Bilastina, autor en Bilastina

Oct 22

Positive effect of Helicobacter pylori treatment on outcome of patients with chronic spontaneous urticaria

By Bilastina Artículos seleccionados, Selected articles

Mohammed Elhendawy, Maha Hagras, Shaimaa Soliman, Engi Seif Shaker

Am J Clin Pathol. 2020 Sep 17;aqaa134. doi: 10.1093/ajcp/aqaa134. Online ahead of print.

People with chronic urticaria have chronic hives, itching, and wheels that come and go for long periods. Chronic spontaneous urticaria represents 80 – 90 % of chronic urticaria cases, and the release of histamine and other inflammatory mediators from mast cells and basophils may be immunoglobulin E (IgE)–mediated or non-IgE-mediated. Helicobacter pylori is a gram-negative bacterium with a high prevalence worldwide, and that persistently colonizes the stomach. Its presence is associated with an increased risk of peptic ulcer and gastric cancer. The association between Helicobacter pylori and chronic spontaneous urticaria is controversial. This study’s objective was to assess the relationship between Helicobacter pylori eradication therapy and chronic spontaneous urticaria remission.

This was a randomized, double-blind, placebo-controlled pilot study that included 72 patients with urticaria. From these, 27 were positive for Helicobacter pylori stool antigen and PCR in gastric biopsy and were randomly assigned to receive anti-Helicobacter pylori treatment or placebo.

Participants with Helicobacter pylori had significantly lower hemoglobin concentrations with microcytic hypochromic anemia and a significantly higher occurrence of dyspepsia symptoms. All Helicobacter pylori patients (except 2) had significant improvement of the urticaria itching and red wheals after two weeks of therapy compared to placebo.

This study showed an association between chronic spontaneous urticaria and the presence of Helicobacter pylori in the gastric tissue. Patients with urticaria who do not respond to usual chronic urticaria treatment should be tested for Helicobacter pylori as therapy of Helicobacter pylori showed to improve the symptoms of chronic spontaneous urticaria.

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Oct 22

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Avances y desarrollos novedosos en la rinitis alérgica

Advances and novel developments in allergic rhinitis

By Bilastina Artículos seleccionados, Selected articles

Yifan Meng, Chengshuo Wang, Luo Zhang

Allergy. 2020 Sep 9. doi: 10.1111/all.14586. Online ahead of print.

Allergic rhinitis is a condition of the upper airways, with a high prevalence worldwide, characterized by symptoms such as nasal obstruction, rhinorrhea, sneezing, and nasal pruritus. This is due to inhaled allergens and respective mucosal inflammation. This review’s objective was to highlight novel mechanisms and treatments of allergic rhinitis to optimize its management.

Proteins such as histone deacetylase (HDAC) and mucin 1 (MUC1) have a role in the epithelial tight junction barrier’s integrity. Inflammatory mediators, such as type 2 innate lymphoid cells (ILC2), myeloid dendritic cells (mDC), and plasmacytoid dendritic cells (pDC), are involved in the development of allergic rhinitis. Other risk factors include genetic susceptibility, age, intrauterine growth restriction, fetal oxidative balance, diet, environmental changes, and essential roles in allergic rhinitis.

Management of allergic rhinitis includes patient education, pharmacotherapy, allergen-specific immunotherapy, and biologics. Novel therapies include highly purified allergens, allergoids, peptides, and new adjuvants for use in specific allergen immunotherapy and specific monoclonal antibodies for blocking the effects of immune mediators.

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Oct 22

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This study aimed to compare the gastrointestinal composition between adults and children suffering from allergic rhinitis.

Comparison of the gastrointestinal composition between adults and children suffering from allergic rhinitis

By Bilastina Artículos seleccionados, Selected articles

Annabelle M Watts; Nicholas West; Ping Zhang; Peter Smith; Allan Cripps; Amanda Cox

Int Arch Allergy Immunol. 2020 Sep 24;1-12. doi: 10.1159/000510536. Online ahead of print.

The gut microbiota has an essential role in the development and regulation of local and systemic immunity. Allergic rhinitis, such as various immune-mediated conditions, has been associated with abnormal gut microbial colonization patterns in children; however, there is not enough data regarding adults. This study aimed to compare the gastrointestinal composition between adults and children who suffer from allergic rhinitis.

