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Challenges in the Management of Asthma in Older Adults
AbstractPurpose of reviewAsthma is a heterogeneous and variable disease directly influenced by genetic factors, environmental triggers, and lung development throughout life. Elderly with asthma have unique needs not fully addressed by current guidelines. This present review aims to discuss the particularities of asthma in older adults and present an overview of tailored treatment strategies in the geriatric population.Recent findingsThe physiologic aging process promotes biological changes leading to dilatation of air spaces, deterioration of lung function, and dysregulation of the immune system. In advanced age, asthma ma...
Source: Current Treatment Options in Allergy - February 21, 2023 Category: Allergy & Immunology Source Type: research

Impact of Sinonasal Disease on Eustachian Tube Dysfunction
AbstractPurpose of reviewEustachian tube dysfunction (ETD) is a common disease caused by abnormal function of the Eustachian tube. Sinonasal diseases, such as allergic rhinitis (AR) and chronic rhinosinusitis (CRS), are known to induce ETD through mucosal edema and Eustachian tube obstruction. As a result, ETD is often treated with medical therapies used to manage AR and CRS. This review serves to summarize the pathologic link between sinonasal diseases and ETD and the current state of evidence on the impact of treatments used for sinonasal diseases on ETD.Recent findingsThere is a high prevalence of ETD in patients with s...
Source: Current Treatment Options in Allergy - February 20, 2023 Category: Allergy & Immunology Source Type: research

Electronic Monitoring Devices to Support Inhalation Technique in Patients with Asthma: a Narrative Review
AbstractPurpose of ReviewImproper inhaling technique is common and is associated with poor patient outcomes. However, digital e-health devices may offer novel opportunities for educational support. This narrative review provides an overview of electronic monitoring devices (EMDs) measuring patient inhalation technique. We summarise their technical features, capabilities and limitations and discuss the steps necessary for implementation in clinical practice.Recent FindingsSix EMDs measuring inhalation were identified. The quality of published evidence varied widely. Devices differed in the inhalation technique steps measure...
Source: Current Treatment Options in Allergy - February 17, 2023 Category: Allergy & Immunology Source Type: research

Beware SABA Overuse: a Message from the Global SABINA Program
Abstract Purpose of reviewThe goal of this paper is to highlight the design and outcomes of the SABa use IN Asthma (SABINA) research program. The SABINA program was designed to evaluate SABA and ICS prescriptions for asthma on a global level and describe associated clinical outcomes of SABA overuse.Recent findingsThe results of these studies, conducted across multiple countries on 6 continents with a broad range of healthcare models, economic realities, and disease severities, show a surprising amount of agreement. SABA overuse is generally associated with poor clinical outcomes.SummaryDespite the diversity across the s...
Source: Current Treatment Options in Allergy - February 8, 2023 Category: Allergy & Immunology Source Type: research

Nutritional Management of Children with Food Allergies
AbstractPurpose of the ReviewThe purpose of the review is to review the evidence for the nutritional management of paediatric food allergy and provide a practical approach for healthcare professionals working in this area.Recent FindingsDietary elimination remains the mainstay for management of food allergies in children. However, the elimination of food allergens increases the risk for growth faltering, micronutrient deficiencies and feeding difficulties. Breastmilk remains the ideal source of nutrition for infants, but when not available, the vast majority will tolerate an extensively hydrolysed formula, and rice hydroly...
Source: Current Treatment Options in Allergy - December 13, 2022 Category: Allergy & Immunology Source Type: research

Underuse of Epinephrine Autoinjectors in Anaphylaxis: Who Is to Blame?
AbstractPurpose of ReviewIdentify barriers to epinephrine autoinjector (EAI) use at the healthcare system, health care provider (HCP), and patient and caregiver levels.Recent FindingsEAI prescription, carriage, and use for the treatment of anaphylaxis remain suboptimal. The under-diagnosis of anaphylaxis contributes to suboptimal EAI prescription rates. The high costs of EAIs and concerns about their efficacy, safety, side effects, or convenience may prevent some patients from filling prescriptions or carrying EAIs or administering EAIs. Gaps in EAI training, knowledge, and skills persist among not only patients and caregi...
Source: Current Treatment Options in Allergy - December 3, 2022 Category: Allergy & Immunology Source Type: research

New Biomarkers in Anaphylaxis (Beyond Tryptase)
AbstractPurpose of ReviewThe purpose of this review is to provide a better understanding of anaphylaxis pathophysiology and describe the underlying mechanisms, effector cells, and the potential biomarkers involved depending on the anaphylaxis endotypes.Recent FindingsNew insight into the potential relevance of pathways others than IgE-dependent anaphylaxis has been unraveled, as well as other biomarkers than tryptase, such as the role of platelet activation factor, basogranulin, dipeptidyl peptidase I, CCL-2, and other cytokines.SummaryGaining knowledge of all the mediators and cellular activation/communication pathways in...
Source: Current Treatment Options in Allergy - November 28, 2022 Category: Allergy & Immunology Source Type: research

