Annals of Allergy Asthma & Immunology最新文献

{"title":"10 ways to improve your management of food allergy","authors":"Aikaterini Anagnostou MD, MSc, PhD , Jay Lieberman MD , Theresa Bingemann MD , Tim Buckey MD , Antonella Cianferoni MD, PhD , Arjola Cosper DO , Edwin Kim MD , Marissa Love MD , Anu Mallapaty DO , Lindsey Moore MD , Richard Wasserman MD, PhD , Anna Nowak-Wegrzyn MD , Shaan Somani MD , Joyce Yu MD , Matthew Greenhawt MD, MBA, MSc","doi":"10.1016/j.anai.2025.01.014","DOIUrl":"10.1016/j.anai.2025.01.014","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"134 5","pages":"Pages 616-618"},"PeriodicalIF":5.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143913085","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":"Depression and anxiety in patients with atopic dermatitis","authors":"Jennifer S. LeBovidge PhD ,&nbsp;Lynda C. Schneider MD","doi":"10.1016/j.anai.2025.02.017","DOIUrl":"10.1016/j.anai.2025.02.017","url":null,"abstract":"<div><div>The psychosocial burden of atopic dermatitis (AD) is extensive, stemming from intense itch, sleep disturbance, unpredictable flares, lifestyle restrictions and missed activities, social stigma, and treatment burden. Overall, adults with AD are at a 2- to 3-fold greater risk for depression and anxiety compared with individuals without AD and children at a 1.5-fold greater risk, with greatest risk for those with more severe disease. A number of mechanisms seem to affect the relationship between AD and mental health, including poorly controlled disease, sleep disturbance, stress-induced itch, inflammation, and coping patterns. In some cases, the mental health burden of AD may also negatively affect AD management and course, creating a reinforcing cycle of psychosocial burden. Although depression and anxiety are known comorbidities of AD, the mental health burden of AD often goes unaddressed, which may further a sense of isolation for patients and families. Given the strong association between symptom severity and increased mental health burden, optimizing AD treatment and reducing itch are critical. Health care professionals can support patients with AD and their caregivers by encouraging open conversations about mental health, addressing common areas of condition-related stress, screening for depression and anxiety, and facilitating referrals to mental health professionals for further assessment and evidence-based care. Existing research supports use of cognitive-behavioral interventions to help manage the physical and mental health burden of AD. Further research is needed to evaluate psychological interventions for pediatric patients with AD and for patients with clinical diagnoses of depression and anxiety to better guide shared decision-making around support for these patients.</div></div>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"134 5","pages":"Pages 506-515"},"PeriodicalIF":5.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674510","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":"On-demand treatment of hereditary angioedema attacks","authors":"Sandra Christiansen MD ,&nbsp;Maeve O'Connor MD ,&nbsp;Timothy Craig DO ,&nbsp;Cristine Radojicic MD ,&nbsp;H. James Wedner MD ,&nbsp;Sherry Danese MBA ,&nbsp;Julie Ulloa BA ,&nbsp;Vibha Desai PhD ,&nbsp;Christopher Utter PhD ,&nbsp;Tomas Andriotti MD ,&nbsp;Paul Audhya MD ,&nbsp;Paula Busse MD","doi":"10.1016/j.anai.2024.12.012","DOIUrl":"10.1016/j.anai.2024.12.012","url":null,"abstract":"<div><h3>Background</h3><div>Hereditary angioedema (HAE) is clinically characterized by recurrent attacks of subcutaneous and submucosal swelling.</div></div><div><h3>Objective</h3><div>To investigate real-world timing, potential barriers, and impact of delaying on-demand treatment (OD) of HAE attacks.</div></div><div><h3>Methods</h3><div>Patients with HAE (type I or II) aged 12 years or older with more than or equal to 1 treated (Treated Cohort) or untreated (Untreated Cohort) attack in the past 3 months were recruited by the US HAE Association. Respondents completed a 20-minute, self-reported, online survey about their last HAE attack.