Annals of Allergy Asthma & Immunology最新文献

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From the pages of AllergyWatch 来自过敏症观察的页面。

IF 5.8 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2025-03-01 DOI: 10.1016/j.anai.2024.11.020

Stanley M. Fineman MD , Samantha Knox MD , Gerald B. Lee MD , Iris Otani MD

引用次数: 0

Patient and physician perspectives on disease burden in chronic spontaneous urticaria 慢性自发性荨麻疹患者和医生对疾病负担的看法：一项真实世界的美国调查。

IF 5.8 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2025-03-01 DOI: 10.1016/j.anai.2024.11.028

Giselle Mosnaim MD, MS , Dhaval Patil MS, BPharm , Merin Kuruvilla MD , James Hetherington BSc , Aaron Keal MSc , Stephanie Mehlis MD

Background

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.

Objective

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.

Methods

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.

Results

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%).

Conclusion

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.

背景：慢性自发性荨麻疹（CSU）经常与严重的疾病相关症状相关，这些症状会对生活质量产生负面影响，但患者和医生对CSU负担的看法可能不同。目的：描述与CSU相关的临床和人文负担，以及患者和医生对疾病负担和治疗满意度的看法的一致程度。方法：这项基于调查的横断面研究纳入了2020年至2021年在Adelphi CSU疾病特异性计划™中收集的数据，研究对象是美国内科医生及其CSU成年患者。总体而言，包括110名医生（包括40名过敏症/免疫学家，50名皮肤科医生和20名初级保健医生）完成的1082份患者记录表格和474份匹配的患者报告问卷。配对的医患记录用于确定疾病负担和治疗满意度的一致性。结果：CSU患者通常经历医生报告的瘙痒（66%）和荨麻疹（49%），并有血管性水肿史（23%）。虽然目前的CSU严重程度自诊断以来已大大改善，但许多患者和医生继续报告中度/重度当前疾病症状（分别为46%和30%）。与轻度疾病相比，中度/重度疾病对生活质量、睡眠、工作障碍和治疗满意度的影响更大。大多数患者和医生对症状严重程度的看法是一致的（61%-74%），其中分歧主要是由于医生相对于患者少报了严重程度。患者/医生对治疗满意度的一致性在轻度CSU严重程度（82%）、轻度蜂房严重程度（80%）和omalizumab或其他生物治疗（87%）时最高。结论：与轻度CSU相比，中度/重度CSU患者疾病负担加重，治疗满意度较低。与患者相比，医生更经常低估CSU的严重程度。

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引用次数: 0

How I counsel a family who is considering food allergy therapy 临床大师：我如何为考虑接受食物过敏治疗的家庭提供咨询。

IF 5.8 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2025-03-01 DOI: 10.1016/j.anai.2024.10.029

Matthew Greenhawt MD, MBA, MSc

引用次数: 0

Analyzing phenotypes post-exposure in allergic rhinitis in the environmental exposure unit 环境暴露单元（EEU）的过敏性鼻炎暴露后表型分析（APPEAR）。

IF 5.8 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2025-03-01 DOI: 10.1016/j.anai.2024.11.002

Abigail Davis BScH , Sophia Linton BSc , Lubnaa Hossenbaccus MSc , Jenny Thiele MSc , Hannah Botting , Terry Walker BA , Lisa M. Steacy BScH , Anne K. Ellis MD, MSc

Background

Previous studies have defined clinical phenotypes of allergic rhinitis (AR) after allergen exposure using the time course of the total nasal symptom score (TNSS).

Objective

To validate previously proposed AR phenotypes across different allergens (birch, grass, ragweed, and house dust mite) after exposure in the environmental exposure unit.

Methods

The Analyzing Phenotypes Post-Exposure in Allergic Rhinitis (APPEAR) database comprises 153 participants from environmental exposure unit studies conducted between 2010 and 2021 by Kingston Allergy Research. TNSS, nasal congestion symptom scores, and percent change in peak nasal inspiratory flow from baseline (%ΔPB) were recorded for each participant. Participants were phenotyped using previously described criteria.

Results

There were 65 participants (42.5%) classified as early-phase responders (EPRs), 58 (37.9%) as protracted EPRs (pEPRs), 13 (8.5%) as dual responders (DRs), and 17 (11.1%) as low responders (LoRs). Significant negative correlations exist between TNSS and %ΔPB (r = −0.99, P < .0001) and nasal congestion symptom score and %ΔPB (r = −0.99, P < .0001). At the beginning of the late-phase AR response (6-7 hours), pEPRs had significantly higher TNSS compared with EPRs, DRs, and LoRs (P < .0001). By the end of the study (up to 12 hours), DRs and pEPRs had significantly higher TNSS compared with EPRs and LoRs (P < .0001). Visible validity and statistical validity between the phenotypes were also confirmed by assessing participants’ mean TNSS and mean %ΔPB over time when grouping by phenotype.

