Pub Date : 2025-01-01DOI: 10.1016/j.anai.2024.09.021
William W. Busse MD
Asthma remissions have been identified as a new treatment outcome and as based on experience with biologics. Remissions are defined as no symptoms, no exacerbations, no use of systemic corticosteroids, and stabilization (optimization) of lung functions; all these criteria need to be sustained for at least 1 year. This study discussed the evolution of remissions, the evolving criteria, and experiences in achieving remission after treatment with biologics. In severe, uncontrolled asthma, treatment with biologics has led to remissions in 20% to 35% of the subjects treated. It is proposed that remissions will become a new and important treatment outcome for asthma.
{"title":"The role of biologics in inducing remission in asthma","authors":"William W. Busse MD","doi":"10.1016/j.anai.2024.09.021","DOIUrl":"10.1016/j.anai.2024.09.021","url":null,"abstract":"<div><div>Asthma remissions have been identified as a new treatment outcome and as based on experience with biologics. Remissions are defined as no symptoms, no exacerbations, no use of systemic corticosteroids, and stabilization (optimization) of lung functions; all these criteria need to be sustained for at least 1 year. This study discussed the evolution of remissions, the evolving criteria, and experiences in achieving remission after treatment with biologics. In severe, uncontrolled asthma, treatment with biologics has led to remissions in 20% to 35% of the subjects treated. It is proposed that remissions will become a new and important treatment outcome for asthma.</div></div>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"134 1","pages":"Pages 19-30"},"PeriodicalIF":5.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394993","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}
Pub Date : 2025-01-01DOI: 10.1016/j.anai.2024.07.034
Aikaterini Anagnostou MD, PhD , Matthew Greenhawt MD, MBA, MSc , Marcus Shaker MD, MSc , Brian P. Vickery MD , Julie Wang MD
Food allergy management has greatly evolved in the last several years, moving from passive approaches, such as strict food allergen avoidance, to more active treatments, including regulatory approval of the first specifically indicated immunotherapy product (for peanut) in 2020. In 2024, a second therapy, omalizumab, received regulatory approval for the treatment of 1 or more IgE-mediated food allergies, providing clinicians with multiple treatment options to offer patients and families. With this expanded armamentarium of food allergy treatment options, the practicing clinician requires detailed knowledge of benefits and risks of omalizumab, how omalizumab fits into the management landscape, and how to use shared decision-making to optimize therapy. This yardstick aims to provide the clinician with a review of data leading to omalizumab's food allergy indication and an evidence-based expert opinion approach regarding on how best to use this and other therapies available to optimize patient management.
{"title":"Food allergy yardstick","authors":"Aikaterini Anagnostou MD, PhD , Matthew Greenhawt MD, MBA, MSc , Marcus Shaker MD, MSc , Brian P. Vickery MD , Julie Wang MD","doi":"10.1016/j.anai.2024.07.034","DOIUrl":"10.1016/j.anai.2024.07.034","url":null,"abstract":"<div><div>Food allergy management has greatly evolved in the last several years, moving from passive approaches, such as strict food allergen avoidance, to more active treatments, including regulatory approval of the first specifically indicated immunotherapy product (for peanut) in 2020. In 2024, a second therapy, omalizumab, received regulatory approval for the treatment of 1 or more IgE-mediated food allergies, providing clinicians with multiple treatment options to offer patients and families. With this expanded armamentarium of food allergy treatment options, the practicing clinician requires detailed knowledge of benefits and risks of omalizumab, how omalizumab fits into the management landscape, and how to use shared decision-making to optimize therapy. This yardstick aims to provide the clinician with a review of data leading to omalizumab's food allergy indication and an evidence-based expert opinion approach regarding on how best to use this and other therapies available to optimize patient management.</div></div>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"134 1","pages":"Pages 110-121"},"PeriodicalIF":5.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057202","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}
Pub Date : 2025-01-01DOI: 10.1016/j.anai.2024.09.015
Claus Bachert MD, PhD , Asif H. Khan MBBS , Claire Hopkins DM , Joseph K. Han MD , Wytske J. Fokkens MD , Leda P. Mannent MD , Jérôme Msihid MSc , Kinga Borsos PharmD , Siddhesh Kamat MS , Scott Nash MD , Harry Sacks MD , Paul J. Rowe MD , Yamo Deniz MD , Juby A. Jacob-Nara MD
Background
Frequently reported outcomes of clinical trials in chronic rhinosinusitis with nasal polyps (CRSwNP) may have limited relatability for patients.
