Allergy and asthma proceedings最新文献

{"title":"Allergen immunotherapy: How to stay current with USP 797 and practice guidelines.","authors":"Maureen M Petersen","doi":"10.2500/aap.2025.46.240078","DOIUrl":"10.2500/aap.2025.46.240078","url":null,"abstract":"<p><p><b>Background:</b> The United States Pharmacopeia (USP) Chapter 797 provides critical standards for compounding sterile preparations to ensure patient safety and medication efficacy. The latest revision, effective November 1, 2023, introduces updates particularly relevant to the compounding of allergenic extracts, which emphasizes stringent compliance measures. <b>Objective:</b> This article aims to review the key updates to USP Chapter 797, outline the compliance requirements for personnel and facilities, and offer strategies for staying current with these practice guidelines, leveraging resources from professional organizations such as American College of Allergy, Asthma, and Immunology and American Academy of Allergy, Asthma, and Immunology. <b>Methods:</b> An extensive review of the updated USP Chapter 797 guidelines was conducted, along with supplementary research from professional resources and literature to provide a comprehensive overview of the new standards and best practices for compliance. <b>Results:</b> The updated USP Chapter 797 mandates comprehensive training and competency testing for compounding personnel, facility maintenance and documentation standards, and robust quality assurance protocols to minimize contamination and ensure the efficacy of compounded allergenic extracts. Key requirements include enhanced personnel hygiene and garbing requirements, facility maintenance protocols, and detailed documentation practices. <b>Conclusion:</b> Staying current with USP Chapter 797 and practice guidelines is crucial for allergists and immunotherapy practitioners to ensure high standards of patient care and safety. By understanding the key updates, complying with personnel and facility requirements, leveraging professional resources, and adopting standardized practices, health-care providers can effectively navigate the evolving regulatory landscape. Continuous education and adherence to quality assurance protocols will further support compliance and enhance patient outcomes in allergen immunotherapy.</p>","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"46 1","pages":"26-31"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world surveillance of standardized quality (SQ) house dust mite sublingual immunotherapy tablets for 3 years in Japan.","authors":"Minoru Gotoh, Yuriko Maekawa, Shiori Saito, Noboru Kato, Eiji Horikawa, Noriaki Nishino","doi":"10.2500/aap.2025.46.240092","DOIUrl":"10.2500/aap.2025.46.240092","url":null,"abstract":"<p><p><b>Background:</b> Standardized quality (SQ) house-dust mite (HDM) sublingual immunotherapy tablets (10,000 Japanese allergy units [JAU], equivalent to 6 SQ-HDM in Europe and the United States) are licensed for the treatment of HDM-induced allergic rhinitis (AR) without age restriction, based on 52-week administration clinical trials. There are no large-scale data on the administration of 10,000 JAU for > 1 year in actual clinical practice. <b>Objective:</b> To examine the safety and effectiveness of 10,000 JAU during use for up to 3 years at real-world clinical sites in Japan. <b>Methods:</b> This survey was a multicenter, observational, prospective study. We assessed the safety and effectiveness of the long-term administration of 10,000 JAU as well as effectiveness after its discontinuation in patients with HDM AR with an observation period of 3 years. <b>Results:</b> The safety analysis included 815 patients, and the effectiveness analysis included 768 patients. Adverse reactions that occurred in 144 patients (17.67%) were mainly site-related events that occurred early in the dosing period. Serious adverse reactions were dyspnea and anaphylactic reaction in one patient each, and both patients recovered. With regard to effectiveness, compared with scores before the administration of SQ-HDM, nasal symptom scores decreased, depending on the administration period, from 6 months to 3 years. Overall, 67.34% of the patients had improved quality of life after 6 months, and this improvement continued after 12 months. The proportion of patients with \"improved and slightly improved\" of overall improvement exceeded 90% after 2 years. Treatment discontinuation because \"symptoms disappeared\" occurred in 24.42% of the patients at 3 years. Patients who discontinued 10,000 JAU (<i>n</i> = 39) had a sustained improvement in nasal symptom scores compared with baseline, even 1 year after discontinuing treatment. <b>Conclusion:</b> The real-world safety and effectiveness of 10,000 JAU SQ-HDM sublingual immunotherapy tablets were confirmed in Japanese patients with HDM AR. No new safety and effectiveness precautions were required.