Monthly Archives

June 2019

chrnic spontaneous urticaria

The impact of omalizumab on quality of life and its predictors in patients with chronic spontaneous urticaria: Real-life data

By | Selected articles

Salman A, Demir G, Bekiroglu N.

A retrospective cohort study was performed to investigate the impact of omalizumab on quality of life and its predictors in chronic spontaneous urticaria.

Omalizumab is an effective and well-tolerated treatment alternative for people with chronic urticaria, however there aren’t studies that assess omalizumab impact on quality of life.

The response to omalizumab therapy was evaluated in 42 patients using urticaria activity score over 7 days and urticaria control test. The impairment in quality of life was assessed using Dermatology Life Quality Index and Chronic Urticaria and Quality of Life Questionnaire.

All scores improved from baseline to first month, remaining stable at the third month. Complete responders had better improvement rates in all scores in all scores compared to others. Gender, age and angioedema had no significant effect on quality of life.

Better scores at baseline might be a predictor of a better response to omalizumab and therefore, more improvement in quality of life of patients with chronic urticaria.

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ácaros del polvo

Determination of the minimally important difference in a nasal symptom score in house dust mite allergy

By | Selected articles

Devillier P, Brüning H, Bergmann KC.

House dust mite (HDM) allergens are responsible for the most prevalent persistent respiratory allergies. Clinical trials in this field often use a four-component nasal symptom score (T4NSS) as a measure of efficacy.

The MID for improvement in the T4NSS is at least -0.90 units in children, adolescents and adults suffering from HDM-induced AR. This value could be rounded up to -1 unit for convenience.

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Urticaria crónica

Systematic reviews of pharmacological and nonpharmacological treatments for patients with chronic urticaria: An umbrella systematic review

By | Selected articles

Shi Y, Zhou S, Zheng Q, Huang Y, Hao P, Xu M, Zhang L, Xiao X, Zheng H, Li Y.

A wide range of pharmacological and nonpharmacological interventions for chronic urticaria (CU) have been evaluated in systematic reviews (SRs). We conducted an umbrella review of SRs of the effectiveness and safety of pharmacological and nonpharmacological interventions for CU.

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conjuntivitis

Local allergic conjunctivitis: a phenotype of allergic conjunctivitis.

By | Selected articles

Yamana Y, Fukuda K, Ko R, Uchio E.

Local allergic rhinitis (LAR) has been reported in the field of otolaryngology; however, the concept of local allergic conjunctivitis (LAC) has not been widely studied in the ophthalmologic community. We routinely examined total IgE levels in tear fluids (t-tIgE) and antigen-specific IgE levels in serum (s-sIgE) in patients with suspected allergic conjunctivitis, on the basis of Japanese guidelines for allergic conjunctival diseases. There are several cases in which the results of t-tIgE and s-sIgE testing are divergent. We suggest that these divergent cases correspond to LAR in otolaryngology.

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Terapia de sangrado

Bloodletting Therapy for Patients with Chronic Urticaria: A Systematic Review and Meta-Analysis

By | Selected articles

Yao Q, Zhang X, Mu Y, Liu Y, An Y, Zhao B.

Many trials have reported that bloodletting therapy is effective when treating chronic urticaria. There are currently no systematic reviews of bloodletting therapy for chronic urticaria.

Bloodletting therapy might be an effective and safe treatment for chronic urticaria, but the evidence is scarce. More high quality trials are needed in the future.

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Rinitis Alergica Local

Nasal Cytology as a Diagnostic Tool for Local Allergic Rhinitis

By | Selected articles

Phothijindakul N, Chusakul S, Aeumjaturapat S, Snidvongs K, Kanjanaumporn J, Ruangritchankul K, Phannaso C.

Nasal eosinophilia on nasal cytology was a good screening tool for diagnosing local allergic rhinitis (LAR) because of its high sensitivity and simplicity of the procedure. Unfortunately, the low specificity of nasal eosinophilia makes the nasal provocation test (NPT) necessary for confirmation of LAR.