Immunological and Non-Immunological Risk Factors in Anaphylaxis
AbstractPurpose of ReviewAnaphylaxis can lead to fatal reactions, the causes of which are very diverse and whose triggers may not always be identifiable. Traditionally, the etiology of anaphylaxis has been thought to depend mainly on the antigen –IgE interaction, with subsequent activation of effector cells and the release of immune mediators such as tryptase and histamine. However, the physiological mechanisms that cause the cellular degranulation that results in these life-threatening reactions are not completely known. Consequently, fa tal reactions may not always be preventable (or treatable).Recent FindingsLatest re...
Source: Current Treatment Options in Allergy - November 11, 2022 Category: Allergy & Immunology Source Type: research

Asthma and Anaphylaxis —interconnected entities
AbstractPurpose of reviewThe relationship between asthma and anaphylaxis is not completely defined, and it is necessary to establish their association and find out the influence of factors contributing to their development. Our aim is to review the most recent literature to optimize the diagnostic and therapeutic approach to both entities.Recent findingsIn severe asthma and anaphylaxis, we found a potentially fatal risk. Both diseases can coexist and, although their association is not entirely clear, poor asthma control seems to worsen the prognosis of anaphylaxis.SummaryKnowing the risk factors for the severity of an asth...
Source: Current Treatment Options in Allergy - November 7, 2022 Category: Allergy & Immunology Source Type: research

Do No Harm: Risk vs. Benefit of the Approach to Childhood Food Allergy
Opinion statementThe prevalence of food allergy is rising across much of the world, but the rate of fatal food anaphylaxis appears generally stable. Given the negligible impact on overall mortality risk from fatal food anaphylaxis in children, probable overdiagnosis of food allergy, and the large psychosocial burden caused by this disease, we aim to reassure patients, families, and allergists regarding risk and propose solutions to improve the current approach to childhood food allergy. Data suggests that children labelled food allergic and their parents frequently overestimate their food allergy risk, leading to excessive...
Source: Current Treatment Options in Allergy - October 26, 2022 Category: Allergy & Immunology Source Type: research

Making a Diagnosis in Allergic Reactions Occurring in the Operating Room
Opinion statementTo summarize the current knowledge of diagnosis in immediate perioperative hypersensitivity reactions (PHR). There is a growing interest in the diagnosis and management of PHR. Recently several clinical guidelines published on PHR; however, its implementation is unknown. The diagnosis and management of PHR is a challenge for both allergologists and anesthesiologists. They are life-threatening and rare reactions, difficult to diagnose for its clinical heterogenic presentation, simultaneous use of many drugs, and the significant pharmacological effects of some drugs. Allergy investigation purpose is to ident...
Source: Current Treatment Options in Allergy - October 20, 2022 Category: Allergy & Immunology Source Type: research

Patch Testing in Special Populations: a Review
Opinion statementContact dermatitis is a frequent and highly impacting skin disorder. Patch testing remains the standard procedure for the diagnosis of allergic contact dermatitis. However, many patients have confounding or influencing factors that may interfere with test results. The goal of this review is to summarize and review the currently available data regarding individual factors that influence the patch test outcome. The interference that specific individual characteristics have on patch testing is still a subject of investigation. Recent evidence, regarding new biological therapies such as dupilumab, shows inhibi...
Source: Current Treatment Options in Allergy - August 22, 2022 Category: Allergy & Immunology Source Type: research

Hypersensitivity Reactions to Monoclonal Antibodies: New Approaches
AbstractPurpose of reviewAdverse reactions to monoclonal antibodies are increasing in parallel with the development of new ones. Hypersensitivity reactions related with these drugs are difficult to classify using the traditional Gell and Coombs hypersensitivity reaction classification. Monoclonal antibodies (mAbs) mainly differ from most “traditional” drugs as they are not chemical compounds, but proteins are very similar to human ones. Therefore, their metabolism, mode of action, and immunogenicity are unlike other drugs, and adverse reactions might also differ. This review focuses on the classification and underlying...
Source: Current Treatment Options in Allergy - August 18, 2022 Category: Allergy & Immunology Source Type: research

De-labeling Penicillin Allergy in Pediatric Population
AbstractPurpose of review At present, penicillin allergy in children is misdiagnosed, leading to undesirable health consequences; thus, a correct diagnosis is needed. De-labelling penicillin allergy strategies in pediatric population is emerging in order to achieve a correct antimicrobial management.Recent findingsNew protocols, specific for pediatric population, are rising from academic societies in order to improve penicillin allergy management in children, so unnecessary tests are avoided.SummaryThis document aims to provide guidance on how to de-label penicillin allergy in children through a correct diagnosis. The w...
Source: Current Treatment Options in Allergy - August 5, 2022 Category: Allergy & Immunology Source Type: research

De-labeling Beta-lactam in Adult Population
AbstractPurpose of reviewThis review summarizes the various strategies used to de-label adults who are considered to be allergic to beta-lactams and focuses on areas for improvement.Recent findingsStrategies for de-labeling penicillin allergy are based on the direct challenge, the classical drug allergy work-up, and stratification of a risk of allergic reaction after exposure to beta-lactams. Strategies based on direct ingestion of aminopenicillin without previous skin tests are safe in low-risk patients. The classical allergy work-up with skin tests and drug provocation has been used for cases where immediate reaction (ur...
Source: Current Treatment Options in Allergy - July 30, 2022 Category: Allergy & Immunology Source Type: research