</p>","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"46 1","pages":"59-69"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142908989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Idiopathic non-mast cell angioedema: Treatment insights from global experts.","authors":"Sandra C Christiansen, Bruce L Zuraw","doi":"10.2500/aap.2025.46.240091","DOIUrl":"10.2500/aap.2025.46.240091","url":null,"abstract":"<p><p><b>Background:</b> Idiopathic non-mast cell angioedema (INMA) is a rare disease typified by recurrent attacks of cutaneous and subcutaneous swelling. Every attack carries the potential for severe morbidity and, in the case of laryngeal involvement, mortality. Whereas therapies approved for hereditary angioedema (HAE) have been used in the care of patients with INMA, little is known with regard to their efficacy for the treatment of this disease. <b>Objective:</b> The objective was to gather evidence from global experts, ranking their assessment of on-demand therapy (ODT) and long-term prophylactic (LTP) treatment efficacy for INMA. <b>Methods:</b> A survey was developed and distributed to international experts invited to attend a 2023 symposium. INMA was diagnosed by standardized criteria. Linkert scales were used to rate the efficacy for ODT and LTP therapy. Enrollment was closed after 1 month and the data were analyzed. <b>Results:</b> Surveys were distributed to 31 experts from 16 countries with a 77% response rate (n = 24) reporting on 300 patients with INMA. Efficacy rankings of ODT were the following: icatibant (14 experts with 93 treated patients), 46.2% high and 38.7% moderate; and plasma-derived C1 inhibitor (C1INH) (13 experts with 31 treated patients), 32.3% moderate and 45.2% mild. Efficacy rankings of LTP were the following: antifibrinolytics (11 experts with 52 treated patients), 23.1% high and 38.5% moderate; lanadelumab (5 experts with 19 treated patients), 21% high and 79% moderate; and subcutaneous C1INH (3 experts with 19 treated patients), 21.1% moderate and 79.0% mild. LTP efficacy was also recorded for berotralstat and progestin. <b>Conclusion:</b> Icatibant (ODT) and either antifibrinolytics or lanadelumab (LTP) were ranked as the most efficacious treatments for the patients with INMA (among medications with at least five treated patients) by the expert physicians. Progestins, berotralstat, and plasma derived C1INH each demonstrated a favorable prophylactic effect; however, broader experience will be required to formulate overall recommendations.</p>","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"46 1","pages":"38-44"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142908986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health disparities investigated in a primary care penicillin allergy removal pathway.","authors":"David Mari, Kelley Henson, William Day, Andrea Mcglynn, Taylor Banks","doi":"10.2500/aap.2025.46.240079","DOIUrl":"10.2500/aap.2025.46.240079","url":null,"abstract":"<p><p><b>Background:</b> Unconfirmed penicillin allergies over time lead to poor health outcomes and increased health-care cost. Health disparities (HD) can create barriers in optimizing penicillin allergy care. <b>Objective:</b> The objective was to characterize HDs in our primary care-led amoxicillin challenge (PLAC) delabeling pathway within a universal coverage health care system. <b>Methods:</b> In three outpatient clinic sites, 41,104 patients were screened, and 1,749 patients were discovered to have penicillin allergies. Of the 1,749 patients with penicillin allergy, 336 (ages 4 months to 76 years) were determined to be candidates for PLAC. A retrospective chart review was completed after 1 year of PLAC implementation to compare demographic characteristics and HD core categories (neighborhood living type, economic stability, background education status, and access to care) between those who completed and those who did not complete their PLAC appointment. All candidates underwent the same PLAC protocol and had universal health coverage that reduced health cost. <b>Results:</b> Of 336 PLAC candidates (45.8%), 154 presented for their PLAC appointment and had their penicillin allergy removed without adverse outcomes. One hundred and eighty-two candidates (54.2%) did not complete a PLAC appointment and retained their penicillin allergy label. Candidates who did not complete their PLAC appointment were older (p = 0.001) and white (p = 0.006), and did not identify as officers (p = 0.04). There was no significant difference in neighborhood type or gender between the groups. In candidates ages ≥ 19 years, those without proactively scheduled appointments more commonly (p < 0.001) did not complete their PLAC appointment; whereas proactive scheduling increased delabeling from 5.8% to 91.3% in candidates ages ≥ 19 years. Of the 199 candidates with proactively scheduled PLAC appointments, those with less perceived economic stability and background education status (enlisted members) were more likely not to attend their PLAC appointment (p < 0.001). <b>Conclusion:</b> Results of our study suggest that our PLAC protocol provides a foundation of decreased HDs to successfully delabel patients at low risk of penicillin allergy when scheduling appointments for all and controlling for health-care cost.