Journal of Allergy and Clinical Immunology in Practice

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BACKGROUND: Dupilumab is an anti-IL4R monoclonal antibody (mAb) with proven efficacy in severe eosinophilic asthma (SEA). A suboptimal response to anti-IL5/5R mAbs is seen in some patients with ongoing evidence of T2 inflammation. OBJECTIVE: To understand whether targeting IL-13 pathways with dupilumab in these patients may lead to better clinical outcomes. METHODS: We performed a retrospective analysis of the extended clinical effectiveness of dupilumab up to 2 years of treatment in patients with SEA who had not responded adequately to anti-IL5/5R biologics...

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BACKGROUND: US-based perioperative anaphylaxis (POA) studies are limited to single center experiences. A recent report found that a serum acute tryptase (sAT) > 9.8 ng/mL or mast cell activation (MCA) can predict POA causal agent identification. Urinary mast cell mediator metabolites (uMC) have not been studied in POA. OBJECTIVE: To analyze the epidemiologic data of POA, to determine if sAT or MCA can predict suspected causal agent identification, and to evaluate uMC utility in POA...

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No abstract text is available yet for this article.

No abstract text is available yet for this article.

Social determinants of health (SDH) have substantial impact on patient care and outcomes globally, both in low-to-middle income countries and high income countries. In the clinic, lack of availability of diagnostic tools, inequities in access to care, and challenges obtaining and adhering to prescribed treatment plans may further compound these issues. This article addresses a case of rhinitis in the context of SDH and inequities in care that may affect various communities and populations around the world. SDH may include various aspects of one's financial means, education, access to medical care, environment and living situation, and community factors - each of which could play a role in the rhinitis disease manifestations, diagnosis, and management...

BACKGROUND: Allergic rhinitis (AR) and asthma may impact health-related quality-of-life. However, national estimates on the quality-of-life of patients with AR or asthma are lacking. OBJECTIVE: To provide estimates for utility scores and EQ-5D Visual Analog Scale (VAS) for patients with AR or asthma. METHODS: We conducted a cross-sectional study using direct patient data from the MASK-air® app on European MASK-air® users with self-reported AR or asthma...

BACKGROUND: Anaphylaxis is a common feature of mastocytosis patients, particularly with Hymenoptera venoms. Hence, it is hypothesized that mastocytosis patients may have an increased susceptibility to developing drug-induced anaphylaxis (DIA). Patients and medical practitioners are therefore concerned when there is a need to use various drugs. However, this issue has not been systematically investigated. OBJECTIVE: Our study aimed to investigate the prevalence and clinical characteristics of anaphylaxis to various types of drugs among mastocytosis patients...

Eosinophilic esophagitis disease course varies during pregnancy. Many patients' symptoms improve during pregnancy and worsen after. Pregnant patients often opt to decrease pharmacotherapy, highlighting the importance of discussing medication safety data, adverse outcomes associated with diet restriction, and close follow-up.

BACKGROUND: In adults with asthma, the long-term impact of previous coronavirus disease 2019 (COVID-19) on severe exacerbations and mortality is unclear. OBJECTIVE: We evaluated the long-term risk of severe exacerbation and mortality in adults with asthma who recovered from COVID-19. METHODS: Using the Korean National Health Insurance claim-based database, we compared the risk of severe exacerbations (emergency room visits or hospitalization) and mortality in adults with asthma aged >20 years recovered from COVID-19 between October 8, 2020, and December 16, 2021 (COVID-19 cohort, n=10,739) with 1:1 propensity score-matched controls (n=10,739)...

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BACKGROUND: Changes from baseline in fractional exhaled nitric oxide (FeNO) and blood eosinophil count (Eos) may be related to efficacy outcomes in dupilumab-treated patients with moderate-to-severe asthma. OBJECTIVE: This post-hoc analysis investigated biomarker changes in placebo- and dupilumab-treated patients with uncontrolled moderate-to-severe asthma enrolled in QUEST (NCT02414854). METHODS: Spline analyses of annualized severe exacerbation rate (AER) and change from baseline in pre-bronchodilator (BD) forced expiratory volume in 1 second (FEV1 ) at Week 52 were performed as a function of fold-change in FeNO at Week 52, and maximum fold-change in Eos over Week 0-12 (also change from baseline in pre-bronchodilator FEV1 at Week 12)...

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Wildfires, including forest fires, bushfires, and landscape fires, have become increasingly prevalent, fueled by climate change and environmental factors, posing significant challenges to both ecosystems and public health. This review article examines the relationship between wildfires and respiratory diseases in outdoor workers, with a main focus on airway disease. In addition to the expected effects of direct thermal respiratory injuries, and possible carbon monoxide poisoning, there are associations between wildfires and upper and lower respiratory effects including infections, as well as exacerbations of asthma and COPD...

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No abstract text is available yet for this article.

The introduction of immune checkpoint inhibitors (ICIs) has transformed the management of various malignancies. Alongside their therapeutic success, the widespread application of ICIs has unveiled a spectrum of immune-related adverse events (irAE), most often affecting the skin. Cutaneous irAEs (cirAE) encompass a range from common morbilliform and lichenoid rashes to more severe conditions such as bullous dermatoses and psoriasiform eruptions, each presenting distinct clinical challenges. Moreover, less common but clinically severe cutaneous reactions like toxic epidermal necrolysis have also been observed...

BACKGROUND: Asthmatic patients with antibody deficiencies (AD) have more severe disease and higher risk of exacerbations. No data exists about the efficacy of biologics in severe asthma (SA) patients with AD. The objective of this study was to evaluate the efficacy of biologics in SA patients with and without AD. METHODS: A case-control real-life study was conducted including 68 patients divided in two groups: group 1 with SA-AD and group 2 with SA. RESULTS: Treatment by biologics for 6 months was effective to decrease the number of exacerbations, hospitalizations, and emergency department (ED) visits, to improve the Asthma Control Questionnaire (ACQ) score and proved a systemic corticosteroid sparing effect...