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August 2019

enfermedades de la piel

Clinical characteristics and epidemiology of chronic urticaria: a nationwide, multicentre study on 1091 patients

By Selected articles

Jankowska-Konsur A, Reich A, Szepietowski J; Polish Chronic Urticaria Working Group.

Urticaria is one of the most common skin diseases. Depending on the length of symptoms, acute (< 6 weeks) and chronic urticaria (> 6 weeks) are distinguished. Chronic urticaria is divided into inducible urticaria and chronic spontaneous urticaria.

This was a nationwide, multicentre, cross-sectional, questionnaire-based study which objective was to assess the epidemiology and clinical characteristics of chronic urticaria in Poland. A total of 1091 patients with chronic urticaria were included. Among these patients, 383 (35,1%) had inducible urticaria and 667 (61,1%) chronic spontaneous urticaria. The remaining 41 patients (3.8%) suffered from both. Participants with chronic spontaneous urticaria were twice more likely to report family history of urticaria than those with inducible urticaria (12.1% vs. 6.0%, p = 0.001).

In conclusion, chronic spontaneous urticaria is about twice as frequent cause of chronic urticaria as compared to inducible urticaria and constitutes a significant economic burden on society in terms of the absence from work and production lost. It is the cause of absenteeism in almost every fifth patient with this condition. The treatment of chronic urticaria is a major challenge for physicians of various specialties and the treatment choice is closely associated with the specialist knowledge of current treatment guidelines.

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Rinitis Alergica Local

VAS for assessing the perception of antihistamines use in allergic rhinitis

By Selected articles

Ciprandi G, La Mantia I.

Antihistamines are commonly prescribed for the management of allergic rhinitis and urticaria. The quantification of their consumption is relevant in clinical practice, as their use is usually associated with severe symptoms. In addition, symptomatic use of antihistamines is a useful parameter for evaluating allergen immunotherapy effectiveness. However, the use of a diary for recording the number of tablets is frequently negligenced as patients forget to register the actual quantity of tablets taken.

A visual analogue scale (VAS) measures the patient’s perception of symptom severity, emotions and pain.

This study aimed at measuring the VAS for assessing the patient’s perception about antihistamines use in allergic rhinitis. A total of 103 patients with allergic rhinitis due to Parietaria pollen were retrospectively evaluated. They recorded monthly the number of antihistamine tablets taken during the pollen season.

There was a strong relationship between the number of tablets and the VAS score, which represents a possibility of using VAS to estimate the patient’s perception of antihistamines use in clinical practice.

This document is only available for registered healthcare professionals.

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Allergic Rhinitis Nasal Mucosa

ARIA masterclass 2018: From guidelines to real-life implementation

By Selected articles

Hellings PW, Seys SF, Marien G, Agache I, Canonica W, Gevaert P, Haahtela T, Klimek L, Mullol J, Pfaar O, Scadding G, Scadding G, Valiulis A, Aria AMD, Bousquet J, Pugin B; ARIA masterclass discussants.

Around 20-30% of the European populations suffer from allergic rhinitis, which affects their social life, sleep and work productivity, indirectly rising the economic burden for society.

The ARIA (allergic rhinitis and its impact on asthma) initiative has been developing guidelines for the treatment of allergic rhinitis and asthma to ensure the highest level of best practices in real-life settings, and has evolved towards integrated care pathways using mobile technology and further to management as the key to provide an active and healthy life to all allergic rhinitis patients.

In September 2018, the first ARIA masterclass was held in Brussels with the following key objectives:

  • To provide unbiased education on the best-practices for allergic rhinitis diagnosis, treatment and follow-up
  • To update clinicians about recent research data in allergic rhinitis and asthma, from clinical trials to real-world evidence
  • To share next generation care pathways for the optimal management of patients with allergic rhinitis and asthma
  • To inform clinicians about change management and its impact on healthcare
  • To support clinicians with the adoption of digital solutions in daily practice.

A recent study showed that allergic rhinitis specialists behave like patients, showing a real disconnection between physician’s prescription and patient’s behavior for allergic rhinitis treatment.

The majority of allergists prescribe medications for the entire pollen season, but the vast majority of patients use their medications on-demand when their symptoms are not well controlled.

The objective of the ARIA masterclass was to anticipate a reconnection between physicians and patients, by promoting a patient-centered approach, with a therapeutic strategy tailored to the patient needs but also to their preferences. The use of integrated care pathways and mobile Apps can facilitate this change in care management. In turn, this would result in better symptoms controls for patients, and a substantial reduction of indirect cost for the society.

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Identifying an effective mobile health application for the self-management of allergic rhinitis and asthma in Australia

By Selected articles

Tan R, Cvetkovski B, Kritikos V, O’Hehir RE, Lourenço O, Bousquet J, Bosnic-Anticevich S.

Up to 40% of the population worldwide is affected by allergic rhinitis, which carries a significant burden on individuals and society. Allergic rhinitis symptoms are often self-managed in the community pharmacy setting, with patients underestimating their symptoms and overestimating their ability for effective self-management. In the current technology world, the use of mobile Apps has become more and more popular and represents a promising tool for management of different conditions.

The objective of this study was to identify an effective App for the management of allergic rhinitis and/or asthma. All English and free of charge mobile health-related Apps from the Australian Apple store and Android Google Play store were included in this study and evaluated regarding three domains: accessibility in both App stores, alignment with theoretical principles of the self-management of allergic rhinitis and/or asthma and usability of the App using a mobile App rating scale.

Of a total of 418 Apps retrieved, 31 were evaluated. Many of the evaluated Apps fall short of the self-management principles and most within the field of allergic rhinitis and asthma only deal with either one or other condition. The MASK-air App achieved the highest mean rank and covered all self-management principles except a doctor appointment reminder, with a high rate of engagement.

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Investigación en laboratorio alergias

Concomitant Bilastine and Montelukast as Additive Therapy for Seasonal Allergic Rhinoconjunctivits and Mild-to-Moderate Asthma. The SKY Study

By Articles about Bilastine

Lavorini F, Matucci A, Rossi O, Pistolesi M; SKY study investigators.

A double-blind, double-dummy, randomised, active-controlled, parallel group design (The SKY study) compared the efficacy and efficacy of concomitant therapy with bilastine and montelukast with each substance alone in patients with seasonal allergic rhinoconjunctivitis and asthma for four weeks.

419 adults with seasonal allergic rhinoconjunctivitis and mild-to-moderate asthma partially controlled by beclomethasone dipropionate or equivalent were included. They had a forced expiratory volume (FEV1) >70%, a positive skin prick test to one or more allergens and nasal/ocular total symptom score (TSS) >3. Participants were screened for one week and then a twelve weeks treatment.

Allergic rhinoconjunctivitis score (TSS), daytime nasal and non-nasal symptom scores and use of rescue medications were registered.

Contrary to the original hypothesis, concomitant administration of bilastine with montelukast was as effective as either agent alone for allergic rhinoconjunctivitis symptoms, however bilastine alone improved allergic rhinoconjunctivitis symptoms more than montelukast in the first two weeks of treatment.

The SKY study investigators concluded that there is no benefit of using bilastine plus montelukast to provide relief of allergic rhinoconjunctivitis in patients with mild-to-moderate asthma.

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