Annals of Allergy Asthma & Immunology最新文献

{"title":"Epidemiology of asthma across the ages.","authors":"Michael Miligkos, Jiyeon Oh, Rosie Kwon, George Ν Konstantinou, Soeun Kim, Dong Keon Yon, Nikolaos G Papadopoulos","doi":"10.1016/j.anai.2024.12.004","DOIUrl":"10.1016/j.anai.2024.12.004","url":null,"abstract":"<p><p>In the past 3 decades, the overall prevalence of asthma appears to be plateauing, although large geographic and socioeconomic variation is evident. Overall, asthma prevalence slightly decreased in most age groups, except for school-aged children. Of note, asthma mortality steadily decreased, potentially highlighting improved asthma management strategies. Several epidemiologic studies indicate that a complex interplay between genetic, environmental, and immunologic factors predisposes individuals to asthma inception and persistence across different life stages. Established risk factors for preschool wheezing to asthma persistence comprise a combination of pre- and post-natal parameters including the maternal history of asthma, prematurity, caesarian section, early-life respiratory infections, exposure to air pollution or tobacco smoke, and allergic polysensitization. On the other hand, persistence into adulthood is mainly driven by disease severity, allergic multimorbidity, relevant comorbidities, severe respiratory infections, and tobacco smoke exposure. It is evident that asthma prevention strategies do not fit a \"one size fits all\" concept and key environmental interventions should be tailored to different regions of the world. Undoubtedly, the heterogeneity of asthma as a disease is at least partly reflected in the reported epidemiologic measures, and continuing, methodologically rigorous studies will allow us to unravel some of the observed discrepancies.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824546","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":"High prevalence of eosinophilic gastrointestinal disorders in patients with atopic disease.","authors":"Alexandra A Weir, Onyinye I Iweala, Evan S Dellon","doi":"10.1016/j.anai.2024.12.001","DOIUrl":"10.1016/j.anai.2024.12.001","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803196","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":"Patient and physician perspectives on disease burden in chronic spontaneous urticaria: A real-world US survey.","authors":"Giselle Mosnaim, Dhaval Patil, Merin Kuruvilla, James Hetherington, Aaron Keal, Stephanie Mehlis","doi":"10.1016/j.anai.2024.11.028","DOIUrl":"10.1016/j.anai.2024.11.028","url":null,"abstract":"<p><strong>Background: </strong>Chronic spontaneous urticaria (CSU) is frequently associated with severe disease-related symptoms that negatively affect quality of life, but patients and physicians may differ in their opinion on CSU burden.</p><p><strong>Objective: </strong>To describe the clinical and humanistic burden associated with CSU and level of agreement between patient and physician perceptions of disease burden and treatment satisfaction.</p><p><strong>Methods: </strong>This cross-sectional, survey-based study of US physicians and their adult patients with CSU included data collected in the Adelphi CSU Disease Specific Programme from 2020 to 2021. Overall, 1082 patient record forms completed by 110 physicians (including 40 allergists/immunologists, 50 dermatologists, and 20 primary care physicians) and 474 matched patient-reported questionnaires were included. Paired physician-patient records were used to determine agreement on disease burden and treatment satisfaction.</p><p><strong>Results: </strong>Patients with CSU often experienced physician-reported itching (66%) and hives (49%) and had a history of angioedema (23%). Although current CSU severity had largely improved since diagnosis, many patients and physicians continued to report moderate/severe current disease symptoms (46% and 30%, respectively). Moderate/severe disease had greater impacts on quality of life, sleep, work impairment, and treatment satisfaction than mild disease. Most patients and physicians agreed on symptom severity (61%-74%), with disagreement largely due to physicians underreporting severity relative to patients. Patient/physician agreement on treatment satisfaction was highest with mild CSU severity (82%), mild hive severity (80%), and omalizumab or other biologic treatment (87%).</p><p><strong>Conclusion: </strong>Moderate/severe CSU was associated with greater disease burden and lower treatment satisfaction than mild CSU. Physicians more frequently underreported CSU severity compared with their patients.