Journal of Allergy and Clinical Immunology-In Practice最新文献

{"title":"Development and Validation of the Coping with Food Allergy Scales (CoFAS) for Children and Young People and Parents","authors":"Rebecca C. Knibb PhD ,&nbsp;Suzanna E.M. Purser MSc ,&nbsp;Jennifer Hammond PhD ,&nbsp;Kate Ambridge BSc","doi":"10.1016/j.jaip.2026.02.034","DOIUrl":"10.1016/j.jaip.2026.02.034","url":null,"abstract":"<div><h3>Background</h3><div>Managing food allergy (FA) entails complex lifestyle changes and development of specific coping strategies. How we cope with long-term conditions is associated with clinical and psychological outcomes and so it is important that adaptive strategies are promoted.</div></div><div><h3>Objective</h3><div>To develop and establish the reliability and validity of new coping with FA scales (Coping with Food Allergy Scales [CoFAS]) for children and young people (CYP) aged 8 to 16 years (CoFAS-C) and for parents (CoFAS-P).</div></div><div><h3>Methods</h3><div>The CoFAS were developed following interviews with 32 CYP aged 8 to 16 years and 8 parents, a systematic review of literature, and consultation with FA experts. Reliability and validity analysis was conducted on 151 CYP aged 8 to 16 years who completed the CoFAS-C and 390 caregivers who completed the CoFAS-P. Participants also completed validation measures of generic coping, anxiety and depression, quality of life, and self-efficacy.</div></div><div><h3>Results</h3><div>Exploratory factor analysis resulted in 4 subscales for the CoFAS-C (Avoidance and Minimisation, Positive Beliefs, Self-Management, and Social Support) and 3 subscales for the CoFAS-P (Avoidance and Minimisation, Planning and Preparation, and Dealing with Emotions). All had good to excellent internal reliability (Cronbach <em>α</em> values = 0.74-0.84) and low to medium correlations with validation measures.</div></div><div><h3>Conclusions</h3><div>The CoFAS are reliable and valid scales to identify coping strategies used for FA management by CYP and parents. Planning and preparation appear to be the most adaptive strategies, with avoidance and minimization the least, but managing emotions is also important to promote. Knowledge of the types of coping strategies used by patients could direct clinical care.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 5","pages":"Pages 1165-1174.e9"},"PeriodicalIF":6.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Epinephrine Nasal Spray in the Treatment of Urticaria","authors":"David I. Bernstein MD ,&nbsp;Neetu Talreja MD ,&nbsp;Thomas B. Casale MD ,&nbsp;H. Henry Li MD, PhD ,&nbsp;Michael A. Kaliner MD ,&nbsp;Richard Lowenthal MS ,&nbsp;Sarina Tanimoto MD, PhD","doi":"10.1016/j.jaip.2026.02.010","DOIUrl":"10.1016/j.jaip.2026.02.010","url":null,"abstract":"<div><h3>Background</h3><div>Although current treatment options for acute exacerbations of antihistamine refractory chronic spontaneous urticaria (CSU) are generally considered safe and effective, patients have breakthrough symptoms necessitating treatment. Epinephrine injections were once used for the treatment for acute urticaria or acute exacerbations of chronic urticaria or angioedema, but their use has declined. The development of an intranasal epinephrine spray (ARS-2) offers a needle-free alternative for the treatment of CSU exacerbations.</div></div><div><h3>Objective</h3><div>To assess the efficacy and safety of ARS-2 for the treatment of exacerbations of CSU.</div></div><div><h3>Methods</h3><div>This was a phase 2, single-dose, randomized, placebo-controlled crossover efficacy study in which adult patients (n = 21) experiencing an acute flare or exacerbation of urticaria symptoms were treated with ARS-2 (1 or 2 mg) or placebo. Urticaria symptoms and severity were assessed based on both patient-reported and investigator-rated assessments.</div></div><div><h3>Results</h3><div>Relative to placebo, both 1- and 2-mg doses of ARS-2 resulted in lower patient-reported hive and pruritus scores (<em>P</em> &lt; .05) and a lower investigator-reported extent of urticaria and erythema scores (<em>P</em> &lt; .05). Additionally, a greater percentage of patients receiving ARS-2 were considered by investigators to have been effectively treated. Patient-reported satisfaction scores were also significantly higher for both doses of ARS-2 relative to placebo. Only minor adverse events were reported.</div></div><div><h3>Conclusion</h3><div>ARS-2 may offer a safe and effective treatment option for urticaria exacerbations.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 5","pages":"Pages 1184-1189"},"PeriodicalIF":6.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146214988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation and interpretation of the Pediatric Asthma Treatment Burden Questionnaire: methodological considerations","authors":"Feifan Qiu MM ,&nbsp;Yuwei Gao MD, PhD","doi":"10.1016/j.jaip.2026.03.002","DOIUrl":"10.1016/j.jaip.2026.03.002","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 5","pages":"Page 1209"},"PeriodicalIF":6.