Objective
To enhance the patient relatability of outcomes in dupilumab clinical trials for CRSwNP, daily symptom scores were used to determine new patient‑centered end points: mild-to-no-symptom months (MSM) and symptom-free months (SFM).
Methods
This work is a post hoc analysis of patients receiving dupilumab 300 mg or placebo every 2 weeks for 24 weeks (SINUS-24 study; NCT02912468) or 52 weeks (SINUS‑52; NCT02898454). Patients recorded symptom severity scores daily for each of nasal congestion, loss of smell, and anterior and posterior rhinorrhea on a scale of 0 to 3 (0 = no symptoms; 1 = mild; 2 = moderate; 3 = severe). We assessed the proportions of patients reporting only MSM or SFM throughout the 28‑day period before randomization, week 24 (pooled studies), and week 52 (SINUS‑52).
Results
Significantly more dupilumab‑treated than placebo-treated patients achieved MSM for all 4 symptoms (week 24: 31.0% vs 4.4%; odds ratio [OR] 12.9 [95% CI 6.4-25.8]; week 52: 38.3% vs 2.6%; OR 15.6 [5.9-41.0]; both P < .0001). In addition, significantly more dupilumab-treated than placebo‑treated patients achieved SFM for at least 1 of the 4 symptoms (week 24: 35.4% vs 10.8%; OR 4.9 [95% CI 3.1-7.8]; week 52: 50.0% vs 9.2%; OR 9.1 [95% CI 4.6-17.9]; both P < .0001).
Conclusion
One-third of patients with severe CRSwNP treated with dupilumab achieved MSM for all 4 cardinal symptoms (nasal congestion, loss of smell, and anterior and posterior rhinorrhea). Moreover, half of the patients achieved SFM for at least 1 of the 4 symptoms. These results support the benefit of dupilumab in improving patient‑centered outcomes.
Trial Registration
ClinicalTrials.gov Identifiers: NCT02912468 (SINUS-24) and NCT02898454 (SINUS-52).
{"title":"Mild and symptom-free months in patients with chronic rhinosinusitis with nasal polyps treated with dupilumab","authors":"Claus Bachert MD, PhD , Asif H. Khan MBBS , Claire Hopkins DM , Joseph K. Han MD , Wytske J. Fokkens MD , Leda P. Mannent MD , Jérôme Msihid MSc , Kinga Borsos PharmD , Siddhesh Kamat MS , Scott Nash MD , Harry Sacks MD , Paul J. Rowe MD , Yamo Deniz MD , Juby A. Jacob-Nara MD","doi":"10.1016/j.anai.2024.09.015","DOIUrl":"10.1016/j.anai.2024.09.015","url":null,"abstract":"<div><h3>Background</h3><div>Frequently reported outcomes of clinical trials in chronic rhinosinusitis with nasal polyps (CRSwNP) may have limited relatability for patients.</div></div><div><h3>Objective</h3><div>To enhance the patient relatability of outcomes in dupilumab clinical trials for CRSwNP, daily symptom scores were used to determine new patient‑centered end points: mild-to-no-symptom months (MSM) and symptom-free months (SFM).</div></div><div><h3>Methods</h3><div>This work is a post hoc analysis of patients receiving dupilumab 300 mg or placebo every 2 weeks for 24 weeks (SINUS-24 study; NCT02912468) or 52 weeks (SINUS‑52; NCT02898454). Patients recorded symptom severity scores daily for each of nasal congestion, loss of smell, and anterior and posterior rhinorrhea on a scale of 0 to 3 (0 = no symptoms; 1 = mild; 2 = moderate; 3 = severe). We assessed the proportions of patients reporting only MSM or SFM throughout the 28‑day period before randomization, week 24 (pooled studies), and week 52 (SINUS‑52).