation with Higher Eosinophil Count.","authors":"Mirna Ayache, Faiza Khalid","doi":"10.1016/j.anai.2025.06.026","DOIUrl":"https://doi.org/10.1016/j.anai.2025.06.026","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of clinical remission on quality of life in severe eosinophilic asthma treated with mepolizumab.","authors":"Yuto Hamada, Dennis Thomas, Vanessa M McDonald, Erin S Harvey, Michael Fricker, Andrew Gillman, Mark Hew, Vicky Kritikos, John W Upham, Peter G Gibson","doi":"10.1016/j.anai.2025.06.017","DOIUrl":"10.1016/j.anai.2025.06.017","url":null,"abstract":"<p><strong>Background: </strong>Biologics can induce clinical remission in severe asthma. However, the benefits of achieving remission from the patient's perspective remain unclear.</p><p><strong>Objective: </strong>To assess the association between achieving clinical remission and health-related quality of life (HRQoL) in patients with severe eosinophilic asthma treated with mepolizumab.</p><p><strong>Methods: </strong>In this nested, matched case-control study, data from the Australian Mepolizumab Registry were used to compare the proportions of participants attaining Asthma QoL Questionnaire (AQLQ(S)) scores of ≥6, indicating minimal or no HRQoL impairment, between 42 participants who achieved clinical remission at 12 months and 64 propensity score-matched participants who did not. Assessed AQLQ(S) scores included overall and domain scores for symptoms, activity limitation, emotional function, and environmental stimuli. Clinical remission was assessed at 12 months, defined as Asthma Control Questionnaire-5 score <1.5, no exacerbations in the previous 12 months, and no OCS use for asthma.</p><p><strong>Results: </strong>A greater proportion of participants achieving clinical remission had AQLQ(S) scores of ≥6 at 12 months compared with those who did not: overall scores (61.9% vs 26.6%, p = 0.001), symptom domain (59.5% vs 29.7%, p = 0.004), activity limitation domain (59.5% vs 28.1%, p = 0.003), emotional function domain (69.0% vs 31.2%, p <0.001), and environmental stimuli domain (57.1% vs 34.4%, p = 0.035).</p><p><strong>Conclusion: </strong>Achieving clinical remission at 12 months was associated with minimal or no impairment in HRQoL, although approximately 38% of participants in remission still experienced impaired HRQoL, highlighting residual unmet needs. Further research is needed to better understand the benefits of asthma remission from the patient's perspective.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Categorizing clinical response to Mepolizumab for Patients with Chronic Rhinosinusitis with Nasal Polyps: SYNAPSE Trial.","authors":"Claire Hopkins, Larry Borish, Jared Silver, Peter Howarth, Robert Chan, Priya Dsilva, Joseph K Han","doi":"10.1016/j.anai.2025.06.018","DOIUrl":"10.1016/j.anai.2025.06.018","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Triple therapy versus dual inhaler therapy for moderate-to-severe asthma: an updated systematic review and meta-analysis.","authors":"Daniel G Rayner, Layla Bakaa, Flavia Hoyte, Tamara T Perry, Katherine Rivera-Spoljaric, Kaharu Sumino, Bradley Chipps, John Oppenheimer, Sharmilee M Nyenhuis, Elliot Israel, Ellen McCabe, Paul M O'Byrne, Lindsay E Shade, Valerie G Press, Gordon H Guyatt, Susana Rangel, Dia Sue-Wah-Sing, Lisa Hall, Hilarry Orr, Angel Melendez, Tonya Winders, Donna D Gardner, Kathyrn Przywara, Matthew A Rank, Leonard B Bacharier, Giselle Mosnaim, Derek K Chu","doi":"10.1016/j.anai.2025.06.011","DOIUrl":"https://doi.org/10.1016/j.anai.2025.06.011","url":null,"abstract":"<p><strong>Background: </strong>Long-acting muscarinic antagonists (LAMA) are commonly added to inhaled corticosteroids (ICS) and long-acting beta-agonists (LABA) for asthma management.</p><p><strong>Objective: </strong>To systematically synthesize the benefits and harms of triple therapy (ICS/LABA/LAMA) compared to dual therapy (ICS/LABA) for asthma management across key subpopulations as part of developing linked AAAAI/ACAAI guidelines.