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147826713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of In Vivo, In Vitro and Pharmacogenomic Diagnostic Approaches to Sulfonamide Allergy","authors":"","doi":"10.1016/j.jaip.2026.04.001","DOIUrl":"10.1016/j.jaip.2026.04.001","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 5","pages":"Page 1033"},"PeriodicalIF":6.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147826722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stepping up ICS doses in asthma: The crucial roles of relievers, triple therapy, and biomarkers","authors":"Zhigang Hu MD ,&nbsp;Xinyu Song MD ,&nbsp;Fanjun Zeng MSC","doi":"10.1016/j.jaip.2026.03.006","DOIUrl":"10.1016/j.jaip.2026.03.006","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 5","pages":"Pages 1210-1211"},"PeriodicalIF":6.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147826715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methodological challenges in evaluating high-dose ICS escalation","authors":"Kuan-Yang Chen Bpharm ,&nbsp;Su-Boon Yong MD, PhD ,&nbsp;Xiao-Ling Liu PhD ,&nbsp;Chao-Yi Wu MD, PhD ,&nbsp;Chia-Jung Li PhD","doi":"10.1016/j.jaip.2026.03.005","DOIUrl":"10.1016/j.jaip.2026.03.005","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 5","pages":"Pages 1211-1212"},"PeriodicalIF":6.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147826716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of tezepelumab in patients with severe, uncontrolled asthma receiving high-dose inhaled corticosteroids in NAVIGATOR","authors":"Guy Brusselle MD ,&nbsp;Jasper H. Kappen MD ,&nbsp;Katrin Milger MD ,&nbsp;Evelyne Frijns PhD ,&nbsp;Neda Stjepanovic MD ,&nbsp;Claudio Marchese MSc ,&nbsp;Jean-Pierre Llanos MD ,&nbsp;Stephanie L. Roseti MD ,&nbsp;Amit Parulekar MD","doi":"10.1016/j.jaip.2026.01.041","DOIUrl":"10.1016/j.jaip.2026.01.041","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 5","pages":"Pages 1199-1202"},"PeriodicalIF":6.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146196145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inpatient Penicillin Allergy Evaluation—Skin Testing Versus Direct Oral Challenge?","authors":"Deanna L. McDanel PharmD, BCACP ,&nbsp;Elise A. Mitri BPharm, MPharmPrac ,&nbsp;James T. Li MD, PhD ,&nbsp;Knut Brockow MD","doi":"10.1016/j.jaip.2025.12.012","DOIUrl":"10.1016/j.jaip.2025.12.012","url":null,"abstract":"<div><div>Penicillin allergy labels are common among patients needing antibiotic treatment. They impact personal treatment outcomes and have public health implications, particularly in the inpatient setting where there is high utilization of antibiotics. Mislabeled allergies often lead to the use of alternative and less effective antibiotics that cause more side effects and contribute to antimicrobial resistance. Penicillin allergy evaluation typically involves 2 main approaches, penicillin skin testing or direct oral challenge. The choice between these strategies is largely driven by risk stratification, availability of resources, health care provider education and training, and patient and provider comfort with testing procedures. Penicillin skin testing is the historical criterion standard diagnostic approach for all-risk phenotypes with an excellent safety record, although it requires specialized training and resources. Direct oral challenge is simpler and is noninferior in low-risk patients, yet it may carry increased risk if patient selection is not rigorous. Both approaches share the common goal of safely “delabeling” penicillin allergies to optimize antibiotic prescribing yet differ in process and have their own limitations. Widespread and routine penicillin allergy evaluation in inpatient care is integral for successful antibiotic stewardship. This article presents the pros and cons for penicillin skin testing versus direct oral challenge for penicillin allergy evaluation in the inpatient setting.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 5","pages":"Pages 1050-1057"},"PeriodicalIF":6.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating Clinical Modeling and Machine Learning for Risk Assessment of Paracetamol and Other Nonsteroidal Anti-Inflammatory Drug Hypersensitivity in Children","authors":"Cankat Genis MD ,&nbsp;Ozge Yılmaz Topal MD ,&nbsp;Can Ates PhD ,&nbsp;Cagatay Berke Erdas PhD ,&nbsp;Fatma Nur Kuzucu MD ,&nbsp;Kezban İpek Demir MD ,&nbsp;Ahmet Selmanoglu MD ,&nbsp;Zeynep Sengül Emeksiz MD ,&nbsp;Emine Dibek Mısırlıoglu MD","doi":"10.1016/j.jaip.2026.02.018","DOIUrl":"10.1016/j.jaip.2026.02.018","url":null,"abstract":"<div><h3>Background</h3><div>Nonsteroidal anti-inflammatory drug (NSAID) hypersensitivity is a common cause of drug-related reactions in children. Pretest risk stratification may improve the safety and efficiency of drug provocation testing.</div></div><div><h3>Objective</h3><div>To develop a clinically interpretable risk stratification tool (nomogram + simplified score) for pediatric paracetamol and/or other NSAID hypersensitivity and to validate its performance against machine learning (ML) models.