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Letter to the Editor—Re: Sabouraud-Leclerc D, Mariotte D, Bradatan E, et al. Food Anaphylaxis: Eight Food Allergens Without Mandatory Labelling Highlighted by the French Allergy-Vigilance Network. Clinical and Experimental Allergy. 2025;0:1–8. Doi: 10.1111/cea.70130 致编辑的信re: Sabouraud-Leclerc D, Mariotte D, Bradatan E,等。食物过敏反应:没有强制性标签的八种食物过敏原由法国过敏警惕网络强调。临床与实验变态反应。2025;0:1-8。Doi: 10.1111 / cea.70130。
IF 5.2 2区 医学 Q1 ALLERGY Pub Date : 2025-11-20 DOI: 10.1111/cea.70179
Scott P. Commins, Tilo Biedermann, Sarah K. McGill, Carin Ottosson, Marija Perusko, Eleanor F. Saunders, Marianne van Hage
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引用次数: 0
Comment on ‘Identification of the Top 15 Drugs Associated With Anaphylaxis: A Pharmacovigilance Study’ 对“鉴定与过敏反应相关的前15种药物:一项药物警戒研究”的评论。
IF 5.2 2区 医学 Q1 ALLERGY Pub Date : 2025-11-20 DOI: 10.1111/cea.70180
Hinpetch Daungsupawong, Viroj Wiwanitkit
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引用次数: 0
Identifying and Prioritising BSACI Service Standards for Paediatric Allergy in the United Kingdom 确定和优先考虑英国儿科过敏的BSACI服务标准。
IF 5.2 2区 医学 Q1 ALLERGY Pub Date : 2025-11-16 DOI: 10.1111/cea.70176
Paul J. Turner, Elizabeth Angier, Karen Brunas, Sarah Burrell, Max Chisholm, Emily Derrick, Matt Doyle, Catrina Drummond, Helen Evans-Howells, Adam Fox, Mudiyur Gopi, Nasreen Khan, Susan Leech, Sian Ludman, Nick Makwana, Tom Marrs, Karina Montagni, Sophie Padua, Nandinee Patel, George Raptis, Ella Stoneham, Deepan Vyas, Amena Warner, Simon Williams, Katherine Cowan

Background

Demand for paediatric allergy services has risen significantly over the past 20 years. National health datasets suggest almost 40% of children have an allergy diagnosis. Existing service standards from the Royal College of Paediatrics and Child Health (RCPCH) have focused on specific disease care pathways and the interface between primary and secondary care services. Given strategic changes to NHS children and young people's services, we undertook a collaborative project between RCPCH and the British Society of Allergy and Clinical Immunology (BSACI) to define service priorities for Paediatric Allergy Care accreditation in the UK.

Methods

A BSACI working group developed 29 potential service standards. A consultation was then undertaken amongst BSACI members to identify indicative priorities. Potential standards were then prioritised using methodology adapted from the James Lind Alliance, by 24 stakeholders representing patients/patient groups (9), commissioners (2) and healthcare professionals (13).

Results

Seventeen strategic priorities were identified, under the following 6 themes: service delivery, prevention, diagnostics, management, communication, maintaining standards/education. These included: setting a minimum staffing mix for multidisciplinary teams providing paediatric allergy care (medical specialist(s), specialist nurse, dietitian, health psychologist); prompt recognition and management of complex, multisystem allergic disease; working within a regional network to ensure access to specialist paediatric allergy services; use of integrated care pathways and supporting primary care accordingly; supporting early access to interventions proven to reduce the risk of atopic disease (with consideration to potential barriers to access, including language, cultural, socioeconomic factors and other communication barriers); offering a referral pathway for disease-modifying treatment where appropriate and effective transitioning to adult care.

Conclusions

These priorities form a basis for the delivery of high-quality care to children and young people affected by allergic disease.