</p><p><strong>Methods: </strong>We searched MEDLINE, Embase, CENTRAL, and ICTRP from January 1, 2020 to February 1, 2025, for randomized trials comparing inhaled triple therapy to dual therapy for asthma to update our previous systematic review. Paired reviewers independently screened citations, extracted data, and assessed risk of bias. Random-effects meta-analyses assessed asthma control (ACQ-7; 0-6), asthma-related quality of life (AQLQ; 1-7), pre-bronchodilator FEV1, severe exacerbations, and serious adverse events. The GRADE approach informed the certainty of evidence. Open Science Framework Registration (https://osf.io/u8t4q/).</p><p><strong>Results: </strong>Twenty-six trials randomized 12,431 participants. Compared to dual therapy, triple therapy reduces severe exacerbations in patients at high risk for future exacerbation (relative risk 0.83, 95%CI 0.76 to 0.90; risk difference 5.3% fewer; high certainty), with trivial improvement in asthma control (mean difference [MD] -0.04, 95%CI -0.07 to 0.00, moderate certainty; lower better), quality of life (MD 0.05, 95%CI -0.03 to 0.14, moderate certainty; higher better), and pre-bronchodilator FEV1 (MD 0.07, 95%CI 0.05 to 0.09; high certainty), without increase in serious adverse events (moderate certainty). Effects were consistent across age, body mass index, and exacerbation history.</p><p><strong>Conclusion: </strong>In patients with moderate-to-severe asthma, triple therapy, compared to dual therapy, reduces severe exacerbations in patients at high risk for future exacerbation with minimal harm.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determining Avenues for Improved Food Allergy Support and Safety on College Campuses.","authors":"Pranav M Bajaj, Madeleine Kanaley, Samantha Sansweet, Kethan Bajaj, Julia Auerbach, Eirene Fithian, Khalid Ibrahim, Ruchi Gupta","doi":"10.1016/j.anai.2025.06.005","DOIUrl":"https://doi.org/10.1016/j.anai.2025.06.005","url":null,"abstract":"<p><strong>Background: </strong>Food Allergy (FA) is a chronic disease with public health importance affecting an estimated 1 in 13 children and 1 in 10 adults. Limited research is available on policies and support available at the college level.</p><p><strong>Objective: </strong>To better understand the experiences of college students with and without FA to determine avenues to improve safety and quality of life for college students with FA.</p><p><strong>Methods: </strong>An online, cross-sectional survey was distributed to college students with and without food allergy in the United States from 2021 to 2023. Descriptive statistics were used to determine respondent demographics, food allergy knowledge, student reaction history, effects of FA on social life, and recommendations for improvement of FA safety and awareness on campus.</p><p><strong>Results: </strong>A total of 204 students-78 with food allergies-completed the survey from 72 U.S. universities. Of students with FA, 41% reported that their university was not aware of their FA and 28% experienced a food allergic reaction in their campus dining hall, with the most common cause being food mislabeled with allergen (43%). Students with FA most endorsed wanting regular FA training for campus dining staff (71%) and increased availability of stock epinephrine in the dining halls (59%) to improve safety on campus.</p><p><strong>Conclusion: </strong>To ensure the safety of students with FA and reduce reactions on campus, it is imperative that universities improve identification of students with food allergies, increase regular FA training for dining staff, and increase availability of stock epinephrine in dining halls.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of eosinophilic granulomatosis with polyangiitis (EGPA)-associated sinusitis with dual biologics: anti-IL5/IL5R plus anti-IL4/IL13.","authors":"S Shahzad Mustafa, Anthony Ocon, Karthik Vadamalai, Allison Ramsey","doi":"10.1016/j.anai.2025.06.010","DOIUrl":"https://doi.org/10.1016/j.anai.2025.06.010","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vaccine hesitancy for allergist-immunologists.","authors":"Charlotte A Moser","doi":"10.1016/j.anai.2025.06.009","DOIUrl":"10.1016/j.anai.2025.06.009","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paradoxical Effects of Dupilumab in ABPA: Resolution of Mucus Plugging but Induction of Eosinophilic Pneumonia.","authors":"Osamu Matsuno, Tansri Wibowo, Yutaka Ishida, Atsuhsi Ogata","doi":"10.1016/j.anai.2025.06.006","DOIUrl":"https://doi.org/10.1016/j.anai.2025.06.006","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}