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Urticaria cronica angioedema

Cost-Utility of Routine Testing in Chronic Urticaria/Angioedema: A Cohort Study

By | Selected articles

Carrillo-Martin I, Dudgeon MG, Chamorro-Pareja N, Haehn DA, Rivera-Valenzuela MG, Spaulding AC, Heckman MG, Diehl NN, Irizarry-Alvarado JM, Helmi H, Gonzalez-Estrada A

Chronic urticaria/angioedema (CUA) guidelines recommend limiting tests to diagnose and assess prognosis, activity, and severity. Routine testing in CUA might substantially increase cost of disease without benefiting outcome.

In CUA, tests rarely uncover underlying conditions or lead to changes in management and outcome, but they substantially increase the costs generated by the disease. Adherence to current recommendations to limit testing might help in reducing the financial burden of CUA and improve delivery of care.

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Rinitis Alergica

Specific immunoglobulin E in nasal secretions for the diagnosis of local allergic rhinitis

By | Selected articles

Meng Y, Wang Y, Lou H, Wang K, Meng N, Zhang L, Wang C.

Chinese investigators hypothesized that local serum specific immunoglobulin E (sIgE) can be used for the diagnosis of local allergic rhinitis instead of nasal allergen provocation test.

This prospective single center study included 73 chronic rhinitis patients with negative findings for serum IgE and positive findings for local eosinophils and 10 healthy patients were used as controls. All participants completed questionnaires to record demographic data, nasal symptom severity and physician-diagnosed comorbid asthma.

A visual analogue scale of 10 cm was used to record symptom severity and the allergic status was assessed by serum IgE. Nasal secretions were collected for analysis of local sIgE and eosinophils and nasal allergen provocation test was performed to confirm local allergic rhinitis.

Fourteen patients demonstrated positive local sIgE, with twelve of them having significantly higher local sIgE levels and positive nasal allergen provocation test compared to controls.

In conclusion, the measurement of local sIgE levels in nasal secretions is a reliable and effective diagnostic method for local allergic rhinitis as its sensitivity, specificity and diagnostic accuracy was over 90%.

 

 

 

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Alergenos farmacoterapia e inmunologia

Responders and nonresponders to pharmacotherapy and allergen immunotherapy

By | Selected articles

Jakalski M, Bozek A, Canonica GW.

A retrospective analysis of 1624 patients with allergic rhinitis who underwent allergen immunotherapy and 1519 matched patients who underwent only symptomatic therapy was performed.

Allergen immunotherapy is a useful treatment for allergic rhinitis; however, some patients do not achieve the expected results and its responsiveness is difficult to assess. The objective of this study was to assess potential reasons for this to happen.

Investigators registered symptoms, medication scores and quality of life related to allergic diseases before and after treatment. A cluster analysis was performed to discover any association between responsiveness to therapy and the parameters registered.

According to the Mailing criteria, which assesses responsiveness to therapy, 77,8% of patients from the allergen immunotherapy group improved 30% or more; and 62,5% of patients met the threshold of 60% or more improvement. Patients with a short history of allergic rhinitis and concomitant allergy to grass pollen or house dust mites were more frequently worse responders to allergen immunotherapy.

In conclusion, the investigators suggest that short term allergic rhinitis and monovalent allergies to grass pollen or mites could correspond to a better response to allergen treatment.

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Urticaria

Eczema and Urticaria in the Adult Population in Portugal: A Prevalence Study

By | Selected articles

Carvalho D, Aguiar P, Ferrinho P, Mendes-Bastos P, Palma-Carlos A.

A prevalence study was conducted in Portugal to compare the rate of eczema and urticaria within regions and with other countries in Europe.

A telephone interview survey was performed in the last quarter of 2017. Investigators analysed 5000 phone calls to subjects over 16 years old, previously diagnosed with eczema or urticaria living in Portugal. The sample had a proportion representative by population, region, gender and age group.

They estimate the prevalence of eczema and urticaria in Portugal is 4,4 and 3,4%, respectively. Algarve is the region with the highest prevalence. Women are also more affected than men are and seem to be more at risk than men.

Overall, the prevalences found are higher than previously reported, but comparable to results from other countries. From a former study by Harrop and his team, in Europe atopic eczema is 0,14-0,60% of general eczema. Portuguese investigators estimate that atopic eczema prevalence in Portugal is around 0,61-2,64%.

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