背景:对儿科过敏服务的需求在过去20年中显著上升。国家健康数据显示,近40%的儿童被诊断为过敏。皇家儿科和儿童健康学院(RCPCH)现有的服务标准侧重于特定的疾病护理途径以及初级和二级保健服务之间的接口。鉴于NHS儿童和青少年服务的战略变化,我们在RCPCH和英国过敏和临床免疫学学会(BSACI)之间开展了一个合作项目,以确定英国儿科过敏护理认证的服务重点。方法:BSACI工作组制定了29项潜在服务标准。然后在BSACI成员之间进行了协商,以确定指示性优先事项。随后,代表患者/患者群体(9人)、专员(2人)和医疗保健专业人员(13人)的24名利益相关方采用詹姆斯·林德联盟(James Lind Alliance)改编的方法对潜在标准进行了优先排序。结果:在以下6个主题下确定了17个战略重点:服务提供、预防、诊断、管理、沟通、维持标准/教育。这些措施包括:为提供儿科过敏治疗的多学科小组(医学专家、专科护士、营养师、健康心理学家)设定最低人员配置组合;及时识别和管理复杂的多系统过敏性疾病;在区域网络内开展工作,确保获得儿科过敏专科服务;采用综合护理途径并相应地支持初级保健;支持及早获得经证明可减少特应性疾病风险的干预措施(考虑到可能存在的获取障碍,包括语言、文化、社会经济因素和其他沟通障碍);提供转诊途径,在适当和有效过渡到成人护理的疾病改善治疗。结论:这些优先事项构成了向受过敏性疾病影响的儿童和青少年提供高质量护理的基础。
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引用次数: 0
Barriers to Seeking Mental Health Services for Atopic Dermatitis Patients and Caregivers. 特应性皮炎患者和护理人员寻求心理健康服务的障碍
IF 5.2 2区 医学 Q1 ALLERGY Pub Date : 2025-11-15 DOI: 10.1111/cea.70178
Allison R Loiselle, Courtney A Chau, Jessica K Johnson, Jennifer LeBovidge, Lynda Schneider, Wendy Smith Begolka
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引用次数: 0
Assessment of the Effectiveness of Allergic Rhinitis Medications Using a Target Trial Emulation Approach Based on Mobile Health Data 基于移动健康数据的目标试验模拟方法评估过敏性鼻炎药物的有效性
IF 5.2 2区 医学 Q1 ALLERGY Pub Date : 2025-11-09 DOI: 10.1111/cea.70173
Nuno Lourenço-Silva, Bernardo Sousa-Pinto, Antonio Bognanni, Matteo Martini, Michal Ordak, Giovanni Paoletti, Sara Gil-Mata, Rita Amaral, Anna Bedbrook, Patrizia Bonadonna, Luisa Brussino, G. Walter Canonica, João Coutinho-Almeida, Alvaro A. Cruz, Wienczyslawa Czarlewski, Mark Dykewicz, Mattia Giovannini, Bilun Gemicioglu, Juan Carlos Ivancevich, Ludger Klimek, Violeta Kvedariene, Desiree E. Larenas-Linnemann, Manuel Marques-Cruz, André Moreira, Marek Niedoszytko, Ana Margarida Pereira, Nikolaos G. Papadopoulos, Nhân Pham-Thi, Frederico S. Regateiro, Sanna K. Toppila-Salmi, Boleslaw Samolinski, Joaquin Sastre, Luís Taborda-Barata, Tuuli Thomander, Ilgım Vardaloğlu Koyuncu, Arunas Valiulis, Leticia de las Vecillas, Maria Teresa Ventura, Jolanta Walusiak-Skorupa, Yi-Kui Xiang, Oliver Pfaar, João A. Fonseca, Torsten Zuberbier, Holger J. Schünemann, Danilo di Bona, Jean Bousquet, Rafael José Vieira
<p>Randomised controlled trials (RCTs) are the paradigm for questions on causal inference but often face challenges in generalisability due to strict eligibility criteria. In allergic rhinitis (AR), this limitation is particularly relevant, with RCTs on AR displaying an overrepresentation of patients with severe disease and not providing sufficiently detailed information on the impact of comorbidities on treatment effectiveness [<span>1-4</span>]. Mobile health (mHealth) applications provide an opportunity to collect large-scale patient-reported data that can complement traditional trial evidence and broaden our understanding of treatment effectiveness in routine care [<span>5</span>]. However, to adequately use mHealth data for that purpose, approaches to adequately deal with confounding must be applied.