</div></div><div><h3>Results</h3><div>Significantly more dupilumab‑treated than placebo-treated patients achieved MSM for all 4 symptoms (week 24: 31.0% vs 4.4%; odds ratio [OR] 12.9 [95% CI 6.4-25.8]; week 52: 38.3% vs 2.6%; OR 15.6 [5.9-41.0]; both <em>P</em> < .0001). In addition, significantly more dupilumab-treated than placebo‑treated patients achieved SFM for at least 1 of the 4 symptoms (week 24: 35.4% vs 10.8%; OR 4.9 [95% CI 3.1-7.8]; week 52: 50.0% vs 9.2%; OR 9.1 [95% CI 4.6-17.9]; both <em>P</em> < .0001).</div></div><div><h3>Conclusion</h3><div>One-third of patients with severe CRSwNP treated with dupilumab achieved MSM for all 4 cardinal symptoms (nasal congestion, loss of smell, and anterior and posterior rhinorrhea). Moreover, half of the patients achieved SFM for at least 1 of the 4 symptoms. These results support the benefit of dupilumab in improving patient‑centered outcomes.</div></div><div><h3>Trial Registration</h3><div>ClinicalTrials.gov Identifiers: NCT02912468 (SINUS-24) and NCT02898454 (SINUS-52).</div></div>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"134 1","pages":"Pages 61-69.e12"},"PeriodicalIF":5.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331822","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}
Pub Date : 2025-01-01DOI: 10.1016/j.anai.2024.10.010
Lulu R. Tsao MD , Lily Li MD , Patricia A. Robertson MD , Roxanna A. Irani MD, PhD , Iris M. Otani MD
{"title":"Aspirin and nonsteroidal anti-inflammatory drug hypersensitivity evaluations in pregnancy","authors":"Lulu R. Tsao MD , Lily Li MD , Patricia A. Robertson MD , Roxanna A. Irani MD, PhD , Iris M. Otani MD","doi":"10.1016/j.anai.2024.10.010","DOIUrl":"10.1016/j.anai.2024.10.010","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"134 1","pages":"Pages 95-97"},"PeriodicalIF":5.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394986","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}
Pub Date : 2025-01-01DOI: 10.1016/j.anai.2024.09.016
Lior Seluk MD , Andrea E. Davis MD , Sarah Rhoads MD , Michael E. Wechsler MD, MMSc
Over the past 2 decades, the management of severe asthma has shifted from relying on inhaled corticosteroids and bronchodilators to more precise, targeted approaches. Monoclonal antibodies designed to address specific molecular pathways in asthma have transformed care for patients with severe asthma. Because therapy targeting IgE became the first biologic developed for allergic asthma in 2003, monoclonal antibodies targeting interleukin (IL)-5, IL-5 receptor, IL-4/-13 receptor, and thymic stromal lymphopoietin have been approved for treating difficult-to-treat asthma, improving symptoms, reducing exacerbations, and reducing oral corticosteroid dosing. Despite these advances, many patients continue to experience asthma exacerbations and symptoms and fail to achieve remission. To address this, pharmaceutical companies and researchers are exploring novel therapies targeting different aspects of asthma pathophysiology, including cytokines, enzymes, and cellular pathways. Innovative treatments such as inhaled biologics, ultra–long-acting biologics, and combination biologics are in development. New molecular targets, such as Bruton tyrosine kinase, OX-40 ligand, and Janus kinase, offer promise for addressing unmet needs in asthma care. Although many therapies have failed to get approval for use because of a lack of efficacy, trial design, or toxicity, these experiments still provide insights into asthma's underlying mechanisms. The future of asthma management looks promising, with emerging therapies aiming to improve patient outcomes. The challenge will lie in identifying the right therapy for each patient and developing personalized treatment strategies.