This was a cross-sectional study that included 57 adults with allergic rhinitis and 23 healthy controls. Investigators compared samples of their stools via next-generation sequencing of the V3-V4 hypervariable regions of the 16S rRNA gene. Investigators used a reference-based approach with the NCBI database to taxonomic classification and identity approach.

Participants with allergic rhinitis had a significant reduction in species richness. They also had declines in operational taxonomic unit counts and diversity indices. In contrast, they had significantly more Bacteroidetes than healthy controls, as well as an increased abundance of Parabacteroides and a reduced abundance of Oxalobacter and Clostriadiales.

Adults with allergic rhinitis have a different gut microbiome than healthy controls, with reduced microbial diversity and altered abundance of some microbes. Identifying the metabolites and mechanisms underlying the relationship microbiota-host will improve how the gut microbiome composition regulates immunity and may be of interest to potential therapeutic options for allergies.

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Sep 25

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Comparison of allergens and symptoms in patients with allergic rhinitis between 1990s and 2010s

By Bilastina Artículos seleccionados, Selected articles

Ji Heui Kim, Shin Ae Kim, Ja Yoon Ku, Won Ki Cho and Chol Ho Shin

Allergy Asthma Clin Immunol. 2020 Jul 1;16:58. doi: 10.1186/s13223-020-00455-9. eCollection 2020.

Allergic rhinitis is a common chronic upper airway inflammatory disease characterized by nasal obstruction, rhinorrhea, sneezing, and itching of the eyes/nose. Its prevalence has been increasing steadily in Korea. Although Korean people’s lifestyle and environment have been changing, the corresponding changes in the characteristics of allergic rhinitis have not been documented. This study’s objective was to describe the changes in allergens and clinical manifestations of allergic rhinitis in Korean patients between 1990 and 2010.

Patients diagnosed with allergic rhinitis in 1990 and 2010 were evaluated and answered a symptom questionnaire. The two sets of patients were compared regarding the differences in allergens and the results of the questionnaire.

Compared with the set of 1990 patients, the rate of sensitization to house dust mites, cockroaches, Aspergillus, Alternaria, and tree pollen significantly increased, and that to cat fur significantly decreased in patients from the 2010s (p < 0,05). The distribution of patients with moderate-to-severe nasal obstruction and itching of the eyes/nose increased (p < 0,05), as well as that of patients with minor symptoms, such as olfactory disturbances, cough, sore throat, and fatigue (p < 0,01).

In conclusion, Korean people with allergic rhinitis from 2010 have different symptom severity and allergen reactivity and type. These results may reflect changes in Korea’s environmental conditions and lifestyle, which may be useful for patient counseling and management.

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Sep 25

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Perception and control of allergic rhinitis in primary care

By Bilastina Artículos seleccionados, Selected articles

Pascal Demoly, Isabelle Bossé and Pascal Maigret

NPJ Prim Care Respir Med. 2020 Aug 20;30(1):37. doi: 10.1038/s41533-020-00195-8.

People with chronic diseases behave according to their perception of the disease, which may impact treatment results. The prevalence of allergic rhinitis is high, around 400 million people worldwide. However, it is poorly self-recognized by patients, as well as it is poorly controlled. The PETRA study’s objective was to evaluate the management of allergic rhinitis by patients and their general practitioners and to describe the relationship between disease perception, patient behavior, and treatment outcomes.

The PETRA study was a cross-sectional study that included 2001 participants between May and October 2017. The study’s main objective was to precisely identify and describe factors associated with a poor perception of the disease in people with allergic rhinitis. 201 French general practitioners selected 1929 patients for analysis (mean age: 39 years; intermittent/persistent symptoms: 46.2/52.3%). 71,7% of the participants had uncontrolled allergic rhinitis (ARCT score < 20), 53,6% had a good perception of their illness (BIPQ score < 5), and 14,1% of the patients had also been diagnosed with asthma.

A poor perception of allergic rhinitis was related to ear, nose, and throat complications, nasal pruritus, uncontrolled allergic rhinitis, and asthma. Also, there was a strong negative correlation between the BIPQ and ARCT scores: the poorer the patient’s perception, the less the disease was controlled.