</p><p>In this study, we aimed to use mHealth data to compare the short-term effectiveness of three common AR medication classes: oral antihistamines (OAH), intranasal corticosteroids (INCS), and fixed-combination intranasal antihistamine plus corticosteroid sprays (INAH+INCS). In particular, we aimed to compare these three medication classes on symptom relief within 24 h, while also exploring whether treatment effects differed according to the presence of self-reported comorbid asthma. To deal with confounding, we applied a target trial emulation approach [<span>6</span>].</p><p>A full description of the Methods is available on https://doi.org/10.5281/zenodo.17215607. We included adult users of the MASK-air app with self-reported AR. MASK-air is a validated app that allows daily reporting of AR symptoms on visual analogue scales (VAS) together with medication use. We included users who completed symptom assessments before and after taking one of the aforementioned medication classes, within a 24-h interval. Measurements less than 60 min apart were excluded. Outcomes were changes in global, nasal, ocular, and asthma-related symptoms (VAS, 0–100).</p><p>To address confounding, we used inverse probability of treatment weighting based on pre-treatment symptom scores, age, sex, ARIA severity score, and asthma status. We then estimated average treatment effects using Bayesian mixed-effects regression models, with patient and month of the year as random effects [<span>7, 8</span>].</p><p>A full description of the Results is available on https://doi.org/10.5281/zenodo.17215607. A total of 648 treatment days were analysed, with a median participant age of 37 years; 37.8% reported asthma. The median interval between pre- and post-medication entries was 480 min (IQR = 568). Most treatment days involved OAH (64.2%), followed by INCS (25.5%) and INAH+INCS (10.3%).</p><p>Compared with OAH, both INCS and INAH+INCS were associated with significantly greater improvements in global symptoms (mean VAS difference = −4.25 [95% CrI = −6.69, −1.15] and −7.27 [−10.30, −4.07], respectively) (Table 1). Both also improved ocular symptoms, while INCS showed superiority ove
随机对照试验(RCTs)是因果推理问题的范式,但由于其严格的资格标准,往往面临普遍性的挑战。在变应性鼻炎(AR)中,这一限制尤为重要,关于AR的随机对照试验显示,严重疾病患者的比例过高,并且没有提供足够详细的信息,说明合并症对治疗效果的影响[1-4]。移动医疗(mHealth)应用程序提供了收集大规模患者报告数据的机会,这些数据可以补充传统的试验证据,并扩大我们对常规护理治疗有效性的理解。然而,为了充分利用移动健康数据,必须采用适当处理混淆的方法。在这项研究中,我们旨在使用mHealth数据来比较三种常见AR药物类别的短期疗效:口服抗组胺药(OAH)、鼻内皮质类固醇(INCS)和鼻内抗组胺药加皮质类固醇喷雾剂(INAH+INCS)。特别是,我们的目的是比较这三种药物在24小时内的症状缓解,同时也探索治疗效果是否因自我报告的共病哮喘的存在而不同。为了处理混杂,我们采用了目标试验仿真方法[6]。这些方法的完整描述可在https://doi.org/10.5281/zenodo.17215607上获得。我们纳入了自我报告AR的MASK-air应用程序的成年用户。MASK-air是一款经过验证的应用程序,允许在视觉模拟量表(VAS)上每天报告AR症状以及药物使用情况。我们纳入了在服用上述药物之前和之后24小时内完成症状评估的用户。间隔小于60分钟的测量被排除在外。结果是全身、鼻、眼和哮喘相关症状的变化(VAS, 0-100)。为了消除混淆,我们使用了基于治疗前症状评分、年龄、性别、ARIA严重程度评分和哮喘状态的治疗加权逆概率。然后,我们使用贝叶斯混合效应回归模型估计平均治疗效果,将患者和月份作为随机效应[7,8]。有关结果的完整描述可在https://doi.org/10.5281/zenodo.17215607上获得。总共分析了648个治疗日,参与者的中位年龄为37岁;37.8%报告哮喘。用药前后记录的中位间隔为480 min (IQR = 568)。大多数治疗天数涉及OAH(64.2%),其次是INCS(25.5%)和INAH+INCS(10.3%)。与OAH相比,INCS和INAH+INCS均与整体症状的显著改善相关(平均VAS差异分别为- 4.25 [95% CrI = - 6.69, - 1.15]和- 7.27[- 10.30,- 4.07])(表1)。