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Monthly Archives

September 2019

The Role of Mobile Health Technologies in Allergy Care: an EAACI Position Paper.

Quality of Life and Work Productivity Impairment of Patients with Allergic Occupational Rhinitis

By Selected articles

Maher Maoua, et al.

(2019) Tanaffos

Allergic rhinitis impacts negatively the quality of life and occupational activities of patients.

A 10-year duration cross-sectional study evaluated the quality of life and work productivity of patients diagnosed with allergic occupational rhinitis. Quality of Life was assessed by the Mini-RQLQ (rhinitis quality of life questionnaire) and work impairment was assessed by the Work Productivity and Activity Impairment questionnaire.

This study included 414 participants from both genders and with a mean age of 38 years old. Most of them were workers from the textile and clothing industry. Absenteeism was not relevant, however participants experienced activity limitations and practical problems, reducing productivity and quality of life.

This document is only available for registered healthcare professionals.

Alergenos farmacoterapia e inmunologia

Psychiatric comorbidity in chronic urticaria patients: a systematic review and meta‑analysis

By Selected articles

Gerasimos N. Konstantinou and George N. Konstantinou

(2019) Clin Transl Allergy

Chronic urticaria may affect the quality of life, namely in respect to an increase of psychiatric disorders.

This study aimed at evaluating the published evidence of psychiatric disorders that may coexist with chronic urticaria and the effect of psychiatric treatments on people with urticaria.

A systematic literature search for studies that investigated the existence of psychiatric comorbidity in patients with chronic urticaria was conducted, and twenty-five studies that met all the criteria were identified. Studies to be included in the study had to possess the following features: distinction between chronic urticaria and allergic conditions, direct collection of diagnostic psychiatric data by using clinical interview and standardized questionnaires, International Classification of Disorders criteria or the Diagnostic and Statistical Manual of Mental Disorders criteria for the diagnosis of mental disorders and manuscripts written or publish in English.

Analysis of the included studies showed that almost one out of three patients with chronic urticaria have at least one underlying psychiatric disorder. However, no studies clarified if the psychiatric disorder pre-existed at chronic urticaria onset and no association between chronic urticaria severity and duration and psychological functioning. Only a case report and two case series referred to the psychiatric disorder treatment as improving of urticaria.

This study shows the importance of a multidisciplinary approach involving recognition and management of any psychiatric disorder in addition to urticaria treatment.

Sólo profesionales sanitarios registrados pueden acceder a esta publicación.

Terapia de sangrado

New treatments for chronic urticaria

By Selected articles

Pavel Kolkhir, Sabine Altrichter, Melba Munoz, Tomasz Hawro, Marcus Maurer,

(2019) Annals of Allergy, Asthma and Immunology

Current international guideline classifies chronic urticaria as inducible or spontaneous, whether there is a defined trigger sign or not. However chronic urticaria is unpredictable in its course and duration and persists for several years in many patients.

Antihistamines and omalizumab are the most common treatments for chronic urticaria.

This study reviewed the off and beyond label use of licensed drugs, novel treatments under development and promising new targets.

A search was performed and some of the key messages include that omalizumab should be explored in chronic inducible urticaria, in children with chronic spontaneous urticaria and at higher doses. Off label treatments, such as dupilumab, reslizumab, mepolizumab and benralizumab are showing effectiveness in chronic urticaria. Ongoing clinical trials include more monoclonal antibodies, ligelizumab and UB-221. Other promising treatments under development for chronic urticaria include a CRTh2 antagonist, a monoclonal antibody to Siglec-8, bruton’s tyrosine kinase inhibitors, a Syk inhibitor and dupilumab.

New pathogenically important targets for chronic urticaria include Mas-related G-protein coupled receptor X2, the H4 receptor, C5a and its receptor, and other inhibitory mast cell receptors.

The ultimate goal remains the development of treatments that can prevent chronic urticaria, alter its course and cure it.

This document is only available for registered healthcare professionals


Eosinopenia, in chronic spontaneous urticaria, is associated with high disease activity, autoimmunity and poor response to treatment

By Selected articles

Pavel Kolkhir, Martin K. Church, Sabine Altrichter, Per Stahl Skov, Tomasz Hawro, Stefan Frischbutter, Martin Metz, Marcus Maurer.

(2019) The Journal of Allergy and Clinical Immunology: In Practice

Chronic spontaneous urticaria is characterized by the degranulation of skin mast cells and the influx of basophils and eosinophils to affected skin sites. Blood basopenia has been linked to severe antihistamine-resistant urticaria and type IIb autoimmunity, whereas the role of eosinophils in chronic spontaneous urticaria is largely unknown.

This study analysed the prevalence, role and relevance of eosinopenia of 1613 patients with chronic spontaneous urticaria from two centres. Peripheral blood eosinophil and basophil counts were analysed, and patient files were screened for clinical characteristics, results of laboratory tests, the autologous serum skin test, the serum-induced basophil-histamine release assay, and response to second generation H1-antihistamines and omalizumab.

Ten percent of the patients analysed had eosinopenia. This was also associated with being female, high disease activity, autologous serum skin test and basophil-histamine release assay positivity, low total IgE and high levels of C-reative protein and IgG-anti-TPO. Non-responders to treatment had even lower eosinophils compared to responders. Blood eosinophil counts correlated with basophil counts and 81% of patients with undetectable eosinophils had basopenia.

Investigators concluded that the combination of eosinopenia and basopenia is a better predictor of non-response to sgAHs than eosinopenia alone and that eosinopenia in patients with chronic spontaneous urticaria is associated with type IIb autoimmunity, high disease activity and poor response to treatment. This makes eosinophils as excellent biomarkers for the management of people with chronic urticaria.

This document is only available for registered healthcare professionals.

Salud y tecnología móvil

Mobile technology in allergic rhinitis: evolution in management or revolution in health and care?

By Selected articles

Jean Bousquet, Ignacio J. Ansotegui, Josep M. Anto, Sylvie Arnavielhe, Claus Bachert, et al.

(2019) The Journal of Allergy and Clinical Immunology: In Practice

Mobile technology has spread rapidly around the globe. Over 5 billion people have mobile devices, with over half of which are smartphones. Mobile health (mHealth) is the use of information and communication technology for health services and information transfer. Internet-based applications and smart devices are already used in allergic rhinitis and may help to undress some unmet needs, including improving quality of life especially in those with asthma.

This study reviewed existing mHealth applications for allergic rhinitis with published studies, discussed applications that included risk factors of allergic rhinitis, examined its impact in phenotype discovery, provided real-word evidence and discussed mHealth tools that enable digital transformation.

WHO recognizes the significant role that digital technologies can play in strengthening the health systems in countries to achieve universal health coverage, the health-related Sustainable Development Goals and other health objectives. mHealth has the potential to profoundly impact healthcare as existing apps represent an important evolution of health and care for rhinitis. Real world evidence has identified patients’ behaviours and practices, and this will have a profound impact on current guidelines and care pathways. Allergic rhinitis is not a severe disease but it does have a major impact on social life, school and work productivity.

This document is only available for registered healthcare professionals.

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