Hereditary angioedema outcomes in US patients switched from injectable long-term prophylactic medication to oral berotralstat.

Background: Berotralstat, a first-line, once-daily, oral plasma kallikrein inhibitor for long-term prophylaxis of hereditary angioedema (HAE), is an effective and well-tolerated treatment option.

Objective: To summarize the safety, effectiveness, and impact on treatment satisfaction in patients who switched from injectable long-term prophylactics to oral berotralstat monotherapy (150 mg daily) at US sites in the international open-label APeX-S study.

Methods: APeX-S was an open-label, Phase II study of berotralstat conducted in 22 countries.

Contextual community epinephrine prescribing: Is more always better?

Objective: Prompt administration of epinephrine is first-line management of anaphylaxis. Although severe anaphylaxis may require more than 1 epinephrine dose, multiple epinephrine device packs may not be necessary for all patients at risk for allergic reactions.

Data Sources: A narrative review was used to describe key considerations to contextualize community epinephrine prescribing.

Subcutaneous Immunoglobulin 16.5% (Cutaquig®) in Primary Immunodeficiency Disease: Safety, Tolerability, Efficacy, and Patient Experience with Enhanced Infusion Regimens.

Purpose: To achieve reductions in infusion time, infusion sites, and frequency, a prospective, open-label, multicenter, Phase 3 study evaluated the safety, efficacy, and tolerability of subcutaneous immunoglobulin (SCIG) 16.5% (Cutaquig®, Octapharma) at enhanced infusion regimens.

Methods: Three separate cohorts received SCIG 16.

Postoperative Polyp Scale (POPS): Development of a New Sinonasal Polyp Grading Scale.

Objective: Commonly used endoscopic grading scales, such as the nasal polyp scale, inadequately describe the degree of polyposis found postoperatively in the paranasal sinus cavities. The purpose of this study was to create a novel grading system that more accurately characterizes polyp recurrence in postoperative sinus cavities, the Postoperative Polyp Scale (POPS).

Methods: A modified Delphi method was utilized to establish the POPS using consensus opinion among 13 general otolaryngologists, rhinologists, and allergists.

Incidence of anaphylaxis and accidental peanut exposure: A systematic review.

Background: Peanut allergy (PA), a common food allergy, is increasing in prevalence and is associated with high rates of anaphylaxis. Prevalence of food-related anaphylaxis is higher in children and adolescents than in adults, and the pediatric incidence is increasing. We conducted a systematic literature review and meta-analysis to determine the incidence of peanut-induced anaphylaxis in children and/or adolescents with PA.

Immunogenicity of Botulinum Toxin Formulations: Potential Therapeutic Implications.

Botulinum neurotoxins (BoNTs) are proteins produced by bacteria of the Clostridium family. Upon oral ingestion, BoNT causes the neuroparalytic syndrome botulism. There are seven serotypes of BoNT (serotypes A-G); BoNT-A and BoNT-B are the botulinum toxin serotypes utilized for therapeutic applications.

Characteristics of Peanut Allergy Diagnosis in a US Health Care Claims Database (2011-2017).

Background: Peanut allergy is the most common food allergy among children. Studies assessing the burden of peanut allergy in a real-world setting are limited.

Objective: To estimate annual incidence and prevalence of peanut allergy cases among children aged 4 to 17 years and assess severe reaction and associated health care utilization rates.

Current trends in food allergy-induced anaphylaxis management at school.

Objective: To review the evidence and current policies regarding the use of epinephrine at schools and child care centers DATA SOURCES AND STUDY SELECTIONS: A narrative review was performed based on the result of conference proceedings of a group of interprofessional stakeholders who attended the USAnaphylaxis Summit 2017 presented by Allergy & Asthma Network.

Results: Anaphylaxis is a well-recognized medical emergency that requires prompt treatment with intramuscular epinephrine. Anaphylaxis can be associated with poor quality of life.

Effect of a mobile health, sensor-driven asthma management platform on asthma control.