两者都能改善眼部症状,而INCS在鼻症状方面优于OAH(表1)。在哮喘患者中,INAH+INCS提供了比单独使用INCS更大的整体症状缓解(平均VAS差异= - 6.64,95% CrI = - 12.0, - 0.17),而在非哮喘患者中,联合使用比INCS更差(平均VAS差异= 5.09,95% CrI = - 5.39, 13.3)。本研究证明了将因果推理方法应用于移动健康数据以评估AR患者治疗效果的可行性。据我们所知,本研究首次使用患者生成的移动健康数据应用目标试验模拟方法。这种方法允许观测数据集模拟假设随机对照试验的关键组成部分,从而加强因果推理,同时利用所谓“现实世界”证据的包容性和生态有效性。我们的研究结果更倾向于鼻内治疗而不是OAH来控制症状。值得注意的是,我们观察到哮喘状态的差异反应。这表明潜在的炎症表型可能会改变治疗反应,在调整AR管理时应考虑哮喘合并症。然而,这一假设应该得到未来研究的证实。我们的发现应该考虑到一些局限性来解释。首先,国家层面的代表性不均衡,这反映了应用的使用模式。然而,我们的分析旨在通过关注针对关键混杂因素调整的个人水平效应来减轻这种影响。其次,我们承认不同的评估药物类别具有不同的药效学。例如,INCS的完全抗炎作用需要几天的时间。然而,(i)对于大多数参与者来说,评估的当天并不是他们第一次用药,(ii)我们检测到的短期改善与先前的证据一致,表明某些分子在7-12小时内出现临床作用(值得注意的是,在我们的研究中,我们检测到第一次和第二次观察之间的中位数间隔为8小时)。 最有趣的观察结果——基于哮喘状态的联合治疗(INAH+INCS)的差异反应——目前还没有明确的机制解释。因此,我们提出这是一个探索性的、产生假设的发现,值得进一步调查,因为它可能受到未测量的表型差异、依从模式或亚组内样本量限制的影响。最后,虽然任何有多重比较的研究都必须考虑偶然发现的可能性,但我们的贝叶斯框架通过提供治疗优势的概率来降低这种风险,提供比单独依赖p值更细致的解释。总之,这项研究表明,移动健康数据可以成功地用于模拟试验和评估现实世界条件下的增强现实治疗。鼻内治疗(INCS和INAH+INCS)在整体和眼部症状缓解方面比OAH更有效。观察到的与哮喘状态相关的影响,特别是对于INAH+INCS,是一个值得进一步调查的新发现,可以帮助完善指南建议。未来的研究应该将这种方法扩展到更长的随访期、更大的数据集和更多的治疗策略,以继续弥合RCT和观察证据之间的差距。、每分钟。和R.J.V.参与了研究设计、数据分析和撰写手稿初稿。a.b., D.B.和J.B.参与了研究设计方法,并撰写了手稿的初稿。m.m., m.o., G.P.和H.J.S.参与了手稿的方法论和批判性审查。所有剩余的作者都参与了数据收集和手稿的批判性审查。Jean Bousquet报告了Cipla, Menarini, Mylan, Novartis, Purina, Sanofi-Aventis, Teva, Noucor的个人费用,其他来自KYomed-Innov,其他来自Mask-air-SAS,提交的工作之外。Oliver Pfaar报告ALK-Abelló的拨款和个人费用、Allergopharma的拨款和个人费用、Stallergenes Greer的拨款和个人费用、HAL Allergy Holding B.V./HAL Allergie GmbH的拨款和个人费用、ben卡德Allergie GmbH/Allergy Therapeutics的拨款和个人费用、Laboratorios LETI/LETI Pharma的拨款和个人费用、葛兰素史克的拨款和个人费用、ROXALL Medizin的个人费用、诺华的个人费用、葛兰素史克的拨款和个人费用。赛诺菲-安万特和赛诺菲-健赞的赠款和个人费用,Med Update Europe GmbH的个人费用,streamedup!来自Pohl-Boskamp的个人费用,来自Inmunotek s.l.的赠款,来自John Wiley and Sons, AS的个人费用,来自Paul-Martini-Stiftung (PMS)的个人费用,来自Regeneron Pharmaceuticals Inc.的个人费用,来自RG aerzteforbildung的个人费用,来自Institut fr Disease Management的个人费用,来自施普林格GmbH的个人费用,来自AstraZeneca的赠款和个人费用,来自IQVIA Commercial的个人费用,来自Ingress Health的个人费用,来自Wort&amp;Bild Verlag的个人费用,Verlag ME的个人费用、宝洁公司的个人费用
{"title":"Assessment of the Effectiveness of Allergic Rhinitis Medications Using a Target Trial Emulation Approach Based on Mobile Health Data","authors":"Nuno Lourenço-Silva,&nbsp;Bernardo Sousa-Pinto,&nbsp;Antonio Bognanni,&nbsp;Matteo Martini,&nbsp;Michal Ordak,&nbsp;Giovanni Paoletti,&nbsp;Sara Gil-Mata,&nbsp;Rita Amaral,&nbsp;Anna Bedbrook,&nbsp;Patrizia Bonadonna,&nbsp;Luisa Brussino,&nbsp;G. Walter Canonica,&nbsp;João Coutinho-Almeida,&nbsp;Alvaro A. Cruz,&nbsp;Wienczyslawa Czarlewski,&nbsp;Mark Dykewicz,&nbsp;Mattia Giovannini,&nbsp;Bilun Gemicioglu,&nbsp;Juan Carlos Ivancevich,&nbsp;Ludger Klimek,&nbsp;Violeta Kvedariene,&nbsp;Desiree E. Larenas-Linnemann,&nbsp;Manuel Marques-Cruz,&nbsp;André Moreira,&nbsp;Marek Niedoszytko,&nbsp;Ana Margarida Pereira,&nbsp;Nikolaos G. Papadopoulos,&nbsp;Nhân Pham-Thi,&nbsp;Frederico S. Regateiro,&nbsp;Sanna K. Toppila-Salmi,&nbsp;Boleslaw Samolinski,&nbsp;Joaquin Sastre,&nbsp;Luís Taborda-Barata,&nbsp;Tuuli Thomander,&nbsp;Ilgım Vardaloğlu Koyuncu,&nbsp;Arunas Valiulis,&nbsp;Leticia de las