</p>","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"46 1","pages":"52-58"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142908790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical remission in patients with severe eosinophilic asthma treated with mepolizumab: A <i>post-hoc</i> analysis of RELIght study.","authors":"Andriana I Papaioannou, Maria Kallieri, Eleftherios Zervas, Evangelia Fouka, Konstantinos Porpodis, Marija Hadji Mitrova, Eleni Tzortzaki, Michael Makris, Maria Ntakoula, Panagiotis Lyberopoulos, Katerina Dimakou, Sofia Koukidou, Sevasti Ampelioti, Anastasia Papaporfyriou, Konstantinos Katsoulis, Maria Kipourou, Nikoletta Rovina, Katerina Antoniou, Stylianos Vittorakis, Petros Bakakos, Paschalis Steiropoulos, Katerina Markopoulou, Panteleimon Avarlis, Ιlias C Papanikolaou, Miltiadis Markatos, Eleni Gaki, Konstantinos Samitas, Konstantinos Glynos, Spyros A Papiris, Despoina Papakosta, Nikolaos Tzanakis, Mina Gaga, Konstantinos Kostikas, Stelios Loukides","doi":"10.2500/aap.2025.46.240084","DOIUrl":"10.2500/aap.2025.46.240084","url":null,"abstract":"<p><p><b>Background:</b> Remission of asthma can occur as part of the natural history of the disease; however, the use of biologics can result in disease remission in some patients. <b>Objective:</b> In this post hoc analysis of the RELIght study, we aimed to evaluate clinical remission in real life among patients treated with mepolizumab, to detect possible differences between \"remitters\" and \"nonremitters,\" and to evaluate possible predictors of remission. <b>Methods:</b> Clinical remission was defined as the absence of asthma exacerbations, discontinuation of oral corticosteroids (OCS), achievement of asthma control (Asthma Control Test [ACT] ≥ 20), and stable or improved lung function. <b>Results:</b> A total of 146 patients were evaluated; remission was achieved in 40 (27.4%) and 29 (22%) after 12 and 24 months, respectively. At 12 months, the patients in remission had a better baseline ACT score (17.0 [14.0-19.0] versus 15.0 [12.0-17.0]; p = 0.027), were more rarely using OCS (35% versus 62.2%; p = 0.004), and required a lower baseline dose of OCS (5.0 mg/day [5.0-10.0 mg/day] versus 10.0 mg/day [5.0-15.0 mg/day]; p = 0.042) at baseline, whereas, at 24 months, they less frequently carried a baseline diagnosis of gastroesophageal reflux disease (GERD) (10.3% versus 32%; p = 0.031) and used lower doses of OCS at baseline (5.0 [1.0-5.0] versus 10.0 [5.0-15.0]; p = ≤0.001) versus nonremitters; 52.5% of patients had sustained remission, whereas 42.5% experienced relapse. These patients more frequently had GERD versus patients with sustained remission (52.9% versus 4.8%; p = 0.002). Finally, regression analysis has shown that GERD was the only predictor of relapse. <b>Conclusion:</b> Remitters had better asthma control and needed lower doses or no maintenance OCS at baseline, whereas GERD seems to be an important factor that affects remission and relapse.Clinical trial NCT04084613, <ext-link xmlns:xlink=\"http://www.w3.org/1999/xlink\" ext-link-type=\"uri\" xlink:href=\"http://www.clinical trials.gov\">www.clinical trials.gov</ext-link>.</p>","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"46 1","pages":"45-51"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142908837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Studies of methylated CpG ODN from <i>Bifidobacterium longum</i> subsp. <i>infantis</i> in a murine model: Implications for treatment of human allergic disease.","authors":"Dongmei Li, Sharareh Sorkhabi, Idalia Cruz, Patricia L Foley, Joseph A Bellanti","doi":"10.2500/aap.2025.46.240100","DOIUrl":"10.2500/aap.2025.46.240100","url":null,"abstract":"<p><p><b>Background:</b> Allergen immunotherapy (AIT) is currently the most effective immunologic form of treatment for patients with atopic allergic diseases commonly used by allergist/immunologists to reduce allergic symptoms by gradually desensitizing the immune system to specific allergens. Currently, the primary mechanism of AIT emphasizes the