Publications by authors named "Luis Ensina"
Objective: This paper aims to review the efficacy and safety of current chronic urticaria (CU) treatment in children and the existing patient-reported outcome measures (PROMs) used in this age group.
Data Source: Since there are few studies of CU in children, the authors performed a non-systematic review of published articles in English, Spanish, and Portuguese in the PubMed database in the last decade. Keywords used were (antihistamines OR omalizumab OR cyclosporine OR treatment) AND (chronic urticaria) AND (children OR adolescents).
Article Synopsis
- Atopic dermatitis (AD) greatly affects patients' quality of life, and existing guidelines often target specialists instead of primary care physicians (PCPs).
- A study aimed to create a consensus document specifically for PCPs, offering evidence-based recommendations to enhance AD patient diagnosis and management.
- The document identifies obstacles PCPs face in implementing guidelines and provides consensus solutions to improve care for AD patients across different medical specialties.
Introduction: Chronic spontaneous urticaria (CSU) is a disease with a high impact on the quality of life of patients. There are some evaluations of the economic cost of the disease in developed countries, but there is little information about the economic cost of the disease in developing countries. Our aim was to assess the economic diagnostic and therapeutic expenses of CSU in five Latin American (LA) countries.
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- CRUSE® is an app designed for people with chronic spontaneous urticaria (CSU) to track their symptoms using visual analogue scales (VASs), aiming to assess the app's effectiveness in measuring disease activity.
- A study analyzed three VASs related to CSU impact on daily life, including one specifically for the severity of urticaria, one for productivity, and a general health measure (EQ-5D), using data from nearly 6,000 patients over many days.
- The results showed that the CRUSE® app's VASs demonstrate strong validity and reliability, with the "VAS urticaria" being most effective in capturing symptom changes, while the minimal important difference (MID) values indicated meaningful changes
Background: Hymenoptera venom is one of the most frequent causes of anaphylaxis. Studies from adults indicate the clinical profiles and risk factors of Hymenoptera venom-induced anaphylaxis (VIA). Much less is known about pediatric VIA.
View Article and Find Full Text PDFPurpose: Unresectable pediatric low-grade gliomas (LGG) usually need adjuvant therapy, and carboplatin hypersensitivity reaction (HR) commonly leads to premature treatment cessation of a standard chemotherapy regimen. In the molecular era, advances in understanding tumor genetic characteristics allowed the development of targeted therapies for this group of tumors; however, cost-effectiveness assessment of treatments, especially in low-income countries, is crucial. The aim is to describe the results of carboplatin desensitization protocol in a single center in a middle-income country.
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- * Current treatment guidelines suggest increasing doses of second-generation antihistamines, but many patients don't see improvement due to various underlying causes.
- * New research is shifting toward personalized treatments based on individual patient factors, with promising developments like targeted therapies and medications that may effectively modify the disease.
Prevalence of atopic conditions in children with chronic urticaria.
J Allergy Clin Immunol Pract
September 2024
Introduction: The role of upadacitinib in the management of moderate to severe atopic dermatitis seems promising, but more data on its efficacy and safety are needed. This study endeavors to assess the practical impact and safety of upadacitinib in patients with moderate to severe atopic dermatitis. The study aims to evaluate the efficacy and safety of upadacitinib in the treatment of moderate to severe atopic dermatitis, focusing on analyzing patient responses to the treatment.
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- Angioedema (AE) is a condition characterized by localized swelling in the skin or mucous membranes and can be hereditary or acquired, making its classification complex due to various underlying mechanisms and taxonomies.
- The DANCE initiative, involving 91 experts from 35 countries, aimed to create a unified consensus on the definition, acronyms, and classification of AE through an extensive online discussion and voting process over 16 months.
- The resulting DANCE classification introduces five types of AE, standardizes terminology, and is designed to enhance research and patient care while complementing existing clinical guidelines without replacing them.
Background: Patient-reported outcome measures (PROMs) are validated and standardized tools that complement physician evaluations and guide treatment decisions. They are crucial for monitoring atopic dermatitis (AD) and chronic urticaria (CU) in clinical practice, but there are unmet needs and knowledge gaps regarding their use in clinical practice.
Objecctive: We investigated the global real-world use of AD and CU PROMs in allergology and dermatology clinics as well as their associated local and regional networks.
Article Synopsis
- There is a significant lack of clear guidance on how and when to reduce treatment for chronic spontaneous urticaria (CSU) despite advances in therapies.