</div></div><div><h3>Results</h3><div>In the Treated Cohort (n = 94), of the 67% who reported treating their attack early, only 26% administered OD in less than 1 hour. Furthermore, 79% (n = 74) reported treatment-related anxiety, which correlated with treatment delay. Time to treatment paralleled changes in attack severity (33% mild attacks treated in &lt;1 hour vs 67% in ≥1 hour, progressed to moderate/severe) and mean duration (&lt;1 hour: 0.7 day; &gt;8 hours: 2.7 days). In the Untreated Cohort (n = 20), 50% of the respondents describing their last untreated attack as mild experienced progression to moderate or severe and 25% reported spread to another site including the larynx and face. Untreated attacks lasted a mean of 2.3 days.</div></div><div><h3>Conclusion</h3><div>The disparity between survey respondents’ perception of treating early and actual time to OD administration is striking. Treatment-related anxiety was a common reason for delaying OD. Increased treatment intervals translated into progression of HAE attack severity, duration, and spread to other sites. Suboptimal management of attacks intensifies the HAE disease burden, underscoring the need for improved treatment options, guidance, and removal of OD administration barriers.</div></div>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"134 5","pages":"Pages 570-579.e4"},"PeriodicalIF":5.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856548","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 MD, MS ,&nbsp;John Oppenheimer MD ,&nbsp;Nicholas L. Rider DO ,&nbsp;David B.K. Golden MDCM ,&nbsp;Aikaterini Anagnostou MD, PhD ,&nbsp;Matthew Greenhawt MD, MBA, MSc","doi":"10.1016/j.anai.2024.11.025","DOIUrl":"10.1016/j.anai.2024.11.025","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Objective</h3><div>To evaluate cost-effectiveness of commercially available noninjectable epinephrine compared with intramuscular epinephrine for treatment of anaphylaxis.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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).</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"134 5","pages":"Pages 587-593.e1"},"PeriodicalIF":5.8,"publicationDate":"2025-05-01","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":"Dupilumab efficacy in relation to changes in club cell secretory protein 16","authors":"Yui Murai MD,&nbsp;Toshiyuki Koya MD, PhD,&nbsp;Hiroki Koda MD,&nbsp;Wakana Uji MD,&nbsp;Moe Tanaka MD,&nbsp;Masahiro Endo MD,&nbsp;Kyoichiro Oshima MD,&nbsp;Takahiro Matsuda MD,&nbsp;Hiroshi Ueno MD, PhD,&nbsp;Ami Aoki MD, PhD,&nbsp;Kenjiro Shima MD, PhD,&nbsp;Yosuke Kimura MD, PhD,&nbsp;Toshiaki Kikuchi MD, PhD","doi":"10.1016/j.anai.2025.02.019","DOIUrl":"10.1016/j.anai.2025.02.019","url":null,"abstract":"<div><h3>Background</h3><div>Although the performance of dupilumab in severe asthma has been evaluated, the detailed mechanism underlying its effect remains unclear.</div></div><div><h3>Objective</h3><div>To analyze the effect of dupilumab on serum club cell secretory protein 16 (CC16).</div></div><div><h3>Methods</h3><div>A total of 25 patients who were administered dupilumab and underwent computed tomography before and approximately 4 months after the introduction of dupilumab were included. Clinical and computed tomography parameters before and after dupilumab administration, such as mucus plug score and wall area measurement, were compared along with serum CC16 levels. The correlation between the clinical background and treatment effects was also evaluated.</div></div><div><h3>Results</h3><div>The number of mucus plugs and airway wall area decreased significantly after dupilumab introduction. The number of mucus plugs was positively correlated with both age and serum IgE levels. The number of mucus plugs and airway wall area was inversely correlated with percent of predicted forced expiratory volume in 1 second (FEV₁) and maximal mid-expiratory flow. Dupilumab treatment resulted in a significant increase in serum CC16 levels and led to a significant improvement in asthma symptoms, quality-of-life scores, FEV₁, and exacerbation frequency. In addition, changes in CC16 were significantly correlated with changes in the fraction of exhaled nitric oxide, IgE, quality-of-life score, FEV₁, maximal mid-expiratory flow, and mucus plug score.</div></div><div><h3>Conclusion</h3><div>These data suggest that dupilumab improves symptoms and respiratory functions by altering the airway epithelial environment.</div></div>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"134 5","pages":"Pages 556-562.e2"},"PeriodicalIF":5.