In conclusion, the PETRA cohort included a high proportion of patients with moderate to severe allergic rhinitis symptoms and a low disease control level. It was shown that many patients were not satisfied with their treatment and did not perceive their disease very well. Although no causal relationship could be drawn from this study, results suggest that improving the perception of allergic rhinitis could be beneficial and lead to better control of symptoms.

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Sep 25

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Fatigue is Common and Predicted by Female Gender and Sleep Disturbance in Patients with Chronic Spontaneous Urticaria

By Bilastina Artículos seleccionados, Selected articles

Kemal Erol, Sule Ketenci Ertas, Ragıp Ertas

J Allergy Clin Immunol Pract . 2020 Aug 25;S2213-2198(20)30836-9. doi: 10.1016/j.jaip.2020.08.020. Online ahead of print.

Chronic spontaneous urticaria is a chronic disease characterized by wheals and pruritus and/or angioedema. Most urticaria patients are women who have their quality of life reduced due to the impact of the disease on daily life and sleep quality. Fatigue is a common symptom in urticaria. This study’s objective was to assess fatigue and how it affects people with chronic spontaneous urticaria compared to healthy people.

This study included 103 patients with chronic spontaneous urticaria and 35 age and gender-matched healthy controls. They were assessed for fatigue with the Fatigue Severity Scale (FSS) and VAS-Fatigue. Duration, activity, and control of disease, as well as anxiety, depression, and quality of life, were also evaluated.

No significant associations were seen in disease activity, disease control scores, FSS, positivity for anti-nuclear antibodies, and IgE levels between fatigued and non-fatigued patients with urticaria. Fatigued patients had significantly higher CRP levels (p=0,009). Also of note was the significant correlation between total FSS score and chronic urticaria quality of life in patients with chronic spontaneous urticaria, where women with urticaria and with disturbed sleep complained of fatigue.

Women with chronic spontaneous urticaria commonly experience fatigue, which is an important symptom that negatively affects their quality of life.

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Sep 25

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Targeted Therapy for Chronic Spontaneous Urticaria: Rationale and Recent Progress

By Bilastina Artículos seleccionados, Selected articles

Ana M. Giménez‑Arnau, Andaç Salman

Drugs . 2020 Aug 28. doi: 10.1007/s40265-020-01387-9. Online ahead of print.

Chronic spontaneous urticaria is characterized by wheals, angioedema, or both for at least 6 weeks and can last for a long time, up to 5 years. The effects of chronic spontaneous urticaria on quality of life are comparable to psoriasis, atopic dermatitis, or even ischemic heart disease.

Antihistamines continue to be the first choice for treatment of urticaria, however rates of response are low (ranging from 38.6% in standard doses to 63.2% in higher doses), some patients don’t experience a complete of symptoms. The use of omalizumab has shown a major advance in treating patients with chronic spontaneous urticaria, however, there is a subgroup of patients who have a partial or even lack of response to omalizumab.

Some of the upcoming targeted therapies for chronic spontaneous urticaria include:

anti-IgE antibodies, such as ligelizumab, a monoclonal antibody directed against the Cε3 domain of IgE and which has shown a six- to ninefold greater potency in vivo compared to omalizumab; UB-221, another monoclonal antibody against IgE with up to eightfold greater affinity for free IgE, compared to omalizumab; quilizumab, a humanized monoclonal antibody directed against membrane-bound IgE.
Anti-Siglec-8. Siglecs are a transmembrane family with regulatory effects on intercellular and intracellular signaling, with Siglec-8 having expression on eosinophils and mast cells.
Bruton’s Tyrosine Kinase (BTK) inhibitors. BTK is a tyrosine kinase expressed in hematopoietic cells, including macrophages, mast cells and basophils. BTK inhibitors are used to treat different malignancies of B-cell origin. Ibrutinib, dasatinib, AVL-292 and CNX-774 effectively suppressed IgE-induced activation and histamine release from basophils and mast cells.
Chemoattractant receptor-homologous molecule expresses on Th2 (CRTH2) inhibitors; Spleen Tyrosine Kinase (SYK) inhibitors; Anti-CD20; Anti-IL-1; Anti-IL-4/13; and Anti-IL-5.

