Annals of Allergy Asthma & Immunology最新文献

{"title":"Risk factors and challenge outcomes in trimethoprim-sulfamethoxazole hypersensitivity in HIV negative patients: A multicenter retrospective report.","authors":"Susan Kinate, Ricardo J Estrada-Mendizabal, Dayne Voelker, Christine R F Rukasin, Saiyara Shama, Ebram N Labib, Matthew A Rank, Miguel A Park, Alexei Gonzalez-Estrada","doi":"10.1016/j.anai.2025.09.008","DOIUrl":"https://doi.org/10.1016/j.anai.2025.09.008","url":null,"abstract":"<p><strong>Background: </strong>Contemporary drug allergy practice parameters suggest performing trimethoprim-sulfamethoxazole (TMP-SMX) challenges in patients with a sulfa allergy label (SAL).</p><p><strong>Objective: </strong>To examine the safety of TMP-SMX challenges and risk factors for confirmed TMP-SMX allergy by challenge in a large cohort.</p><p><strong>Methods: </strong>Retrospective data review from all consecutive TMP-SMX challenges in HIV negative SAL patients performed between 2017 and 2022 across all 4 Mayo Clinic sites. Independent variables included demographics, index reaction history, etc. We performed univariate and multivariable logistic regression analysis with challenge outcome as the dependent variables.</p><p><strong>Results: </strong>Among 348 patients (mean age 58.9; 76% female), 29 (8%) had a positive objective challenge, and an additional 33 (9%) reported subjective symptoms. Most patients underwent two-step challenges (57%). Rash occurred in 8%, and 3 patients (0.9%) received epinephrine. In multivariable analysis, recent index reactions (<5 years) (OR 3.17; 95% CI, 1.03-8.66) and immediate-onset (<6 hrs.) reactions (OR 3.67; 95% CI, 1.10-10.62) were independently associated with a positive objective challenge. For subjective symptoms during challenges, multi-drug intolerance syndrome (OR 3.33; 95% CI, 1.45-7.64) and myalgias (OR 17.43;95% CI, 1.38-419.36) were significant predictors of a positive subjective challenge. Two patients (0.6%) required ED evaluation post-challenge; one for transient epinephrine-related symptoms, and one for infection concenrs requiring brief admission.</p><p><strong>Conclusion: </strong>In this large cohort, 319 of 348 patients (92%) with a SAL tolerated a TMP-SMX challenge. TMP-SMX challenges are safe with <1% of patients receiving intramuscular epinephrine. SAL patients with immediate index reactions occurring within 5 years of evaluation were more likely to have TMP-SMX allergy confirmed.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103197","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":"Comparative analysis of biologics' effects on lung function parameters in severe asthma.","authors":"Angelica Tiotiu, Charles Pilette, Diego Bagnasco, Benedetta Bondi, Fulvio Braido, Giuseppe Liistro","doi":"10.1016/j.anai.2025.09.002","DOIUrl":"https://doi.org/10.1016/j.anai.2025.09.002","url":null,"abstract":"<p><strong>Background: </strong>Different biologics available as add-on treatment for severe asthma (SA) showed modest benefits on lung function parameters but head-to-head comparisons are lacking.</p><p><strong>Objective: </strong>This study aims to compare the effects of four biologics on lung function parameters (including small airways) at 6 and 12 months of treatment in patients with SA.</p><p><strong>Methods: </strong>An observational multicenter study was conducted on adults patients with SA naïve to biologics treated by benralizumab, dupilumab, mepolizumab and omalizumab with lung function assessment by spirometry and gas dilution method at baseline (T0), after 6 (T6) and 12 months (T12) of treatment.</p><p><strong>Results: </strong>One hundred fifty-eight included patients were divided into four groups: 41 patients treated with omalizumab, 41 patients with mepolizumab, 36 patients with benralizumab, and 40 patients with dupilumab. Most lung function parameters were improved after 6 and 12 months of treatment without significant differences between groups except for the changes in the forced expiratory volume in one second in % (ΔFEV1%) (5.8±15.2 vs. 10.3±10.8 vs. 14.3±15.3 vs. 11.8±14.6, p=0.025) and forced vital capacity in % (ΔFVC%) (3.0±15.6 vs. 6.7±14.6 vs. 13.6±14.7 vs. 8.4±14.9, p=0.014) at T6, higher in the group receiving benralizumab. Trends for greater effectiveness of dupilumab in improving small airway dysfunction and benralizumab on distal airway obstruction were noted but the results are not always significant.</p><p><strong>Conclusion: </strong>All four biologics showed comparable effectiveness in the improvement of lung function parameters after 6 and 12 months of treatment, except the changes of FEV1 and FVC in % at T6 in favor of benralizumab.