Conclusion

This study confirms that distinct phenotypes exist in the late-phase AR response among different allergens and in a greater sample size than described previously, which could provide clinical benefit.

背景：以往的研究利用过敏原暴露后的总鼻腔症状评分（TNSS）时间进程来定义过敏性鼻炎（AR）的临床表型：以前的研究利用鼻部症状总评分（TNSS）的时间过程定义了过敏性鼻炎（AR）接触过敏原后的临床表型：我们旨在验证之前提出的不同过敏原（桦树、草、豚草、屋尘螨）在环境暴露单元（EEU）暴露后的 AR 表型：过敏性鼻炎暴露后表型分析（APPEAR）数据库由金斯顿过敏研究中心在2010-2021年间进行的EEU研究的153名参与者组成。记录了每位参与者的 TNSS、鼻塞症状评分和鼻吸气流量峰值与基线相比的百分比变化（%ΔPB）。结果：65 名参与者（42.5%）被归类为早期反应者 (EPR)，58 名参与者（37.9%）被归类为持久早期反应者 (pEPR)，13 名参与者（8.5%）被归类为双重反应者 (DR)，17 名参与者（11.1%）被归类为低反应者 (LoR)。TNSS 与 %ΔPB 之间存在显著的负相关（r = -0.99，p 结论：这项研究证实了不同过敏原在晚期 AR 反应中存在不同的表型，而且样本量比以前描述的更大，这可能会给临床带来益处。

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引用次数: 0

Real-world mepolizumab treatment in eosinophilic granulomatosis with polyangiitis reduces disease burden in the United States 在美国，嗜酸性粒细胞肉芽肿伴多血管炎患者使用甲泼尼珠单抗的实际治疗减少了疾病负担。

IF 5.8 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2025-03-01 DOI: 10.1016/j.anai.2024.11.004

Sameer K. Mathur MD, PhD , Jared Silver MD, PhD , Sean D. MacKnight MScPH , Ana Urosevic MA , Cristina Martinez MA , Kaixin Zhang MSc , François Laliberté MA , Arijita Deb PhD

Background

Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare, chronic inflammatory disease characterized by asthma and small/medium vessel vasculitis. Mepolizumab is approved for use in EGPA disease management alongside oral corticosteroids (OCS), but evidence of its real-world impact is limited.

Objective

To compare real-world treatment patterns and health outcomes, particularly OCS use, EGPA-related hospitalizations/relapses, and asthma exacerbations pre- and post-mepolizumab initiation in US patients with EGPA.

Methods

Patients with EGPA receiving more than or equal to 2 mepolizumab doses were identified using administrative claims data from Komodo Health's Comprehensive Dataset (between December 2016–March 2020). Outcomes assessed pre- and post-mepolizumab initiation included corticosteroid/other medication use, EGPA-related hospitalizations/relapses, and asthma exacerbations.

Results

Overall, 114 patients were identified; of these, 60 (53%) received mepolizumab 300 mg at index. Average daily OCS dose per dispensing was significantly lower post- vs pre-mepolizumab initiation (21.2 vs 26.8 mg/d, 21% relative reduction, P < .001); mean number of OCS bursts also decreased (0.9 vs 1.8, 50% relative reduction, P < .001). Patients experienced significantly lower rates of EGPA-related hospitalization (0.86 vs 1.55 per-person year [PPY], 49% relative reduction, P = .004) and EGPA relapse (3.18 vs 3.94 PPY, 19% relative reduction, P = .004) post- vs pre-initiation. Most patients (91%) had an asthma diagnosis at baseline; among these patients, asthma exacerbation rates were significantly lower post- vs pre-initiation (1.05 vs 1.84 PPY, 42% relative reduction, P = .004).

Conclusion

Mepolizumab was associated with significant steroid-sparing benefits and significantly reduced rates of EGPA-related hospitalizations, EGPA relapses, and asthma exacerbations in this real-world study of US patients with EGPA, confirming the benefits of mepolizumab treatment seen in clinical trials.