Vecillas,&nbsp;Maria Teresa Ventura,&nbsp;Jolanta Walusiak-Skorupa,&nbsp;Yi-Kui Xiang,&nbsp;Oliver Pfaar,&nbsp;João A. Fonseca,&nbsp;Torsten Zuberbier,&nbsp;Holger J. Schünemann,&nbsp;Danilo di Bona,&nbsp;Jean Bousquet,&nbsp;Rafael José Vieira","doi":"10.1111/cea.70173","DOIUrl":"10.1111/cea.70173","url":null,"abstract":"&lt;p&gt;Randomised controlled trials (RCTs) are the paradigm for questions on causal inference but often face challenges in generalisability due to strict eligibility criteria. In allergic rhinitis (AR), this limitation is particularly relevant, with RCTs on AR displaying an overrepresentation of patients with severe disease and not providing sufficiently detailed information on the impact of comorbidities on treatment effectiveness [&lt;span&gt;1-4&lt;/span&gt;]. Mobile health (mHealth) applications provide an opportunity to collect large-scale patient-reported data that can complement traditional trial evidence and broaden our understanding of treatment effectiveness in routine care [&lt;span&gt;5&lt;/span&gt;]. However, to adequately use mHealth data for that purpose, approaches to adequately deal with confounding must be applied.&lt;/p&gt;&lt;p&gt;In this study, we aimed to use mHealth data to compare the short-term effectiveness of three common AR medication classes: oral antihistamines (OAH), intranasal corticosteroids (INCS), and fixed-combination intranasal antihistamine plus corticosteroid sprays (INAH+INCS). In particular, we aimed to compare these three medication classes on symptom relief within 24 h, while also exploring whether treatment effects differed according to the presence of self-reported comorbid asthma. To deal with confounding, we applied a target trial emulation approach [&lt;span&gt;6&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;A full description of the Methods is available on https://doi.org/10.5281/zenodo.17215607. We included adult users of the MASK-air app with self-reported AR. MASK-air is a validated app that allows daily reporting of AR symptoms on visual analogue scales (VAS) together with medication use. We included users who completed symptom assessments before and after taking one of the aforementioned medication classes, within a 24-h interval. Measurements less than 60 min apart were excluded. Outcomes were changes in global, nasal, ocular, and asthma-related symptoms (VAS, 0–100).&lt;/p&gt;&lt;p&gt;To address confounding, we used inverse probability of treatment weighting based on pre-treatment symptom scores, age, sex, ARIA severity score, and asthma status. We then estimated average treatment effects using Bayesian mixed-effects regression models, with patient and month of the year as random effects [&lt;span&gt;7, 8&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;A full description of the Results is available on https://doi.org/10.5281/zenodo.17215607. A total of 648 treatment days were analysed, with a median participant age of 37 years; 37.8% reported asthma. The median interval between pre- and post-medication entries was 480 min (IQR = 568). Most treatment days involved OAH (64.2%), followed by INCS (25.5%) and INAH+INCS (10.3%).