The future treatment of chronic urticaria will probably change once potential new treatments are completely developed.

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Sep 25

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Clinical presentation at the onset of COVID-19 and allergic rhinoconjunctivitis

By Bilastina Artículos seleccionados, Selected articles

Fabio Ferreli, Francesca Gaino, Elena Russo, Matteo Di Bari, Francesca Pirola, Andrea Costantino, Luca Malvezzi, Armando De Virgilio, Giovanni Colombo, Giovanni Paoletti, Emanuela Morenghi, Giorgio Walter Canonica, Giuseppe Spriano, Enrico Heffler, Giuseppe Mercante

J Allergy Clin Immunol Pract . 2020 Aug 18;S2213-2198(20)30823-0. doi: 10.1016/j.jaip.2020.08.009. Online ahead of print.

COVID-19 is characterized by various clinical conditions, from mild symptoms to pneumonia and death. Mild symptoms, such as nasal and ocular manifestations, can be confused with allergic rhinoconjunctivitis at the onset. This article describes the differences that let one distinguish COVID-19 and allergic rhinoconjunctivitis.

This study included 204 patients that were infected with coronavirus were included. They were retrospectively studied via telephone interview, where they were requested to complete a validated questionnaire, The Mini Rhinoconjunctivitis Quality of Life Questionnaire (MiniRQLQ), which evaluated a series of 14 signs and symptoms on a scale from 0 to 6, indicating “not troubled” and “extremely troubled”, respectively. Patients were also asked to compare the manifestations of their last allergic symptomatic period with COVID-19 manifestations and to evaluate their sense of taste and/or smell.

Among all 204 participants, 22 were also affected by allergic rhinoconjunctivitis. Clinical manifestations of allergic rhinoconjunctivitis compared with those at the onset of COVID-19 were defined as “completely different” by 15 patients (68,2%), “different” by 3 (13.6%), and “similar” by 4 (18,2%). The two clinical presentations were never reported as “identical”.

Although COVID-19 may present some overlap in symptoms with seasonal allergies, the MiniRQLQ scored significantly different between allergic rhinoconjunctivitis and COVID-19. Also, in this study, there were no differences in taste and smell dysfunction reported. Patients with allergic rhinoconjunctivitis are familiar with its symptoms and were able to distinguish them from COVID-19 rhinoconjunctival manifestations.

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Aug 24

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Clinical Control of CSU with Antihistamines Allows for Tolerance of NSAID-Exacerbated Cutaneous Disease

By Bilastina Selected articles

Jorge Sánchez

J Allergy Clin Immunol Pract . 2020 Jul 14;S2213-2198(20)30700-5. doi: 10.1016/j.jaip.2020.06.057. Online ahead of print.

A great number of patients with chronic spontaneous urticaria experience exacerbations after treatment with non-steroidal anti-inflammatory drug (NSAID). Although international guidelines suggest that people with urticaria avoid NSAIDs, this is sometimes difficult. Some case reports recommend that H1-antihistamines can help prevent these exacerbations.

The objective of this study was to evaluate if H1-antihistamines can help prevent NSAID-exacerbated reactions in people with chronic spontaneous urticaria.

This was a cross-over, multi-center, and ambispective study in 3 centers in Medellín, Colombia that included 121 participants with chronic spontaneous urticaria and a history of NSAIDs exacerbations. A diagnostic challenge test without the use of antihistamines and a challenge test using antihistamines were performed using the NSAID reported in the medical record. The order in which test were performed in each participant was determined by the investigator: participants with a positive first diagnostic challenge, were subject to a second challenge using H1-antihistamines, those with a negative first challenge using H1-antihistamines, were subject to a second one without the use of H1-antihistamines, and those with a negative first diagnostic challenge or a positive first challenge using H1-antihistamines, did not undergo a second challenge. Some patients were subject to an alternative NSAID before the diagnostic challenge test or the challenge test using H1-antihistamines.

The diagnostic challenge test retrieved 96 participants testing positive, with 75 % (72 participants) tolerating the NSAID involved in the reaction when they added H1-antihistamines.