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814974","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":"Thinking like a Bayesian: Diagnostic food allergy testing at the extremes of clinical certainty.","authors":"Marcus S Shaker, Aikaterini Anagnostou, Matthew Greenhawt, Benjamin T Prince, Kristin Sokol","doi":"10.1016/j.anai.2024.11.027","DOIUrl":"10.1016/j.anai.2024.11.027","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792733","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":"A health economic analysis of noninjectable epinephrine compared with intramuscular epinephrine.","authors":"Marcus S Shaker, John Oppenheimer, Nicholas L Rider, David B K Golden, Aikaterini Anagnostou, Matthew Greenhawt","doi":"10.1016/j.anai.2024.11.025","DOIUrl":"10.1016/j.anai.2024.11.025","url":null,"abstract":"<p><strong>Background: </strong>Noninjectable epinephrine to treat allergic reactions addresses an unmet need. Intranasal epinephrine is approved and a sublingual form is under development. Inhaled epinephrine is poorly studied for anaphylaxis. These forms have unknown cost-effectiveness.</p><p><strong>Objective: </strong>To evaluate cost-effectiveness of commercially available noninjectable epinephrine compared with intramuscular epinephrine for treatment of anaphylaxis.</p><p><strong>Methods: </strong>Markov cohort analyses evaluated the cost-effectiveness of noninjectable epinephrine forms. The base-case assumed exaggerated anaphylaxis fatality rates (50-fold increase) for using inhaled epinephrine given low certainty evidence in anaphylaxis and deliberately reduced fatality risk for nasal or sublingual forms (10-fold reduction) theorizing higher adherence and early use during an allergic reaction.</p><p><strong>Results: </strong>In the base-case scenario, assuming a 10-fold decreased risk in peanut allergy fatality associated with intranasal or sublingual epinephrine treatment for a severe allergic reaction (net monetary benefit [NMB], $2,189,134) vs intramuscular epinephrine use (NMB, $2,189,114), intranasal or sublingual epinephrine was the most cost-effective option (incremental cost-effectiveness ratio [ICER], $83,748/quality-adjusted life-year [QALY]), but only at a marginal annual cost of $4. Intramuscular epinephrine was cost-effective (ICER, $17,900/QALY) vs inhaled epinephrine (NMB, $2,183,531), although inhaled epinephrine reached cost-effectiveness (willingness to pay [$100,000/QALY]) if associated fatality risk fell below 2.5-fold. Substituting a single noninjectable form of epinephrine for a second injectable device (in patients prescribed 2 autoinjectors already) would be cost-effective; however, adding a supplemental noninjectable device was not cost-effective, even assuming a 10-fold risk reduction with multiple device carriage (ICER, $858,462).</p><p><strong>Conclusion: </strong>Noninjectable routes of epinephrine can be cost-effective options provided fatality risk is not significantly elevated. Carriage of redundant epinephrine autoinjectors with noninjectable forms is not cost-effective if associated with excess cost of redundant device packs.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787681","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":"Effect of the Israel-Hamas war on allergy and immunology care and research","authors":"Alon Y. Hershko MD, PhD ,&nbsp;Francesca Levi-Schaffer PharmD, PhD","doi":"10.1016/j.anai.2024.02.022","DOIUrl":"10.1016/j.anai.2024.02.022","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"133 6","pages":"Pages 621-622"},"PeriodicalIF":5.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139984356","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":"“Nothing good ever comes of violence”","authors":"Agartha Kankam BS ,&nbsp;Joseline Marlene Cruz Vazquez MPH ,&nbsp;Donald Y.M. Leung MD, PhD ,&nbsp;Jonathan M. Spergel MD, PhD ,&nbsp;Anna Nowak-Wegrzyn MD, PhD","doi":"10.1016/j.anai.2024.10.002","DOIUrl":"10.1016/j.anai.2024.10.002","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"133 6","pages":"Pages 619-620"},"PeriodicalIF":5.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142756726","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":"Onset of efficacy of azelastine hydrochloride 0.15% nasal spray for allergic rhinitis in an environmental exposure chamber","authors":"Shu-Ning Hsu PhD ,&nbsp;Fatima Sajjad PharmD ,&nbsp;Elizabeth Brigham BA ,&nbsp;Robert Centofanti MS ,&nbsp;Robert An PhD ,&nbsp;Patricia Couroux MD ,&nbsp;Charlene Ng PhD","doi":"10.1016/j.anai.2024.07.020","DOIUrl":"10.1016/j.anai.2024.07.020","url":null,"abstract":"<div><h3>Background</h3><div>Azelastine nasal spray is effective in relieving symptoms of seasonal and perennial allergic rhinitis.