&lt;/p&gt;&lt;p&gt;Compared with OAH, both INCS and INAH+INCS were associated with significantly greater improvements in global symptoms (mean VAS difference = −4.25 [95% CrI = −6.69, −1.15] and −7.27 [−10.30, −4.07], respectively) (Table 1). Both also improved ocular symptoms, while INCS showed superiority ove","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":"56 2","pages":"176-179"},"PeriodicalIF":5.2,"publicationDate":"2025-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12879269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145480981","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}
引用次数: 0
Airway, Breathing or Circulation Failure in Fatal Food Anaphylaxis: A Nationally Representative Case Series. 致死性食物过敏的气道、呼吸或循环衰竭:全国代表性病例系列。
IF 5.2 2区 医学 Q1 ALLERGY Pub Date : 2025-11-07 DOI: 10.1111/cea.70175
John Coveney, Tom Roberts, Sylvia Stoianova, Nicholas Sargant
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引用次数: 0
Uncovering Mite Sensitisation: Epidemiological Insights From a General Population Study. 揭示螨致敏:来自一般人群研究的流行病学见解。
IF 5.2 2区 医学 Q1 ALLERGY Pub Date : 2025-11-05 DOI: 10.1111/cea.70174
Laura Romero-Sánchez, Francisco Gude, Arturo González-Quintela, Manuela Alonso-Sampedro, Óscar Lado-Baleato, Carmen Fernández-Merino, Flora Miranda-Pena, Carmen Vidal
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引用次数: 0
Adrenaline Auto-Injector Prescribing in Primary Care in England: An Analysis of Non-Standard Dosing 肾上腺素自动注射器处方在英国初级保健:非标准剂量的分析。
IF 5.2 2区 医学 Q1 ALLERGY Pub Date : 2025-11-02 DOI: 10.1111/cea.70163
Louise J. Michaelis, Thomas Owen, Andrew D. Bright, Lucy Sherwin-Robson
<div> <section> <h3> Introduction</h3> <p>The recommended first-line treatment for anaphylaxis in the community is intramuscular injection of adrenaline. The treatment is a standardised dose of either a 150 μg or a 300 μg adrenaline auto-injector (AAI) device depending upon the patient's weight. Currently, no standardised mechanisms exist to transition patients onto the higher 300 μg dose when they reach 25–30 kg (depending upon the manufacturer).</p> </section> <section> <h3> Methods</h3> <p>We undertook analysis of NHS prescriptions data dispensed in the community in England to identify rates of non-standard AAI dose prescribing. Non-standard prescribing is defined as patients who are likely to have exceeded the 25–30 kg threshold but still received a 150 μg dose. Data were limited to the most recent AAI prescription for an individual patient that occurred in the last 2 years (December 2022–2024). Patient weight at the time of prescribing was approximated using an age-to-weight correlation model. AAI recommended switching weights, based on device metadata, were compared to the patients' approximated weight to identify non-standard prescribing. Statistical comparison between rates of non-standard prescribing and patient deprivation was computed using Kendall's Tau correlation coefficient. A complementary analysis to identify patients who received a 300 μg dose but were likely under the 25–30 kg threshold was also carried out.