{"title":"Novel asthma treatments","authors":"Lior Seluk MD , Andrea E. Davis MD , Sarah Rhoads MD , Michael E. Wechsler MD, MMSc","doi":"10.1016/j.anai.2024.09.016","DOIUrl":"10.1016/j.anai.2024.09.016","url":null,"abstract":"<div><div>Over the past 2 decades, the management of severe asthma has shifted from relying on inhaled corticosteroids and bronchodilators to more precise, targeted approaches. Monoclonal antibodies designed to address specific molecular pathways in asthma have transformed care for patients with severe asthma. Because therapy targeting IgE became the first biologic developed for allergic asthma in 2003, monoclonal antibodies targeting interleukin (IL)-5, IL-5 receptor, IL-4/-13 receptor, and thymic stromal lymphopoietin have been approved for treating difficult-to-treat asthma, improving symptoms, reducing exacerbations, and reducing oral corticosteroid dosing. Despite these advances, many patients continue to experience asthma exacerbations and symptoms and fail to achieve remission. To address this, pharmaceutical companies and researchers are exploring novel therapies targeting different aspects of asthma pathophysiology, including cytokines, enzymes, and cellular pathways. Innovative treatments such as inhaled biologics, ultra–long-acting biologics, and combination biologics are in development. New molecular targets, such as Bruton tyrosine kinase, OX-40 ligand, and Janus kinase, offer promise for addressing unmet needs in asthma care. Although many therapies have failed to get approval for use because of a lack of efficacy, trial design, or toxicity, these experiments still provide insights into asthma's underlying mechanisms. The future of asthma management looks promising, with emerging therapies aiming to improve patient outcomes. The challenge will lie in identifying the right therapy for each patient and developing personalized treatment strategies.</div></div>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"134 1","pages":"Pages 9-18"},"PeriodicalIF":5.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142407176","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}
Pub Date : 2025-01-01DOI: 10.1016/j.anai.2024.10.018
Francisco J. Gallegos-Koyner MD , Franc Hodo MD , Nelson I. Barrera MD , Roberto C. Cerrud-Rodriguez MD, MS , Theresa Henson MD , Lisa N. Glass MD, PhD , David H. Chong MD
Background
Patients with asthma and opioid use disorder (OUD) experience higher rates of acute exacerbation, but the effects of OUD on asthma hospitalizations have been poorly described.
Objective
To explore how concurrent OUD may affect the clinical outcomes of adult patients hospitalized for asthma.
Methods
Using the National Inpatient Sample, adult patients admitted for asthma with concomitant OUD were identified and compared with those without OUD. Cohorts were matched in a 1:1 ratio using propensity score matching, with mortality as primary outcome of interest.
Results
A total of 491,990 patients were hospitalized for asthma, and 3.49% had a concomitant diagnosis of OUD. Patients with asthma and OUD were younger, with a mean age of 41 years (SD ± 12.2) vs 51 years (SD ± 17.2) in those without OUD. After matching, both cohorts had 17,125 patients. There was no significant difference regarding in-hospital mortality (odds ratio [OR] 0.92, 95% CI 0.51-1.63, P = .77) between the cohorts. Patients with asthma with OUD had significantly higher rates of mechanical ventilation (OR 1.52, 95% CI 1.23-1.87, P < .001), noninvasive mechanical ventilation (OR 1.37, 95% CI 1.15-1.62, P < .001), and mean length of stay (3.18 vs 2.92 days, P < .001) compared with patients with asthma without OUD. Patients with OUD had no difference in mean total hospitalization costs ($33,514 vs $31,529, P = .054) compared with patients without OUD. Compared with a routine hospital discharge, patients with OUD were more likely to leave against medical advice (relative risk [RR] 2.67, 95% CI 2.28-3.13, P < .001), be discharged to a long-term facility (RR 1.40, 95% CI 1.01-1.95, P = .045), and be discharged with home health care (RR 1.56, 95% CI 1.22-1.99, P < .001) than patients without OUD.
Conclusion
Concomitant OUD has no impact on mortality in asthma hospitalizations, but patients with asthma with OUD have worse secondary outcomes compared with those without OUD.