In conclusion, although NSAID may represent some restrictions for people with chronic spontaneous urticaria, the use of H1-antihistamines can help control further urticaria exacerbations due to NSAID treatment.

This document is only available for registered healthcare professionals

Aug 24

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High dose Bilastine for the treatment of Bascule Syndrome

By Bilastina Articles about Bilastine

L Cunningham

Clin Exp Dermatol . 2020 Jul 13. doi: 10.1111/ced.14377. Online ahead of print.

Bascule syndrome (bier anaemic spots and cyanosis with urticarial-like eruption) was described for the first time in 2016 and it remains to be fully elucidated. To date no successful treatment has been described.

This is a case study of a 16-year old boy who presented a patchy discolouration of the lower legs in a dependent position, associated with burning and stinging sensations and dizziness and light-headedness when moving from sitting to standing. These symptoms were present for a year. Allergy, neurology and cardiology consultations were inconclusive, Tilt table testing revealed no evidence of orthostatic hypotension or postural orthostatic tachycardic syndrome but triggered his symptoms. A dermatologist diagnosed him with Bascule syndrome, based on his clinical findings.

Different antihistamines were trialled (cetirizine 10 mg daily, bilastine 20 mg daily) with no success. A dose of bilastine 40 mg twice daily completely resolved his symptoms, but recurred when the dose was reduced to half.

This is the first documented case of a successful treatment of Bascule syndrome with bilastine. It is likely that the dose needed may be higher than usual dose antihistamines. Also, the decision to treat with antihistamines should be based on symptoms.

This document is only available for registered healthcare professionals

Aug 24

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Characteristics and determinants of patient burden and needs in the treatment of chronic spontaneous urticaria

By Bilastina Selected articles

Rachel Sommer, Neuza da Silva, Anna Langenbruch, Marcus Maurer, Petra Staubach-Renz, Matthias Augustin

Eur J Dermatol. 2020 Jun 1;30(3):259-266. doi: 10.1684/ejd.2020.3763

About 1 % of the population suffers from chronic spontaneous urticaria. The highest incidence is between 30 and 40 years of age, with women being most affected. The objective of this study was to characterise the specific needs and treatment objectives in chronic spontaneous urticaria from the view of the patient.

This was a cross-sectional study that included 103 participants from 4 German outpatient dermatology clinics. The validated Patient Needs Questionnaire (PNQ) for chronic spontaneous urticaria was used to determine patient needs and potential treatment objectives. To determine the relationship between patient needs and disease burden, different scales were used: disease-specific (CU-Q2oL), skin-generic (DLQI) and health generic (EQ VAS).

Most participants were female (71,4 %), with a mean age of 43,92 ± 14,96 years. The most important treatment objective was the absence of visible skin lesions (92,3 % considered important/ very important), then to be free of itching (91,5 %) and lately the desire to be healed of all skin defects (89,5 %). All other 26 items analysed, were considered to be quite important/ very important by, at least, 30 % of the participants. In relation to patient specific needs, this were related to gender and duration of disease.

In conclusion, these data show that people with chronic spontaneous urticaria have an individual broad range of needs, enabling specialists to adapt treatment to their needs. Innovative treatments may also help increase overall benefits. Independently of the treatment, the decision should be shared to help a better management of the condition.

This document is only available for registered healthcare professionals

Aug 24

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Molecular mechanisms and epidemiology of COVID-19 from an allergist’s perspective

By Bilastina Selected articles

Koa Hosoki, Abhijit Chakraborty, Sanjiv Sur.

J Allergy Clin Immunol. 2020 Jul 2;146(2):285-299. doi: 10.1016/j.jaci.2020.05.033. Online ahead of print.

Back in March 2020, the World Health Organization declared COVID-19 a global pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The aim of this article was to discuss how the development in some allergic rhinitis symptoms can serve as clues for the onset of COVID-19, and also to understand why patients with asthma can be at a higher risk for severe COVID-19.