背景：嗜酸性粒细胞肉芽肿伴多血管炎（EGPA）是一种罕见的慢性炎症性疾病，以哮喘和中小血管炎为特征。美妥珠单抗已被批准与口服皮质类固醇（OCS）一起用于EGPA疾病的治疗，但有关其实际影响的证据却很有限：目的：比较美国 EGPA 患者开始使用美泊珠单抗前后的实际治疗模式和健康结果，尤其是 OCS 使用情况、EGPA 相关住院/复发以及哮喘加重情况：利用 Komodo Health 综合数据集（2016 年 12 月至 2020 年 3 月）中的行政报销数据，确定了接受≥2 次美泊珠单抗治疗的 EGPA 患者。对开始使用甲泼尼珠单抗前后的结果进行了评估，包括皮质类固醇/其他药物的使用、与EGPA相关的住院/复发以及哮喘加重：共确定了 114 名患者，其中 60 人（53%）在发病时接受了 300 毫克的美泊利珠单抗治疗。与开始使用美泊利珠单抗前相比，开始使用美泊利珠单抗后的患者平均每日OCS剂量明显降低（21.2 mg/day vs 26.8 mg/day，相对减少21%）：在这项针对美国 EGPA 患者的真实世界研究中，美泊利珠单抗具有明显的类固醇节省优势，并能显著降低 EGPA 相关住院率、EGPA 复发率和哮喘加重率，证实了临床试验中发现的美泊利珠单抗治疗优势。

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引用次数: 0

A 10-year review of severe eosinophilia and hypereosinophilia from a pediatric hospital in the United States 美国儿科医院严重嗜酸性粒细胞增多症和嗜酸性粒细胞增多症的10年回顾

IF 5.8 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2025-03-01 DOI: 10.1016/j.anai.2024.12.019

Natsumon Udomkittivorakul MD , Mengwei Ni MD , Maleewan Kitcharoensakkul MD, MSCI

引用次数: 0

Laryngeal Obstruction, Vocal Cord Dysfunction, and Exertional Dyspnea

IF 5.8 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2025-03-01 DOI: 10.1016/j.anai.2024.12.009

Miles Weinberger MD

引用次数: 0

Drug-induced enterocolitis syndrome to amoxicillin-clavulanic acid in an adult patient with markers of gastrointestinal inflammation.

IF 5.8 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2025-03-01 DOI: 10.1016/j.anai.2025.02.021

Anna Moshkovich, Bradley Sabin, Katharine Foster Nehme, Madeline Schutt

引用次数: 0

Computed tomography-based measurements associated with rapid lung function decline in severe asthma 基于计算机断层扫描的测量与重症哮喘患者肺功能快速下降有关。

IF 5.8 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2025-03-01 DOI: 10.1016/j.anai.2024.08.957

Da Woon Sim PhD , Sanghun Choi PhD , Jinyoung Jeong BS , Suh-Young Lee PhD , Young‑Hee Nam PhD , Byung-Keun Kim PhD , Young-Soo Lee PhD , Ji-Su Shim PhD , Min-Suk Yang PhD , Min-Hye Kim PhD , So Ri Kim PhD , Young-Il Koh PhD , Sang-Heon Kim PhD , Heung-Woo Park MD, PhD , Korean Severe Asthma Registry (KoSAR) Investigators

Background

Patients with severe asthma are susceptible to lung function decline (LFD), but biomarkers that reliably predict an accelerated LFD have not been fully recognized.

Objective

To identify variables associated with previous LFD occurrences in patients with severe asthma by exploring the computed tomography (CT) imaging features within predefined LFD groups.

Methods

We obtained inspiratory and expiratory CT images of 102 patients with severe asthma and derived 2 airway structural parameters (wall thickness [WT] and hydraulic diameter) and 2 parenchymal variables (functional small airway disease and emphysema). We retrospectively calculated the annual changes in forced expiratory volume in 1 second and grouped participants by their values determined. The 4-imaging metrics, along with levels of several biomarkers, were compared among the LFD groups.

Results

Patients with severe asthma with enhanced LFD exhibited significantly lower WT and smaller hydraulic diameter compared with those with minimal change or slight decline in lung function, after an adjustment of smoking status. Conversely, CT-based percentages of emphysema and functional small airway disease did not significantly differ according to LFD. Furthermore, fractional exhaled nitric oxide (FeNO) level and the blood matrix metalloproteinase-9/TIMP metallopeptidase inhibitor 1 ratio were significantly higher in patients with severe asthma with enhanced LFD compared with those in the others.