{"title":"Opioid use disorder's impact on asthma hospitalizations","authors":"Francisco J. Gallegos-Koyner MD , Franc Hodo MD , Nelson I. Barrera MD , Roberto C. Cerrud-Rodriguez MD, MS , Theresa Henson MD , Lisa N. Glass MD, PhD , David H. Chong MD","doi":"10.1016/j.anai.2024.10.018","DOIUrl":"10.1016/j.anai.2024.10.018","url":null,"abstract":"<div><h3>Background</h3><div>Patients with asthma and opioid use disorder (OUD) experience higher rates of acute exacerbation, but the effects of OUD on asthma hospitalizations have been poorly described.</div></div><div><h3>Objective</h3><div>To explore how concurrent OUD may affect the clinical outcomes of adult patients hospitalized for asthma.</div></div><div><h3>Methods</h3><div>Using the National Inpatient Sample, adult patients admitted for asthma with concomitant OUD were identified and compared with those without OUD. Cohorts were matched in a 1:1 ratio using propensity score matching, with mortality as primary outcome of interest.</div></div><div><h3>Results</h3><div>A total of 491,990 patients were hospitalized for asthma, and 3.49% had a concomitant diagnosis of OUD. Patients with asthma and OUD were younger, with a mean age of 41 years (SD ± 12.2) vs 51 years (SD ± 17.2) in those without OUD. After matching, both cohorts had 17,125 patients. There was no significant difference regarding in-hospital mortality (odds ratio [OR] 0.92, 95% CI 0.51-1.63, <em>P</em> = .77) between the cohorts. Patients with asthma with OUD had significantly higher rates of mechanical ventilation (OR 1.52, 95% CI 1.23-1.87, <em>P</em> < .001), noninvasive mechanical ventilation (OR 1.37, 95% CI 1.15-1.62, <em>P</em> < .001), and mean length of stay (3.18 vs 2.92 days, <em>P</em> < .001) compared with patients with asthma without OUD. Patients with OUD had no difference in mean total hospitalization costs ($33,514 vs $31,529, <em>P</em> = .054) compared with patients without OUD. Compared with a routine hospital discharge, patients with OUD were more likely to leave against medical advice (relative risk [RR] 2.67, 95% CI 2.28-3.13, <em>P</em> < .001), be discharged to a long-term facility (RR 1.40, 95% CI 1.01-1.95, <em>P</em> = .045), and be discharged with home health care (RR 1.56, 95% CI 1.22-1.99, <em>P</em> < .001) than patients without OUD.</div></div><div><h3>Conclusion</h3><div>Concomitant OUD has no impact on mortality in asthma hospitalizations, but patients with asthma with OUD have worse secondary outcomes compared with those without OUD.</div></div>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"134 1","pages":"Pages 55-60.e2"},"PeriodicalIF":5.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479911","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}
Pub Date : 2025-01-01DOI: 10.1016/j.anai.2024.09.008
Hana B. Ruran , Ashley Y. Wu MD, MS , Michael A. Fifer MD , Wanda Phipatanakul MD, MS , Saleh Alsulami MD
{"title":"Venom allergy in hypertrophic cardiomyopathy","authors":"Hana B. Ruran , Ashley Y. Wu MD, MS , Michael A. Fifer MD , Wanda Phipatanakul MD, MS , Saleh Alsulami MD","doi":"10.1016/j.anai.2024.09.008","DOIUrl":"10.1016/j.anai.2024.09.008","url":null,"abstract":"","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"134 1","pages":"Pages 102-103"},"PeriodicalIF":5.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565074","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}
Pub Date : 2025-01-01DOI: 10.1016/j.anai.2024.09.020
Jill A. Fisher PhD, Maral Erol PhD, Edwin H. Kim MD, MS
Background
Biologics are an important area of research and development, including for treatment of food allergy (FA). However, how allergists perceive the risks and benefits of biologics to treat FA remains largely unknown.
Objective
To explore how US-based allergists perceive the use of biologics in FA treatment.
Methods
Using a combination of purposive and snowball sampling, providers were recruited through direct solicitation by email to participate in a telephone or Zoom interview about their perceptions of the risks and benefits of current and future FA treatment options. Interviews were transcribed, deidentified, and coded to conduct a thematic analysis.