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024630","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":"Advanced Practice Practitioners in Allergy & Immunology: Where Are We Now and Future Directions.","authors":"Maureen Bauer, Stephanie Leeds, Megan O Lewis, Maria Crain, Amanda Michaud, Marylee Verdi, Nancy de Guzman, Marcus Shaker, Anna Nowak-Wegrzyn","doi":"10.1016/j.anai.2025.08.727","DOIUrl":"https://doi.org/10.1016/j.anai.2025.08.727","url":null,"abstract":"<p><p>There has been substantial growth of Advanced Practice Practitioners (APPs) in health care since their inception in the 1960's with APPs providing high quality and cost-effective care in a variety of medical settings. While most of the growth is in primary care, APPs are becoming increasingly leveraged in subspeciality care including Allergy & Immunology (A&I). At present there is limited literature on APPs in A&I specifically but there is growing literature on APP utilization and training in other specialties. Structured transition to practice programs (including onboarding programs and formal residency/fellowships) for APPs in other specialties are increasingly common and are associated with improved clinical productivity, practice autonomy, expertise, confidence, and decreased turn over. It would benefit A&I to adopt a similar approach as at present, the training and educational experiences APPs receive in A&I is quite varied. This article will review the training/certification of APPs, lessons learned from other specialties', what is known about the role of APPs in A&I and next steps for the future.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024625","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":"Engaging rural schools: Unique perspectives on stock inhaler policy implementation.","authors":"Emily Wilt, Ana Ongtengco, Paige Hardy, Molly A Martin, Andrea A Pappalardo","doi":"10.1016/j.anai.2025.08.729","DOIUrl":"10.1016/j.anai.2025.08.729","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024667","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":"Lanadelumab's impact on hereditary angioedema control and quality of life across disease activity subgroups: Real-world evidence.","authors":"Andrea Zanichelli, Walter A Wuillemin, Emel Aygören-Pürsün, Aleena Banerji, Paula J Busse, Stephen D Betschel, Mauro Cancian, Remi Gagnon, M Dawn Goodyear, Tamar Kinaciyan, Aharon Kessel, Markus Magerl, Andreas Recke, H James Wedner, Daniel Nova Estepan, Maureen Watt, Irmgard Andresen, Salomé Juethner, Natalie Khutoryansky, Inmaculada Martinez-Saguer","doi":"10.1016/j.anai.2025.07.025","DOIUrl":"10.1016/j.anai.2025.07.025","url":null,"abstract":"<p><strong>Background: </strong>Real-world clinical data support effectiveness and safety of lanadelumab in patients with hereditary angioedema (HAE); however, disease activity between patients can vary substantially in the absence of long-term prophylactic treatment.</p><p><strong>Objective: </strong>To assess the effectiveness of lanadelumab in patients with HAE by baseline HAE attack frequency.</p><p><strong>Methods: </strong>Patients with HAE from the phase 4 EMPOWER (NCT03845400) and ENABLE (NCT04130191) studies with available baseline attack rate data were included in this post hoc analysis. Disease activity subgroups were defined per pre-enrollment/lanadelumab (baseline) HAE attack rate (low, <1; moderate, ≥1 to <2; high, ≥2 to <3; very high, ≥3 attacks/mo).</p><p><strong>Results: </strong>The analysis included 152 patients (low disease activity, n = 29; moderate, n = 29; high, n = 15; very high, n = 79). In all 4 subgroups, mean and median HAE attack rates after lanadelumab initiation were low (0.0-0.5 attacks/mo). Clinically meaningful improvements (≥6-point decreases) in mean Angioedema Quality of Life total scores were observed regardless of pre-lanadelumab attack rates. From month 1 after lanadelumab initiation to the end of follow-up, mean Angioedema Control Test Scores were 10 or more (indicating patient perception of well-controlled disease) in all 4 subgroups.</p><p><strong>Conclusion: </strong>In these real-world data sets, on-treatment lanadelumab attack rates were low regardless of baseline disease activity. Patients from all 4 subgroups experienced improvements in health-related quality of life and disease control. Overall, these findings support long-term prophylaxis with lanadelumab across disease activity levels.</p><p><strong>Trial registration: </strong>EMPOWER: ClinicalTrials.gov Identifier: NCT03845400; ENABLE: ClinicalTrials.gov Identifier: NCT04130191.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796015","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":"Translational significance of endogenous epinephrine suppression in allergic states","authors":"Ankan Gupta MD","doi":"10.1016/j.anai.2025.05.019","DOIUrl":"10.1016/j.anai.2025.05.019","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"135 3","pages":"Page 349"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144921238","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":"Information for Readers","authors":"","doi":"10.1016/S1081-1206(25)00390-4","DOIUrl":"10.1016/S1081-1206(25)00390-4","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"135 3","pages":"Page A1"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144921195","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":"Long-term safety and efficacy of once-daily berotralstat in patients with hereditary angioedema","authors":"Henriette Farkas MD ,&nbsp;Jonny G. Peter MD ,&nbsp;Marcin Stobiecki MD ,&nbsp;John Anderson MD ,&nbsp;Emel Aygören-Pürsün MD ,&nbsp;David Hagin MD ,&nbsp;Miloš Jeseňák MD ,&nbsp;Aharon Kessel MD ,&nbsp;Sorena Kiani-Alikhan MD ,&nbsp;Tamar Kinaciyan MD ,&nbsp;Michael Manning MD ,&nbsp;Avner Reshef MD ,&nbsp;Adrian Wu MD ,&nbsp;Heather A. Iocca PhD ,&nbsp;Douglas T. Johnston MD ,&nbsp;Lindsey Noble PhD ,&nbsp;Dianne Tomita PhD ,&nbsp;Aleena Banerji MD","doi":"10.1016/j.anai.2025.06.004","DOIUrl":"10.1016/j.anai.2025.06.004","url":null,"abstract":"<div><h3>Background</h3><div>Berotralstat is a once-daily oral medication for the prophylaxis of hereditary angioedema (HAE) attacks in patients aged 12 years and older.