</div></div><div><h3>Objective</h3><div>To evaluate the time to onset of efficacy of azelastine hydrochloride (HCl) 0.15% vs placebo in participants with seasonal allergic rhinitis.</div></div><div><h3>Methods</h3><div>A total of 110 participants aged 18 to 65 years were randomized to receive azelastine HCl 0.15% 2 sprays per nostril vs placebo nasal spray after being continuously exposed to ragweed pollen in an environmental exposure chamber. Symptoms were evaluated subjectively by the total nasal symptom score (TNSS) scale. The primary efficacy parameter was the time to onset of efficacy of azelastine as measured by the change from baseline in TNSS 15, 30, 45, 60, 90, 120, 180, and 240 minutes post-dose.</div></div><div><h3>Results</h3><div>The azelastine nasal spray group had statistically significant improvement in TNSS compared with placebo 30 minutes post-dose (<em>P</em> = .0002), and the effect was sustainable throughout the environmental exposure chamber session for all subsequent time points (<em>P</em> &lt; .0001). Adverse events were mild, including bitter taste, nasal discomfort, epistaxis, sinusitis, and nausea. No major adverse events were reported during the study.</div></div><div><h3>Conclusion</h3><div>Azelastine HCl 0.15% nasal spray relieves nasal symptoms associated with allergic rhinitis and has a fast onset of action within 30 minutes. The overall safety profile of azelastine has also been proven to be safe. These results, along with previous findings on efficacy and improved quality of life for people with allergic rhinitis, establish the important clinical role of azelastine HCl 0.15%.</div></div><div><h3>Trial Registration</h3><div>ClinicalTrials.gov Identifier: NCT04264637.</div></div>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"133 6","pages":"Pages 675-681"},"PeriodicalIF":5.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lower skeletal muscle density and airway structure on computed tomography in asthma","authors":"Yusuke Hayashi MD ,&nbsp;Naoya Tanabe MD, PhD ,&nbsp;Kaoruko Shimizu MD, PhD ,&nbsp;Tomoki Maetani MD ,&nbsp;Yusuke Shiraishi MD, PhD ,&nbsp;Tsuyoshi Oguma MD, PhD ,&nbsp;Hironobu Sunadome MD, PhD ,&nbsp;Ryo Sakamoto MD, PhD ,&nbsp;Atsuyasu Sato MD, PhD ,&nbsp;Susumu Sato MD, PhD ,&nbsp;Hiroshi Date MD, PhD ,&nbsp;Hisako Matsumoto MD, PhD ,&nbsp;Toyohiro Hirai MD, PhD","doi":"10.1016/j.anai.2024.08.016","DOIUrl":"10.1016/j.anai.2024.08.016","url":null,"abstract":"<div><h3>Background</h3><div>Lower skeletal muscle density may reflect muscle adiposity and metabolic dysregulation that potentially impair disease control and lung function independent of high body mass index (BMI) in patients with asthma.</div></div><div><h3>Objective</h3><div>To investigate whether the lower density of pectoralis muscles (PMs) and erector spinae muscles (ESMs) on chest computed tomography was associated with airway structural changes in patients with asthma.</div></div><div><h3>Methods</h3><div>Consecutive patients with asthma and healthy controls undergoing chest computed tomography were retrospectively analyzed. The ESM and PM density, areas of subcutaneous adipose tissue near the PM and epicardial adipose tissue, wall area percent of the airways, and airway fractal dimension (AFD) were quantified on computed tomography.</div></div><div><h3>Results</h3><div>The study included 179 patients with asthma (52% women) and 88 controls (47% women). All the controls were 60 years old or younger. The PM and ESM density in female patients with asthma who were 60 years old or younger were significantly lower than those in controls after adjustment for BMI. In female patients with asthma at all ages, lower PM and ESM density (but not subcutaneous or epicardial adipose tissue area) was associated with greater wall area percent of the airways and lower AFD after adjusting for age, height, BMI, smoking status, blood eosinophil count, and oral corticosteroid use. The only association between ESM density and AFD was found in male patients with asthma.</div></div><div><h3>Conclusion</h3><div>Lower skeletal muscle density may be associated with airway wall thickening and less complexity of the airway luminal tree in female patients with asthma.</div></div>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"133 6","pages":"Pages 667-674.e4"},"PeriodicalIF":5.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142047463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"I Want You","authors":"Erin L. Reigh MD, MS","doi":"10.1016/j.anai.2024.07.007","DOIUrl":"10.1016/j.anai.2024.07.007","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"133 6","pages":"Pages 658-659"},"PeriodicalIF":5.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142756740","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}