Yang J, Zhong W, Xue K, Wang Z.
The importance of epigenetics has increased due to identification of its role in the pathophysiology of a number of diseases including allergic rhinitis. This review discusses the studies describing the epigenetic changes taking place in the host cells in response to allergen along with possible mechanisms.
Bousquet J, (…), Zuberbier T; ARIA Working Group.
Allergen immunotherapy (AIT) is a proven therapeutic option for the treatment of allergic rhinitis and/or asthma. Many guidelines or national practice guidelines have been produced but the evidence-based method varies, many are complex and none propose care pathways.
Bousquet J, (…)Okamoto Y, Wallace DV; The MASK study group.
Mobile Airways Sentinel NetworK (MASK) belongs to the Fondation Partenariale MACVIA-LR of Montpellier, France and aims to provide an active and healthy life to rhinitis sufferers and to those with asthma multimorbidity across the life cycle, whatever their gender or socio-economic status, in order to reduce health and social inequities incurred by the disease and to improve the digital transformation of health and care. The ultimate goal is to change the management strategy in chronic diseases.
Tantilipikorn P, Siriboonkoom P, Sookrung N, Thianboonsong A, Suwanwech T, Pinkaew B, Asanasaen P.
Local allergic rhinitis (LAR) is a localized nasal allergic response in the absence of systemic atopy that is characterized by local production of specific immunoglobulin E (sIgE), and a positive response to NAPT (nasal allergen provocation test). The objective of this study is to investigate the prevalence of LAR in adults with chronic rhinitis (CR) and negative skin prick test to Dermatophagoides pteronyssinus (Dp), and to assess the clinical characteristics of LAR, comparing to non-allergic rhinitis (NAR).
Hon KLE, Leung AKC, Ng WGG, Loo SK.
Chinese investigators provided an update on the epidemiology, pathogenesis, clinical manifestations, diagnosis, aggravating factors, complications, treatments and prognosis of chronic urticaria.
They searched for meta-analyses, randomized controlled trials, clinical trials, reviews and other pertinent references.
Chronic urticaria is a clinical diagnosis, based on the appearance of characteristic urticarial lesions that wax and wane rapidly, with or without angioedema, most days of the week for more than six weeks. It is a common, debilitating and hard to treat condition. Medications, physical stimuli and stress can be the trigger of 10-20% of cases. After ruling out an underlying disorder, second generation H1 antihistamines are the choice for initial therapy. These are often safe and effective.
When an improvement does not occur in 2-4 weeks of treatment, the dose can be increased up to fourfold the recommended dose. If improvement does not occur after increase in the dosage, omalizumab should be added.
When a satisfactory improvement does not happen after 6 months or earlier, or if symptoms are intolerable after omalizumab, there is still the possibility of treatment with cyclosporine and second generation H1 antihistamines.
Short-term use of oral corticosteroids may be considered for acute exacerbation of chronic urticaria or in refractory cases.
In conclusion, chronic urticaria is an idiopathic disease in most cases, with the average duration of two to five years. Complications may include skin excoriations, adverse effect on quality of life, anxiety and depression. Treatment is primarily symptomatic with second generation antihistamines on the first line of treatment. Omalizumab has been showing a good support in the management of chronic urticaria and improves patients’ quality of life.
Wertenteil S, Strunk A, Garg A.
Investigators made a cross-sectional analysis using electronic health records data for a demographically heterogeneous population-based sample of over 55 million patients in all four census regions the United States in order to understand the disease burden in chronic urticaria.
From the analysis of the available census data, they estimate that the overall chronic urticaria prevalence is 0,23% (or 230 patients per 100,000 adults). The adjusted prevalence in women was 310 per 100,000 adults, more than twice that of men (146 per 100,000 adults).
Patients aged 40-49 and 50-59 years old had a higher prevalence compared with all other age groups. Also, Caucasians had a lower prevalence of urticaria than African American and “other” people.
In conclusion, despite census data available may underestimate the burden of chronic urticaria, this team estimates that over 500,000 people have chronic urticaria in the United States, most of whom are women and adults over 40 years old.
Bédard A, (…); MASK study group.
A cross-sectional real-world observational study took place in 22 countries to complement a pilot study and provide new information on medication use, disease control and work productivity in people with allergic rhinitis.
A mobile phone app (“Allergy diary”, available for free on Google Play and Apple store) was used to collect data of daily visual analogue scale scores for overall allergic symptoms, nasal, ocular and asthma symptoms, work and medication used by choosing from a list that included all allergic rhinitis medications (prescribed and over-the-counter) available in 22 countries.
The 4 most common intranasal medications containing intranasal corticosteroids and 8 oral antihistamines were considered for the study.
9,122 people who used the mobile application filled the equivalent to 112,054 days of visual analogue scale scores in 2016 and 2017. All other assessments were informative. Users with allergic rhinitis selected between none, single, or multiple treatments, with those referring multiple treatments corresponding to the worst control of symptoms and increasing the range of treatments used.
The analysis also revealed a similar trend for asthma, eye symptoms and work productivity.
Conclusively, although differences between oral antihistamines were found, this study confirms the usefulness of the application Allergy Diary in accessing and assessing behaviour of people with allergic rhinitis.
Jimena Coimbra, Cristina Campo, Luis Labeaga, Montserrat Puntes, Ignasi Gich, Joan Martínez, Rosa Antonijoan.
The main objective of this study was to compare the efficacy of bilastine 20mg administered orally, under fasting and fed conditions, in the reduction of histamine-induced skin reactivity (wheal and flare response) in healthy volunteers, taking into account the first treatment day (Day1) and the steady state (Day4). The final aim of this study was to assess the clinical relevance of this food-drug interaction.
As a conclusión of the study, the pharmacokinetic interaction of bilastine with food does not imply a significant reduction of its antihistamine efficacy, and the interaction of bilastine with food lacks clinical relevance since no significant pharmacodynamic interaction was observed.
© 2024 Bilastina.
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