crucial role of immune regulation, which involves a shift from a T-helper type 2 (Th2) cell response, which promotes allergy, to a T-regulatory (Treg) cell population, which inhibits the allergic inflammatory response through the production of immunosuppressive cytokines interleukin 10 and transforming growth factor β, which play pivotal roles in suppressing the allergic reaction. In a series of previous in vitro and in vivo experiments, we have demonstrated the capacity of synthetic methylated cytosine-phosphate-guanine (CpG) oligodeoxynucleotide (ODN) moieties as well as methylated genomic DNA ODN motifs from Bifidobacterium longum subspecies infantis to activate Treg cell differentiation in contrast to the unmethylated ODN moiety, which promotes proinflammatory responses driven by Th17-mediated responses. <b>Objective:</b> The purpose of the present study was to continue exploring the reciprocally related effects of methylated and unmethylated forms of DNA motifs from B. longum subspecies infantis on inflammation, specifically focusing on evaluating their capacity to alleviate allergic symptoms in a murine allergic disease model. <b>Results:</b> We show that methylated CpG moieties (ODNA) inhibit inflammation by stimulating Treg cells whereas unmethylated CpG moieties (ODNB) promote inflammation through Th1/Th17 pathways. <b>Conclusion:</b> Analysis of our data confirms and extends our previous research on the mechanisms by which methylated and unmethylated forms of DNA motifs influence inflammation. Specifically, the findings demonstrate that methylated CpG moiety (OVA + ODNA) inhibits inflammation by stimulating Treg cells, whereas unmethylated CpG moiety (OVA + ODNB) promotes inflammation through Th1/Th17 pathways. Consequently, these effects were shown to alleviate or to exacerbate allergic symptoms in a murine model of allergic disease. These results set the stage for future clinical trials and studies in humans to explore the therapeutic potential of targeting CpG motifs in the treatment of allergic diseases.</p>","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"46 1","pages":"e13-e23"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142908991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of parenteral bronchodilators on ventilatory outcomes in pediatric critical asthma: a national cohort study.","authors":"Jonathan M Gabbay, Michael D Fishman, Benjamin V M Bajaj, Cara S Guenther, Robert J Graham, Jennifer M Perez","doi":"10.2500/aap.2025.46.240099","DOIUrl":"10.2500/aap.2025.46.240099","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the association of parenteral epinephrine and terbutaline use on ventilatory support in children admitted to the intensive care unit (ICU) with critical asthma in the United States. <b>Methods:</b> Data were obtained from the Pediatric Health Information System data base for children ages 2 to 18 years admitted to the ICU with a diagnosis of asthma exacerbation from January 1, 2016, to December 31, 2023. The primary outcomes included noninvasive ventilation (NIV) and/or invasive mechanical ventilation (IMV) use after receipt of terbutaline and/or epinephrine. Secondary outcomes included serious adverse events from parenteral bronchodilators, including arrhythmias and elevated troponins. <b>Results:</b> Our study population included 53,328 patient encounters. Terbutaline and epinephrine were associated with decreased odds of subsequent NIV (terbutaline: odds ratio [OR] 0.52 [95% confidence interval {CI}, 0.44-0.63], p < 0.001; and epinephrine: OR 0.49 [95% CI, 0.43-0.55], p  < 0.001) and subsequent IMV (terbutaline: OR 0.51 [95% CI, 0.42-0.61], p < 0.001; and epinephrine: OR 0.34 [95% CI, 0.29-0.41], p < 0.001). There were no differences in adverse events in the terbutaline group when compared with the epinephrine group for both arrhythmia and elevated troponins (arrhythmia: terbutaline = 1.9%, epinephrine = 1.7%; p = 0.6; and elevated troponins: terbutaline = 0.1%, epinephrine = 0.1%, p  > 0.9). <b>Conclusion:</b> Parenteral bronchodilator use was associated with decreased odds of receiving subsequent ventilatory support in critical asthma. There were low rates of arrhythmia and elevated troponin overall. Our findings should inform future clinical trials to evaluate the use of parenteral bronchodilators in critical asthma in the United States.