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study (2014-2025) of children evaluated for suspected paracetamol and/or other NSAID hypersensitivity. Analyses used the index reaction as the unit, classifying definitive outcomes as NSAID-hypersensitive or NSAID-tolerant. Independent predictors from multivariable logistic regression were used to develop a clinically interpretable risk stratification tool, implemented as a nomogram and a simplified point-based score. were trained. Eight ML models were trained using fivefold cross-validation under three data scenarios (original, matched, and Synthetic Minority Oversampling Technique for Nominal and Continuous Variables).</div></div><div><h3>Results</h3><div>Among 507 index reactions (from 487 children) evaluated for suspected paracetamol and/or other NSAID hypersensitivity, 90 of 507 (17.7%) had confirmed hypersensitivity. Independent predictors were age 82.5 months or older at the time of reaction, coexisting asthma and/or allergic rhinitis, latency between exposure and symptom onset of 60 minutes or less, having angioedema, respiratory symptoms, and hypotension or syncope during the index reaction. The nomogram and simplified point-based score showed strong discrimination (receiver operating characteristic [ROC] area under the curve [AUC] = 0.877) and bedside applicability. After class balancing (Synthetic Minority Oversampling Technique for Nominal and Continuous Variables), ensemble ML achieved top performance: gradient boosting ROC AUC = 0.955, recall = 0.895, and F1 = 0.896; random forest ROC AUC = 0.953, recall = 0.890, and F1 = 0.883; and AdaBoost ROC AUC = 0.940, recall = 0.873, and F1 = 0.874.</div></div><div><h3>Conclusion</h3><div>The nomogram and simplified point-based score provide practical pre-drug provocation testing risk stratification for children evaluated for suspected paracetamol and/or other NSAID hypersensitivity. Ensemble ML can complement the tool by improving sensitivity to minimize false negatives. Multicenter external validation and prospective impact studies are warranted before clinical implementation.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 5","pages":"Pages 1094-1102.e2"},"PeriodicalIF":6.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147322669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Oral Antihistamines for Allergic Rhinitis: Network Meta-Analysis","authors":"Rafael José Vieira PhD ,&nbsp;Sara Gil-Mata MD ,&nbsp;André Ferreira PhD ,&nbsp;Pau Riera-Serra PhD ,&nbsp;Antonio Bognanni MD ,&nbsp;Vítor Henrique Duarte BSc ,&nbsp;Hugo Viegas BSc ,&nbsp;Ana Margarida Pereira MD ,&nbsp;Renato Ferreira-da-Silva PhD ,&nbsp;Henrique Ferreira-Cardoso MD ,&nbsp;Manuel Marques-Cruz PhD ,&nbsp;João Castro-Teles MD ,&nbsp;Miguel Campos-Lopes MD ,&nbsp;Ana Teixeira-Ferreira MD ,&nbsp;Nuno Lourenço-Silva MD ,&nbsp;José Laerte Boechat PhD ,&nbsp;Ewa Borowiack BSc ,&nbsp;Ewelina Sadowska BSc ,&nbsp;Raquel Albuquerque Costa BSc ,&nbsp;Paula Perestrelo MD ,&nbsp;Jaron Zuberbier","doi":"10.1016/j.jaip.2025.12.034","DOIUrl":"10.1016/j.jaip.2025.12.034","url":null,"abstract":"<div><h3>Background</h3><div>Oral H1-antihistamines (OAHs) are among the most frequently used medications for the treatment of allergic rhinitis (AR).</div></div><div><h3>Objective</h3><div>To perform a systematic review and network meta-analysis comparing the efficacy and safety of individual OAHs in patients with AR.</div></div><div><h3>Methods</h3><div>We searched 4 electronic bibliographic databases and 3 clinical trial databases for randomized controlled trials assessing adults with perennial or seasonal AR, and comparing (1) OAH <em>versus</em> placebo or (2) different individual OAHs. We performed a network meta-analysis on the Total Nasal Symptom Score, Total Ocular Symptom Score, Rhinoconjunctivitis Quality-of-Life Questionnaire, development of adverse events, and withdrawals due to adverse events. Certainty of evidence for comparisons involving the most clinically relevant second-generation OAHs was assessed using Grading of Recommendations, Assessment and Evaluation approach to network meta-analysis.</div></div><div><h3>Results</h3><div>We included 74 randomized controlled trials (21 on perennial AR and 53 on seasonal AR). Cetirizine, ebastine, bilastine, and rupatadine were among the individual medications associated with the highest efficacy for improving nasal symptoms. For other efficacy outcomes, the most efficacious interventions varied. A similar frequency of adverse events was observed among different individual second-generation OAHs, with serious adverse events being rare. For most comparisons, the certainty of evidence was rated as “low” or “very low,” indicating substantial uncertainty regarding the treatment effects.</div></div><div><h3>Conclusions</h3><div>Although some OAHs seem to be more efficacious than others, most of the differences between individual second-generation medications are trivial or small. In addition, we did not find any relevant differences in the safety profiles of second-generation OAHs.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 5","pages":"Pages 1175-1183"},"PeriodicalIF":6.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146221929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}