Results
We conducted 60 interviews with providers from 34 states working either in community practice (53.3%) or academic medical centers (46.7%). Our sample was primarily non-Hispanic White (60.0%) and men (56.7%). The plurality was in their 40s (41.7%). Our findings clustered in the following 4 main themes: (1) perceived benefits of biologics, (2) ideal use of biologics, (3) concerns about biologics, and (4) biologics as the perceived future of FA. Community and academic providers had largely similar views, but academic providers more often emphasized the benefits of biologics, and community providers were, on the whole, more supportive of using biologics as an adjunct to oral immunotherapy rather than as monotherapy.
Conclusion
This study indicates that providers hold mixed views about the use of biologics to treat FA. However, most were enthusiastic about prescribing biologics for FA while also being highly concerned about the cost to patients and the health care system.
背景：生物制剂是一个重要的研发领域，包括用于治疗食物过敏（FA）。然而，过敏症专家如何看待生物制剂治疗 FA 的风险和益处在很大程度上仍是未知数：目的：探讨美国过敏症专家如何看待生物制剂在 FA 治疗中的应用：方法：采用目的性抽样和滚雪球抽样相结合的方法，通过电子邮件直接邀请医疗服务提供者参加电话或 Zoom 访谈，了解他们对当前和未来 FA 治疗方案的风险和益处的看法。我们对访谈内容进行了转录、去标识和编码，以进行主题分析：我们对来自 34 个州的社区医疗机构（53.3%）或学术医疗中心（46.7%）的医疗服务提供者进行了 60 次访谈。我们的样本主要为非西班牙裔白人（60.0%）和男性（56.7%）。年龄大多在 40 多岁（41.7%）。我们的研究结果分为以下 4 个主题：(1) 认为生物制剂有益；(2) 理想使用生物制剂；(3) 对生物制剂的担忧；(4) 认为生物制剂是食物过敏的未来。社区和学术机构医疗服务提供者的观点大体相似，但学术机构医疗服务提供者更多强调生物制剂的益处，而社区医疗服务提供者总体上更支持将生物制剂作为 OIT 的辅助疗法，而非单一疗法：本研究表明，医疗服务提供者对使用生物制剂治疗 FA 的看法不一。然而，大多数医疗服务提供者对使用生物制剂治疗扁桃体炎充满热情，同时也高度关注患者和医疗系统的成本问题。
{"title":"Community and academic allergists’ perspectives on integrating biologics into food allergy care","authors":"Jill A. Fisher PhD, Maral Erol PhD, Edwin H. Kim MD, MS","doi":"10.1016/j.anai.2024.09.020","DOIUrl":"10.1016/j.anai.2024.09.020","url":null,"abstract":"<div><h3>Background</h3><div>Biologics are an important area of research and development, including for treatment of food allergy (FA). However, how allergists perceive the risks and benefits of biologics to treat FA remains largely unknown.</div></div><div><h3>Objective</h3><div>To explore how US-based allergists perceive the use of biologics in FA treatment.</div></div><div><h3>Methods</h3><div>Using a combination of purposive and snowball sampling, providers were recruited through direct solicitation by email to participate in a telephone or Zoom interview about their perceptions of the risks and benefits of current and future FA treatment options. Interviews were transcribed, deidentified, and coded to conduct a thematic analysis.</div></div><div><h3>Results</h3><div>We conducted 60 interviews with providers from 34 states working either in community practice (53.3%) or academic medical centers (46.7%). Our sample was primarily non-Hispanic White (60.0%) and men (56.7%). The plurality was in their 40s (41.7%). Our findings clustered in the following 4 main themes: (1) perceived benefits of biologics, (2) ideal use of biologics, (3) concerns about biologics, and (4) biologics as the perceived future of FA. Community and academic providers had largely similar views, but academic providers more often emphasized the benefits of biologics, and community providers were, on the whole, more supportive of using biologics as an adjunct to oral immunotherapy rather than as monotherapy.</div></div><div><h3>Conclusion</h3><div>This study indicates that providers hold mixed views about the use of biologics to treat FA. However, most were enthusiastic about prescribing biologics for FA while also being highly concerned about the cost to patients and the health care system.</div></div>","PeriodicalId":50773,"journal":{"name":"Annals of Allergy Asthma & Immunology","volume":"134 1","pages":"Pages 70-78.e2"},"PeriodicalIF":5.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394988","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}
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