- The SDown-CSU study, which involved 103 physicians across 34 countries, found that many national management guidelines do not address the specifics of discontinuing CSU treatments, especially for medications like antihistamines and cyclosporine.
- The study emphasizes the need for clear protocols and provides a step-down algorithm to help manage CSU treatment more effectively at various stages.
Background: Chronic spontaneous urticaria (CSU) is unpredictable and can severely impair patients' quality of life. Patients with CSU need a convenient, user-friendly platform to complete patient-reported outcome measures (PROMs) on their mobile devices. CRUSE , the Chronic Urticaria Self Evaluation app, aims to address this unmet need.
View Article and Find Full Text PDFBackground: Many patients with chronic spontaneous urticaria (CSU) do not achieve complete control of their symptoms with current available treatments. In a dose-finding phase 2b study, ligelizumab improved urticaria symptoms in patients with H1-antihistamine (H1-AH) refractory CSU. Here, we report the efficacy and safety outcomes from two ligelizumab phase 3 studies.
View Article and Find Full Text PDFBackground: Anaphylaxis is a serious systemic reaction-data on fatal and near-fatal reactions are limited.
Objective: To better understand clinical patterns and risks factors of severe anaphylaxis by a deep analysis of data from fatal and near-fatal anaphylaxis.
Methods: Data from the European Anaphylaxis Registry on fatal/near-fatal anaphylactic reactions and national data on anaphylaxis fatalities were investigated.
Article Synopsis
- - The integrated care pathways for atopic dermatitis (AD-ICPs) serve to connect existing treatment guidelines and expert insights into a structured plan that caters to different levels of AD severity and healthcare resources across various countries.
- - Developed by the GA LEN ADCARE network and other stakeholders in 2020-2021, the AD-ICPs detail diagnostics, treatment options, and emphasize the roles of pharmacologists and other contributors in managing AD, particularly in pediatric cases.
- - The initiative aims to enhance AD management through a multidisciplinary approach that addresses urgent needs like better access to care, specialist training, educational programs, and personalized treatments, ultimately leading to improved patient outcomes.
Exercise-induced anaphylaxis (EIA) is a rare disorder in which anaphylaxis occurs exclusively after physical activity. Here, we report a case of severe EIA where anaphylaxis was initially only induced by strenuous exercise. Suddenly the anaphylaxis got out of control to the degree that usual daily activities triggered it.
View Article and Find Full Text PDFBackground: Concern about disease exacerbations and fear of reactions after coronavirus disease 2019 (COVID-19) vaccinations are common in chronic urticaria (CU) patients and may lead to vaccine hesitancy.
Objective: We assessed the frequency and risk factors of CU exacerbation and adverse reactions in CU patients after COVID-19 vaccination.
Methods: COVAC-CU is an international multicenter study of Urticaria Centers of Reference and Excellence (UCAREs) that retrospectively evaluated the effects of COVID-19 vaccination in CU patients aged ≥18 years and vaccinated with ≥1 dose of any COVID-19 vaccine.
Since more than a century ago, there has been awareness of the connection between viral infections and the onset and exacerbation of urticaria. Our knowledge about the role of viral infection and vaccination in acute and chronic urticaria improved as a result of the COVID-19 pandemic but it has also highlighted knowledge gaps. Viral infections, especially respiratory tract infections like COVID-19, can trigger the onset of acute urticaria (AU) and the exacerbation of chronic urticaria (CU).
View Article and Find Full Text PDFLatin American anaphylaxis registry.
World Allergy Organ J
February 2023
Background: Recent data about clinical features, triggers and management of anaphylaxis in Latin America is lacking.
Objective: To provide updated and extended data on anaphylaxis in this region.
Method: An online questionnaire was used, with 67 allergy units involved from 12 Latin-American countries and Spain.
Background: Drugs are a frequent cause of severe anaphylactic reactions. Here, we analyze a large dataset on drug induced anaphylaxis regarding elicitors, risk factors, symptoms, and treatment.
Methods: Data from the European Anaphylaxis Registry (2007-2019) with 1815 reported cases of drug-induced anaphylaxis were studied accordingly.
Background: Although chronic urticaria (CU) is a common and primarily affects females, there is little data on how pregnancy interacts with the disease.
Objective: To analyse the treatment use by CU patients before, during and after pregnancy as well as outcomes of pregnancy.
Methods: PREG-CU is an international, multicentre study of the Urticaria Centers of Reference and Excellence network.