</div></div><div><h3>Objective</h3><div>To assess the long-term safety and efficacy of berotralstat in patients with HAE caused by C1 inhibitor deficiency.</div></div><div><h3>Methods</h3><div>APeX-S was a global, open-label phase 2 study (NCT03472040) assessing berotralstat 150 and 110 mg for up to 96 weeks in the United States and 240 weeks elsewhere. The primary objective was long-term safety and tolerability; secondary objectives included efficacy and impact on quality of life (QoL) of berotralstat. Safety was evaluated by means of treatment-emergent adverse events and laboratory analyses. Efficacy was assessed using the number and rate of HAE attacks, durability of response, and number and proportion of days with angioedema symptoms. QoL was evaluated using the Angioedema Quality of Life Questionnaire.</div></div><div><h3>Results</h3><div>In APeX-S, 387 patients were enrolled and received berotralstat 150 mg (n = 287) or 110 mg (n = 100) from day 1. A total of 70 patients on berotralstat 110 mg crossed over to berotralstat 150 mg after a median (range) of 48 (46–71) weeks. Treatment-emergent adverse events up to 240 weeks were reported by 334 patients (86.3%); the most common being nasopharyngitis (23.8%), headache (14.7%), diarrhea (14.5%), upper respiratory tract infection (12.9%), and abdominal pain (11.1%). Treatment with berotralstat led to improvements in HAE attack rates and Angioedema Quality of Life Questionnaire scores up to week 96, with greater improvements observed in patients who received berotralstat 150 mg from day 1.</div></div><div><h3>Conclusion</h3><div>This study supports the long-term safety of berotralstat and its efficacy in preventing HAE attacks and improving QoL.</div></div><div><h3>Clinical Trial Registration</h3><div>This trial was registered at ClinicalTrials.gov as NCT03472040 (<span><span>https://clinicaltrials.gov/study/NCT03472040</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"135 3","pages":"Pages 311-319.e6"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259294","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":"From the pages of AllergyWatch","authors":"Stanley M. Fineman MD ,&nbsp;Timothy Chow MD ,&nbsp;Shyam R. Joshi MD ,&nbsp;Iris Otani MD","doi":"10.1016/j.anai.2025.05.025","DOIUrl":"10.1016/j.anai.2025.05.025","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"135 3","pages":"Pages 352-353"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144192464","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":"Beyond respiratory syncytial virus and rhinovirus","authors":"Samer Abdelkader DO ,&nbsp;Divya R. Voladri MD ,&nbsp;Joshua L. Kennedy MD","doi":"10.1016/j.anai.2025.06.012","DOIUrl":"10.1016/j.anai.2025.06.012","url":null,"abstract":"<div><div>Asthma affects approximately 25 million people in the United States, with respiratory viruses playing a significant role in both the onset and exacerbations of the condition. Although rhinovirus and respiratory syncytial virus (RSV) are the most well-known triggers, other iratory viruses playing a significant role in both the on, human parainfluenza virus, human bocavirus, enterovirus D68, influenza, and SARS-CoV-2 are increasingly recognized for their significant impact on asthma. These viruses contribute to both the development of asthma and exacerbations by inducing airway inflammation, disrupting epithelial barriers, and skewing immune responses—particularly toward type 2 inflammation. Human metapneumovirus and human parainfluenza virus, members of the Paramyxoviridae family such as RSV, have been linked to early life wheezing and long-term airway changes. Although often co-detected with other viruses, human bocavirus has been associated with recurrent wheezing and asthma risk. Enterovirus D68, notably during the 2014 outbreak, caused severe exacerbations in children with asthma. Influenza and SARS-CoV-2 can cause significant morbidity in those with asthma, even if they are not the primary drivers of exacerbations or onset. As RSV vaccines become more widespread, shifts in viral ecology may lead to increased prevalence of these lesser known viruses due to viral interference and immunity gaps. Understanding their epidemiology and mechanisms is crucial for addressing the evolving asthma burden. Comprehensive surveillance, improved diagnostics, and mechanistic research are essential for developing effective preventive strategies. Broadening the focus beyond rhinovirus and RSV will be critical to fully understand and mitigate the impact of asthma on childrenng be critical to fth.</div></div>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"135 3","pages":"Pages 249-260"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144921199","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}