There are some differences in symptoms in people with allergic rhinitis and those infected with the SARS-CoV-2. The later usually develop symptoms such as dry cough, sore throat, nasal congestion, shortness of breath, myalgia, fatigue, fever and rarely conjuctival congestion. People who suffer from allergic rhinitis present with runny itchy nose, itchy eyes, sneezing, postnasal drip and conjunctival congestion. From an allergist’s perspective, a shift from common allergic rhinitis symptoms to those related in COVID-19 (fever, cough and shortness of breath), may suggest the onset of COVID-19 in people with allergic rhinitis. Also, the prevalence of taste or olfactory dysfunctions such as anosmia and dysgeusia is higher in COVID-19 patients than in allergic rhinitis.

Wheezing, which is common in asthma exacerbations, rarely occurs in hospitalized patients with COVID-19. However, as asthma and COVID-19 are associated with cough and shortness of breath, it is important to exclude COVID-19 in people with asthma exacerbations. The mechanisms underlying the association between asthma and COVID-19 are related to the attenuated IFN-I and IFN-III response to respiratory infections that people with asthma have. Because COVID-19 infects lung and airway cells, it also induces and attenuated IFN-I and IFN-III signature, similar to the one observed in people with asthma, the reason why it is expected that COVID-19 frequently triggers asthma exacerbations.

Until an effective vaccine and treatments develop, it is important to understand the scientific rationale of the disease and to maintain mitigation strategies such as wearing facemasks and social distancing.

This document is only available for registered healthcare professionals

Aug 24

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Effectiveness, safety and tolerability of Bilastine 20 mg versus Levocetirizine 5 mg for the treatment of chronic spontaneous urticaria: a double-blind, parallel group, randomized controlled trial

By Bilastina Articles about Bilastine

Indrashis Podder, Anupam Das, Shouvik Ghosh, Debalina Biswas, Sujata Sengupta, Satyendra Nath Chowdhury

Dermatol Ther. 2020 Jul 2;e13946. doi: 10.1111/dth.13946. Online ahead of print.

Chronic urticaria is characterized by wheals with or without angioedema for, at least, 6 weeks. It is a debilitating condition that affects people’s quality of life. Bilastine is a novel non-sedative H1 antihistamine approved for symptomatic treatment of allergic rhinoconjunctivitis and urticaria in patients older than 12 years old.

The objective of this study was to compare the effectiveness, safety and tolerability of bilastine 20 mg with levocetirizine 5 mg in moderate-to-severe chronic spontaneous urticaria.

This was a double-blind, randomized, controlled study with two arms: bilastine 20 mg once daily (31 participants) and levocetirizine 5 mg once daily (27 participants) for 42 days. The severity of urticaria, global urticaria-induced discomfort and quality of life were evaluated with UAS7 (urticaria activity score), VAS (visual analogue scale) and DLQI (dermatology life quality index) at baseline and follow-up visits.

Primary objective was to assess the variation of the UAS7, and secondary objectives assessed changes in DLQI and VAS. Safety, tolerability and compliance were evaluated by analysis of drug-related adverse events, biochemical investigations and electrocardiogram.

Both bilastine and levocetirizine improved UAS7, DLQI and VAS at the end of treatment. Also, all parameters showed greater improvement with bilastine, but only the UAS7 revealed a significant reduction (p = 0,03). Sedation was also significantly less with bilastine (p = 0,04). Both treatments improved UAS7 and VAS significantly from day 14. No serious adverse effects were registered.

In conclusion, bilastine demonstrated a better efficacy and less sedation for chronic spontaneous urticaria when compared to levocetirizine, however similar effect on quality of life.

This document is only available for registered healthcare professionals

Jul 23

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Utility of Environmental Exposure Unit Challenge Protocols for the Study of Allergic Rhinitis Therapies

By Bilastina Selected articles

Lubnaa Hossenbaccus, Lisa M. Steacy, Terry Walker, Anne K. Ellis.

Current Allergy and Asthma Reports (2020) 20:34. https://doi.org/10.1007/s11882-020-00922-8

Allergic rhinitis is an inflammatory disease of the nasal mucosa triggered by allergen exposure in sensitized patients. This study explores how the Environmental Exposure Unit (EEU) experimental model can be used to understand new therapies for allergic rhinitis. This study evaluated recent advances in allergic rhinitis therapies using the EEU model.