Background: Asthma inflicts a significant health and economic burden in the United States. Self-management approaches to monitoring and treatment can be burdensome for patients.

Objective: To assess the effect of a digital health management program on asthma outcomes.

Comparison of systemic reactions in rush, cluster, and standard-build aeroallergen immunotherapy.

Background: Given the choice of standard, cluster, and rush build-up for aeroallergen immunotherapy, standard-build immunotherapy has generally been preferred because of a perceived high rate of systemic reactions (SRs) associated with cluster and rush immunotherapy.

Objective: To characterize the incidence of SRs during standard, cluster, and rush build-up immunotherapy in an allergy practice during a 5-year period.

Methods: A retrospective review was conducted among patients receiving standard-build, 8- to 10-step cluster, or 2-day rush immunotherapy from January 1, 2010, through December 31, 2014, at Family Allergy & Asthma clinics in Louisville, Kentucky.

Addressing barriers to emergency anaphylaxis care: from emergency medical services to emergency department to outpatient follow-up.

Background: Anaphylaxis is a systemic life-threatening allergic reaction that presents unique challenges for emergency care practitioners. Allergists and emergency physicians have a history of collaborating to promote an evidence-based, multidisciplinary approach to improve the emergency management and follow-up of patients with or at risk of anaphylaxis.

Objectives: To review recent scientific literature about anaphylaxis, discuss barriers to care, and recommend strategies to support improvement in emergency anaphylaxis care.

Factors associated with hospitalization of patients with angiotensin-converting enzyme inhibitor-induced angioedema.

Angiotensin-converting enzyme inhibitor (ACE-I)-induced angioedema can be life-threatening without emergent intervention. The putative mediator is believed to be bradykinin, similar to hereditary angioedema, so these patients respond poorly to corticosteroids and antihistamines. This study was designed to determine characteristics and clinical outcomes of patients presenting to an emergency department (ED) with ACE-I angioedema.

Characterization of patients with suspected seminal plasma hypersensitivity.

The epidemiology of seminal plasma hypersensitivity (SPH) is unknown. Case reports and a previous survey have identified two distinct phenotypes: localized and systemic reactors. The objective of this study was to use an Internet-based questionnaire to characterize and examine the differences among a population of women with suspected SPH.

Occupational rhinitis.

Work-related rhinitis, which includes work-exacerbated rhinitis and occupational rhinoconjunctivitis (OR), is two to three times more common than occupational asthma. High molecular weight proteins and low molecular weight chemicals have been implicated as causes of OR. The diagnosis of work-related rhinitis is established based on occupational history and documentation of immunoglobulin E (IgE) mediated sensitization to the causative agent if possible.

Is trimellitic anhydride skin testing a sufficient screening tool for selectively identifying TMA-exposed workers with TMA-specific serum IgE antibodies?

Objective: Trimellitic anhydride (TMA) can elicit specific IgE-mediated immune responses leading to asthma. This single-blinded study investigated the ability of TMA skin testing to identify workers with TMA-serum specific IgE antibodies.

Methods: Forty TMA-exposed workers who were previously screened for the presence of TMA-IgG and/or IgE serum specific antibodies were skin tested to a TMA-human serum albumin reagent by nurses blinded to their antibody responses.

Seminal plasma hypersensitivity reactions: an updated review.

Seminal plasma hypersensitivity manifests as a spectrum of systemic and/or localized clinical symptoms after exposure to specific protein components in seminal fluid. The prevalence of this disease is largely unknown, but it is believed to affect up to 40,000 women in the United States. Although no definitive risk factors have been confirmed, women with systemic reactions are frequently atopic.

Occupational rhinitis.

Work-related rhinitis, which includes work-exacerbated rhinitis and occupational rhinitis, may be two to three times more common than occupational asthma. Both high molecular weight proteins and low molecular weight chemicals have been implicated as causes of occupational rhinitis. A diagnosis is established based on occupational history and, if appropriate, documentation of IgE-mediated sensitization to the causative agent.