</p>","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"46 1","pages":"e6-e12"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142908840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of allergic diseases in children diagnosed with cutaneous mastocytosis.","authors":"Hatice Irmak Celik, Funda Aytekin Guvenir, Zeynep Sengul Emeksiz, Emine Dibek Misirlioglu","doi":"10.2500/aap.2025.46.240093","DOIUrl":"10.2500/aap.2025.46.240093","url":null,"abstract":"<p><p><b>Background:</b> Cutaneous mastocytosis (CM) is the most common type of mastocytosis in children. The atopy frequency in these patients is typically similar to that in the general population, but a higher incidence of anaphylaxis is reported. <b>Objective:</b> This study aimed to evaluate the presence of allergic diseases in children diagnosed with CM and its impact on clinical manifestations. <b>Methods:</b> Children diagnosed with CM at Ankara Bilkent City Hospital Pediatric Allergy and Immunology Clinic between September 2019 and September 2023 were included in the study. Data, including demographic information, clinical details, and laboratory results, were gathered from medical records, encompassing personal and family allergy history. <b>Results:</b> The study included 58 patients (median [interquartile range{IQR}] age, 64 months [29-100.5 months]; 69% boys) with skin lesions as the primary concern. The median (IQR) age at which the lesions appeared was 9 months (3-39.25 months), and the median (IQR) age at hospital admission was 12 months (5- 50 months). The median (IQR) age at CM diagnosis was 13 months (6-53.5 months). The median (IQR) baseline tryptase value was 5.45 μg/L (3.93-9.00 μg/L), and 16 had an elevated tryptase value (>8 μg/L). Allergic diseases were present in 39.65% of the patients, with atopic dermatitis (18.9%) being the most common, followed by asthma (10.3%), allergic rhinitis (5.2%), food allergy (1.7%), and drug and bee venom allergies (1.7%). One patient had a history of anaphylaxis, diagnosed 4 months after consuming yogurt. A total of 18 patients, including this patient, were prescribed an adrenaline autoinjector. <b>Conclusion:</b> Various allergic diseases occurred in ∼40% of patients with CM and most commonly manifest as atopic dermatitis; 31% patients with risk factors for anaphylaxis were prescribed an adrenaline autoinjector.</p>","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"46 1","pages":"e1-e5"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142908854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring mast cell disorders: Tryptases, hereditary alpha-tryptasemia, and MCAS treatment approaches.","authors":"Joseph A Bellanti, Russell A Settipane","doi":"10.2500/aap.2025.46.240102","DOIUrl":"10.2500/aap.2025.46.240102","url":null,"abstract":"","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"46 1","pages":"1-3"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142908788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic review of omalizumab for refractory clonal and non-clonal mast cell activation syndrome.","authors":"Meghan V Matheny, Timothy Craig, Taha Al-Shaikhly","doi":"10.2500/aap.2025.46.240076","DOIUrl":"10.2500/aap.2025.46.240076","url":null,"abstract":"<p><p><b>Background:</b> Patients with mast cell activation syndrome (MCAS) can be refractory to standard antimediator therapy. Alternative treatment options to reduce disease burden and improve quality of life are needed. <b>Objective:</b> To compile the evidence that supports the use of omalizumab for patients with refractory MCAS. <b>Methods:</b> Through a systematic review of the PubMed database, we compiled and analyzed the characteristics of patients with refractory MCAS, unresponsive to histamine 1 receptor antihistamines plus another antimediator agent (refractory MCAS), and who were treated with omalizumab. We categorized the clinical response to omalizumab as no, partial, or complete response. <b>Results:</b> We identified nine studies that described a total of 28 patients (median age, 48 years; males, 54%) with refractory MCAS. Twenty-one patients (75%) had nonclonal MCAS, and seven patients (25%) had clonal MCAS. The omalizumab dose ranged from 150 mg every 4 weeks to 300 mg every 3 weeks, with the most common dose being 150 mg every 2 weeks. Most patients had a partial response (61%), and five patients achieved a complete response. Omalizumab was successful in ameliorating anaphylaxis and allowed for discontinuation of systemic glucocorticoids in two of three patients. The response pattern was not influenced by sex or mast cell clonality, but a complete response was reported more commonly among receivers of a higher omalizumab dose (≥300 mg/month). No major adverse events were reported. <b>Conclusion:</b> The majority of patients with refractory MCAS reported in the literature had a reduction in mast cell mediator-related symptoms with the addition of omalizumab.</p>","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"46 1","pages":"11-18"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142908993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}