The EEU models are experimental models for the study of allergic rhinitis, including but not limited to phase 3 efficacy outpatient studies and outdoor park studies. Their use is increasing for the study of combination therapies, immunotherapies and novel AR treatments. Some examples include a combined antihistamine/corticosteroid nasal spray formulation, which was seen to have a faster onset of action relative to the therapies individually, house dust mite sublingual immunotherapy tables that have demonstrated to be safe and effective, a novel peptide-based immunotherapy approach effective in reducing grass pollen allergic rhinitis, and nasal filters that reduce seasonal AR symptoms.

The EEUs are controlled, reproducible and unique models for the study of allergic rhinitis therapies. EEUs provide valuable efficacy about the efficacy, onset and duration of action and dose-related impacts of allergic rhinitis therapies, with direct clinical relevance. Unlike phase 3 efficacy trials and park studies which rely on the natural environment, EEUs allow for the control of study variables, such as humidity, temperature, and allergen distribution. Allergic rhinitis symptoms generated in EEUs are comparable with natural pollen seasons which allows for allergen-specific research to continue even outside of the natural season.

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Jul 23

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EAACI Guideline on the effective transition of adolescents and young adults with allergy and asthma

By Bilastina Selected articles

Graham Roberts, et al.

Allergy. 2020 Jun 19. doi: 10.1111/all.14459. Online ahead of print.

Adolescents and young adults represent a large group of patients with allergic rhinitis and/or asthma. Most times their treatment is complicated due to the biological and psychosocial changes that occur as they grow. Sometimes they have difficulty in understanding the consequences of their disease, failing to take responsibility for self-management, leading to suboptimal adherence and other negative consequences. The transitional care should address the psychological, medical, educational and vocational needs of adolescents and young adults.

The European Academy of Allergy and Clinical Immunology has developed a clinical practice guideline that provides evidence-based recommendations for healthcare professionals to support the transitional care of adolescents and young adults with allergic rhinitis and/or asthma.

This guideline includes general recommendations on operating a clinical service for these patients, which include: starting the transition as early as 11-13 years old, using a structured, multidisciplinary approach, ensuring they fully understand their condition and have resources they can access, active monitoring of adherence and discussing any implications for further education and work.

Specific allergy and asthma transition recommendations include simplifying medication regimes and using reminders, focusing on areas where these patients are not confident and involving peers in training them. Identifying and managing psychological and socioeconomic issues impacting disease control and quality of life; enrolling the family in assisting them to undertake self-management and encouraging them to let their friends know about their allergies and asthma are also recommendations of this guideline.

National healthcare systems may need to adapt these recommendations according to each culture. If optimal care is received by adolescents and young adults, they will become expert adult patients with the knowledge and skills to manage their condition throughout their lifes.

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Bilastina

Positive effect of Helicobacter pylori treatment on outcome of patients with chronic spontaneous urticaria

Advances and novel developments in allergic rhinitis

Comparison of the gastrointestinal composition between adults and children suffering from allergic rhinitis

Comparison of allergens and symptoms in patients with allergic rhinitis between 1990s and 2010s

Perception and control of allergic rhinitis in primary care

Fatigue is Common and Predicted by Female Gender and Sleep Disturbance in Patients with Chronic Spontaneous Urticaria

Targeted Therapy for Chronic Spontaneous Urticaria: Rationale and Recent Progress

Clinical presentation at the onset of COVID-19 and allergic rhinoconjunctivitis

Clinical Control of CSU with Antihistamines Allows for Tolerance of NSAID-Exacerbated Cutaneous Disease

High dose Bilastine for the treatment of Bascule Syndrome

Characteristics and determinants of patient burden and needs in the treatment of chronic spontaneous urticaria

Molecular mechanisms and epidemiology of COVID-19 from an allergist’s perspective

Effectiveness, safety and tolerability of Bilastine 20 mg versus Levocetirizine 5 mg for the treatment of chronic spontaneous urticaria: a double-blind, parallel group, randomized controlled trial

Utility of Environmental Exposure Unit Challenge Protocols for the Study of Allergic Rhinitis Therapies

EAACI Guideline on the effective transition of adolescents and young adults with allergy and asthma

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