Conclusion

Lower WT on CT scans with increased FeNO that may represent increased airway inflammation significantly correlated with enhanced LFD in patients with severe asthma. Consequently, active management plans may help to attenuate LFD for patients with severe asthma with lower WT and high FeNO.

背景：重症哮喘患者容易出现肺功能下降（LFD），但可靠预测LFD加速的生物标志物尚未得到充分认识：在这项研究中，我们探讨了预先定义的 LFD 组别中的计算机断层扫描（CT）成像特征，以确定与重症哮喘患者之前发生的 LFD 相关的变量：我们获取了 102 名重症哮喘患者的吸气和呼气 CT 图像，并得出了两个气道结构参数（气道壁厚度 [WT] 和液压直径 [Dh]）和两个实质变量（功能性小气道疾病 [fSAD] 和肺气肿 [Emph]）。我们回顾性地计算了一秒钟用力呼气量的年度变化，并根据所确定的数值对参与者进行了分组。我们比较了 LFD 组的四项成像指标和几种生物标志物的水平：结果：在对吸烟状况进行调整后，与肺功能变化极小或轻微下降的患者相比，LFD增强的重症哮喘患者的WT明显较低，Dh也较小。相反，基于 CT 的 Emph 和 fSAD 百分比在 LFD 方面没有明显差异。此外，与其他患者相比，LFD增强的重症哮喘患者的部分呼出一氧化氮（FeNO）水平和血液基质金属蛋白酶-9/TIMP金属肽酶抑制剂1比值明显更高：结论：CT 扫描显示的 WT 值较低，而 FeNO 值升高可能代表气道炎症加重，这与重症哮喘患者 LFD 增高密切相关。因此，对于 WT 较低、FeNO 较高的重症哮喘患者，积极的治疗计划可能有助于减轻 LFD。

{"title":"Computed tomography-based measurements associated with rapid lung function decline in severe asthma","authors":"Da Woon Sim PhD , Sanghun Choi PhD , Jinyoung Jeong BS , Suh-Young Lee PhD , Young‑Hee Nam PhD , Byung-Keun Kim PhD , Young-Soo Lee PhD , Ji-Su Shim PhD , Min-Suk Yang PhD , Min-Hye Kim PhD , So Ri Kim PhD , Young-Il Koh PhD , Sang-Heon Kim PhD , Heung-Woo Park MD, PhD , Korean Severe Asthma Registry (KoSAR) Investigators","doi":"10.1016/j.anai.2024.08.957","DOIUrl":"10.1016/j.anai.2024.08.957","url":null,"abstract":"<div><h3>Background</h3><div>Patients with severe asthma are susceptible to lung function decline (LFD), but biomarkers that reliably predict an accelerated LFD have not been fully recognized.</div></div><div><h3>Objective</h3><div>To identify variables associated with previous LFD occurrences in patients with severe asthma by exploring the computed tomography (CT) imaging features within predefined LFD groups.</div></div><div><h3>Methods</h3><div>We obtained inspiratory and expiratory CT images of 102 patients with severe asthma and derived 2 airway structural parameters (wall thickness [WT] and hydraulic diameter) and 2 parenchymal variables (functional small airway disease and emphysema). We retrospectively calculated the annual changes in forced expiratory volume in 1 second and grouped participants by their values determined. The 4-imaging metrics, along with levels of several biomarkers, were compared among the LFD groups.</div></div><div><h3>Results</h3><div>Patients with severe asthma with enhanced LFD exhibited significantly lower WT and smaller hydraulic diameter compared with those with minimal change or slight decline in lung function, after an adjustment of smoking status. Conversely, CT-based percentages of emphysema and functional small airway disease did not significantly differ according to LFD. Furthermore, fractional exhaled nitric oxide (FeNO) level and the blood matrix metalloproteinase-9/TIMP metallopeptidase inhibitor 1 ratio were significantly higher in patients with severe asthma with enhanced LFD compared with those in the others.</div></div><div><h3>Conclusion</h3><div>Lower WT on CT scans with increased FeNO that may represent increased airway inflammation significantly correlated with enhanced LFD in patients with severe asthma. Consequently, active management plans may help to attenuate LFD for patients with severe asthma with lower WT and high FeNO.</div></div>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"134 3","pages":"Pages 306-314.e5"},"PeriodicalIF":5.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146787","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}

引用次数: 0

Sino-Nasal Outcome Test-22

IF 5.8 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology

Pub Date : 2025-03-01 DOI: 10.1016/j.anai.2024.12.007

Thomas L. Offerle MD , Larry Borish MD

引用次数: 0

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