American Academy of Allergy, Asthma & Immunology, Feb. 25-28 – Consumer Health News

The annual meeting of the American Academy of Allergy, Asthma & Immunology was held February 25-28 in Phoenix and attracted attendees from around the world, including clinicians, academics, allied health professionals and other interested individuals by allergic and immunological diseases. The conference highlighted recent advances in the areas of allergy, asthma and immunology.

In a study, Edmond S. Chan, MD, of the University of British Columbia and British Columbia Children’s Hospital Research Institute in Vancouver, Canada, and colleagues identified predictors of reactions to oral nut immunotherapy (OIT) in preschool children.

The authors explored the relationship between baseline patient characteristics and responses during OIT to peanuts to better understand the factors influencing the safety of OIT. They conducted a retrospective analysis of data from 672 preschool children across Canada who underwent peanut OIT. During the accumulation phase of OIT, increasing doses of peanuts were given approximately every two weeks, and all symptoms were documented. These symptoms have been graded using a modified World Allergy Organization subcutaneous immunotherapy reaction classification system (1 = mildest; 5 = fatal). A multivariate logistic regression model was used, with the safety outcome being the maximum degree of reaction (grade 2+ versus grade 1/no reaction) during OIT. Researchers found that older age, higher baseline serum immunoglobulin E, a Grade 2 or greater reaction prior to initiation of OIT, and a lower trigger dose were predictive of Grade 2 or greater reactions during the ILO.

“These preliminary results will aid in the development of a personalized approach to improving OIT safety, including selection of appropriate initial doses and frequency of accumulation, and will encourage shared decision-making between families and providers. health care,” Chan said.

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In another study, Onyinye I. Iweala, MD, Ph.D., of the University of North Carolina at Chapel Hill, and colleagues found that COVID-19 vaccines are tolerated in patients with Down syndrome. confirmed or suspected mast cell activation (MCAS), despite increased vaccine hesitancy in this population.

The authors performed a retrospective chart review of 379 patients seen in a single academic allergy and immunology practice from January to December 2021 for confirmed or suspected MCAS, and they determined the proportion receiving at least one dose of any vaccine COVID-19. Researchers found that replication-incompetent COVID-19 adenovirus and mRNA vaccines were tolerated in patients with suspected or confirmed MCAS. However, as of December 31, 2021, the proportion of patients with confirmed MCAS receiving at least one dose of vaccine (64%) was lower than the proportion of North Carolina residents age 18 or older who received at least one dose of vaccine. vaccine (71 percent) and lower than the proportion of U.S. residents 18 or older who have received at least one dose (74 percent). This suggests some vaccine hesitancy in this population.

Additionally, only three of the 41 patients required emergency treatment with medication for an acute allergic reaction within zero to four hours of vaccination. One of these three patients required epinephrine and two required only oral antihistamines.

“This study provides a little more information for allergists and other health care providers to present to their patients with symptoms of nervous or unstable mast cells, when these patients come to see them to find out if they should be vaccinated against the COVID-19 in my opinion, this suggests to me that the benefits of protection against severe COVID-19 that you get from vaccines outweigh the risk of developing side effects from vaccination,” Iweala said. , this can help patients and providers get an idea of ​​the types of side effects they might experience if they chose to get vaccinated and how long they might expect to manage the side effects.”

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Margaret S. Kim, MD, of Northwestern Medicine in Chicago, and colleagues found that chronic rhinosinusitis is common in patients with asthma and bronchiectasis, and that the presence of asthma and bronchiectasis is associated with use increased health care.

The authors reviewed electronic medical records and identified patients with asthma and comorbid chronic rhinosinusitis and/or bronchiectasis. International Classification of Diseases codes were used to identify asthma and chronic rhinosinusitis; Computed tomography of chest scans was used to identify bronchiectasis. Researchers found that chronic rhinosinusitis in patients with asthma and bronchiectasis produced a subset of patients with high healthcare utilization.

“We should assess the signs and symptoms of chronic rhinosinusitis in patients with asthma and bronchiectasis, and conversely, look for bronchiectasis in patients with asthma and chronic rhinosinusitis,” Kim said.

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In a randomized, open-label, two-center phase I study, John Oppenheimer, MD, of the University of Medicine and Dentistry of New Jersey Rutgers Pulmonary and Allergy Associates in Newark, and colleagues found that AQST-109 (a prodrug epinephrine sublingual film) shows promise as a new alternative for patients who need acute treatment for anaphylaxis.

The authors aimed to evaluate the safety and tolerability of AQST-109 in four film formulations at doses ranging from 3 to 24 mg in healthy young male volunteers. Twelve people were randomly assigned to receive the AQST-109 1 or 2 formulation in a single escalating dose. Participants were followed for adverse events and local tolerance. Pharmacokinetic and pharmacodynamic measurements (systolic blood pressure, diastolic blood pressure, and heart rate) were taken pre-dose and at post-dose intervals for six hours. Pharmacokinetic results showed that administration of AQST-109 resulted in peak blood epinephrine concentrations and time to peak blood concentration (Tmax) values ​​comparable to published data for autoinjectors. Similarly, pharmacodynamic results showed changes in heart rate and blood pressure similar to those of injected epinephrine.

“AQST-109 sublingual film showed relatively consistent Tmax values ​​over a narrower range than those reported for injectable epinephrine. These formulations were safe and well tolerated at all dose levels. is the first time it has been demonstrated that therapeutic plasma concentrations of epinephrine can be achieved after sublingual administration,” said Oppenheimer. “AQST-109 continues to show promise as a viable alternative to epinephrine. injection of epinephrine for the treatment of anaphylaxis.”

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AAAAI: additional inhaled glucocorticoid reduces severe asthma exacerbations

TUESDAY, March 1, 2022 (HealthDay News) — The provision of an inhaled glucocorticoid and instructions on its use, in addition to usual care, is associated with a lower rate of severe asthma exacerbations in black and Latino adults with moderate to severe asthma, according to a study published online February 26 in the New England Journal of Medicine to coincide with the annual meeting of the American Academy of Allergy, Asthma & Immunology, held Feb. 25-28 in Phoenix.

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