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568686","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 outcomes and safety of combination biologic therapy with dupilumab: A systematic review.","authors":"Samantha Keow, Bonnie Lu, Grace Xiong, Eric Yu, David Weng, Mohannad Abu-Hilal","doi":"10.1016/j.anai.2025.04.012","DOIUrl":"10.1016/j.anai.2025.04.012","url":null,"abstract":"<p><p>Dupilumab is a biologic therapy approved for the treatment of various chronic inflammatory conditions. Clinically, it has been used in combination with other biologic agents for patients who are refractory to biologic monotherapy or who require immunotherapy for multiple conditions. However, the safety and efficacy of such combinations remain unclear. Our objective is to evaluate the safety profile, adverse effects (AEs), and clinical outcomes in these patients. A systematic search of Ovid MEDLINE, EMBASE, PubMed, and Web of Science was conducted from inception to April 2024. English-language primary studies assessing patients treated with dupilumab and at least 1 other biologic agent were included. Additional studies were identified through citation chaining and handsearching. A total of 27 studies comprising 156 patients were analyzed. A total of 51.9% were treated for a single condition and 48.1% for comorbid conditions. The most common indications for combination biologic therapy were respiratory (34.7%) and dermatologic (73.3%) disorders. Mild AEs were reported in 94.9% of cases, with injection site reactions, upper respiratory tract infections, and headaches being the most frequent. Serious AEs were rare, and none were directly attributed to biologic therapy. Clinical outcomes were generally favorable, with improved disease control observed in 62.1% of cases. Combination biologic therapy with dupilumab is well-tolerated in select patients, suggesting promising efficacy in addressing comorbid conditions, refractory disease, and AEs from monotherapy. Long-term effects and disease-specific AEs remain unclear. Additional research is needed to determine the efficacy and safety profiles of specific biologic combinations.</p>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042388","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":"Drug-induced enterocolitis syndrome to amoxicillin-clavulanic acid in an adult patient with markers of gastrointestinal inflammation","authors":"Anna Moshkovich MD ,&nbsp;Bradley Sabin MD ,&nbsp;Katharine Foster Nehme MD ,&nbsp;Madeline Schutt MD","doi":"10.1016/j.anai.2025.02.021","DOIUrl":"10.1016/j.anai.2025.02.021","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"134 5","pages":"Pages 611-613"},"PeriodicalIF":5.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544461","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":"What to carry? Understanding the health economic costs of nasal spray vs injectable epinephrine and a need for shared decision-making","authors":"Jennifer L.P. Protudjer PhD","doi":"10.1016/j.anai.2025.01.025","DOIUrl":"10.1016/j.anai.2025.01.025","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"134 5","pages":"Pages 500-501"},"PeriodicalIF":5.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143913162","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":"Recommended immunizations to reduce respiratory morbidity and mortality among US adults with asthma, by age","authors":"Tia C. Dowling MPhil ,&nbsp;Melisa M. Shah MD, MPH ,&nbsp;Danielle L. Moulia MPH ,&nbsp;Joy Hsu MD, MS","doi":"10.1016/j.anai.2025.01.019","DOIUrl":"10.1016/j.anai.2025.01.019","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"134 5","pages":"Pages 535-538"},"PeriodicalIF":5.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143913165","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 call to action to use icatibant down to age 2 for hereditary angioedema","authors":"Alisha Mutch PharmD, BCPS ,&nbsp;Tiffany Truong MD ,&nbsp;Sana Master BA ,&nbsp;Timothy Craig DO","doi":"10.1016/j.anai.2024.11.029","DOIUrl":"10.1016/j.anai.2024.11.029","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"134 5","pages":"Pages 614-615"},"PeriodicalIF":5.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143913084","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}