</p> </section> <section> <h3> Results</h3> <p>Overall, 46,999 patients were identified as having received a 150 μg strength injector in their most recent AAI prescription; of these, over 95% received two or more devices in line with national guidance. Estimates based on age for weight growth centiles show that between 9480 (20.2%) and at least 1747 (3.7%) of those prescribed a 150 μg autoinjector were likely to exceed the weight threshold for this dose. Using a Resuscitation Council UK guideline of age 6 years for switching to a 300 μg dose, the estimated proportion prescribed a non-standard AAI dose increases to 23,059 patients (49.1%). Estimated rates of non-standard AAI prescribing were found to be higher in areas of England with the most deprivation. Conservative estimates found only 67 children likely under 25 kg and 330 children likely under 30 kg who received a 300 μg dose.</p> </section> <section> <h3> Conclusions</h3> <p>This analysis of community AAI prescriptions in England suggests that underdosing of AAI prescriptions in children and adults is not uncommon. Healthcare professionals with patients at risk of anaphy
简介:社区推荐的过敏反应一线治疗是肌肉注射肾上腺素。治疗是根据患者的体重使用150 μg或300 μg肾上腺素自动注射(AAI)装置的标准剂量。目前,尚无标准化机制使患者在体重达到25-30公斤时改用300 μg的较高剂量(取决于制造商)。方法:我们对英格兰社区分发的NHS处方数据进行分析,以确定非标准AAI剂量处方的比例。非标准处方被定义为可能超过25-30公斤阈值但仍接受150 μg剂量的患者。数据仅限于过去2年内(2022年12月至2024年12月)单个患者的最新AAI处方。使用年龄-体重相关模型来估计开药时患者的体重。AAI推荐的切换体重,基于设备元数据,与患者的近似体重进行比较,以识别非标准处方。使用Kendall's Tau相关系数计算非标准处方率与患者剥夺率的统计比较。还进行了一项补充分析,以确定接受300 μg剂量但可能低于25-30 kg阈值的患者。结果:总体而言,46,999例患者在其最近的AAI处方中接受了150 μg强度的注射器;其中,超过95%的人获得了符合国家指导的两个或更多设备。根据年龄对体重增长百分位数的估计表明,处方150 μg自动注射器的患者中有9480人(20.2%)至至少1747人(3.7%)可能超过该剂量的体重阈值。根据英国复苏委员会(Resuscitation Council UK)的6岁指南,将剂量改为300 μg,估计使用非标准AAI剂量的比例增加到23,059例(49.1%)。在英格兰最贫困的地区,非标准AAI处方的估计比率更高。保守估计发现,只有67名体重可能低于25公斤的儿童和330名体重可能低于30公斤的儿童接受了300微克的剂量。结论:对英格兰社区AAI处方的分析表明,儿童和成人的AAI处方剂量不足并不罕见。有过敏反应风险的患者的医疗保健专业人员应审查给患者开的AAI设备是否适合他们的体重。
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引用次数: 0
Exploring the Disease Duration of Urticaria and Associated Determinants in Primary Care. 在初级保健中探讨荨麻疹的病程和相关决定因素。
IF 5.2 2区 医学 Q1 ALLERGY Pub Date : 2025-10-30 DOI: 10.1111/cea.70170
R Soegiharto, B J Hengevelt, N Boekema-Bakker, I A M Groenewegen, A C Knulst, J M P A Van den Reek, H Röckmann
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引用次数: 0
Comparison Between a Rush and a Conventional Oral Immunotherapy Protocol to Treat Cow's Milk and Hen's Egg Allergy. CompITO Study Methodology. Rush与传统口服免疫治疗方案治疗牛奶和鸡蛋过敏的比较。编译研究方法。
IF 5.2 2区 医学 Q1 ALLERGY Pub Date : 2025-10-30 DOI: 10.1111/cea.70168
Itziar Eusebio-Cartagena, Rodrigo Jiménez-Saiz, Vanesa Esteban, Emilio Nuñez-Borque, Alessandra Ruiz-Sánchez, Carmelo Escudero, Silvia Sánchez-García, Juan Trujillo, Audrey Dunn-Galvin, María Dolores P Ibáñez-Sandin, Pablo Rodríguez Del Río
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引用次数: 0
期刊
Clinical and Experimental Allergy
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