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Vieira RJ, Azevedo LF, Pereira AM, Nogueira-Leite D, Rocha Gonçalves FN, Larenas-Linnemann DE, Cruz AA, Gemicioglu B, Samolinski B, de Las Vecillas L, Giovannini M, Cunha MJ, Rodrigues J, Kvedariene V, Klimek L, Pfaar O, Zuberbier T, Fonseca JA, Bousquet J, Sousa-Pinto B. Impact of Allergic Rhinitis Control on Work Productivity and Costs: A Real-World Data MASK-air Study. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024:S2213-2198(24)00776-1. [PMID: 39111363 DOI: 10.1016/j.jaip.2024.07.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 07/16/2024] [Accepted: 07/22/2024] [Indexed: 09/05/2024]
Abstract
BACKGROUND Allergic rhinitis (AR) has a substantial socioeconomic impact associated with impaired work productivity. OBJECTIVE To study the impact of AR on work productivity and estimate the corresponding indirect costs for 40 countries. METHODS We conducted a cross-sectional study using direct patient data from the MASK-air app on users with self-reported AR. We used the Work Productivity and Activity Impairment Questionnaire: Allergy Specific to measure the impact of AR on work productivity (presenteeism and absenteeism). Weekly indirect costs were estimated per country for each level of rhinitis control. Patients with and without asthma were considered. RESULTS We assessed data from 677 weeks (364 patients), 280 of which were reported by patients with asthma. Regarding presenteeism, the median impact of AR in weeks of poor disease control was 60.7% (percentiles 25-75 [P25-P75] 24.9%-74.2%), whereas partial and good disease control were, respectively, associated with an impact of 25.0% (P25-P75 12.1%-42.4%) and 4.4% (P25-P75 0.8%-12.9%). In poorly controlled weeks, presenteeism was associated with indirect costs ranging from 65.7 US$ purchase power parities (PPPs) (P25-P75 29.2-143.2) in Brazil to 693.6 US$ PPP (P25-P75 405.2-1,094.9) in Iceland. Median absenteeism per week was of 0% for all levels of rhinitis control. Patients with AR + asthma showed higher overall work impairment than patients with AR alone, particularly in poorly controlled weeks (median work impairment in AR alone 39.1% [P25-P75 12.5%-71.9%]; median work impairment in AR + asthma 68.4% [P25-P75 54.6%-80.2%]). CONCLUSIONS Poor AR control was associated with decreased work productivity and increased indirect costs, particularly in patients with AR + asthma. The estimates from this study underpin the economic burden of AR.
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Affiliation(s)
- Rafael José Vieira
- MEDicina da Comunidade, Informação e Decisão em Saúde (MEDCIDS)-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS@RISE-Centre for Health Technology and Services Research, Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Luís Filipe Azevedo
- MEDicina da Comunidade, Informação e Decisão em Saúde (MEDCIDS)-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS@RISE-Centre for Health Technology and Services Research, Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Ana Margarida Pereira
- MEDicina da Comunidade, Informação e Decisão em Saúde (MEDCIDS)-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; PaCeIT-Patient Centered Innovation and Technologies, Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal; Allergy Unit, Institute and Hospital Companhia União Fabril (CUF) (Instituto and Hospital Companhia União Fabril - CUF), Porto, Portugal
| | - Diogo Nogueira-Leite
- MEDicina da Comunidade, Informação e Decisão em Saúde (MEDCIDS)-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS@RISE-Centre for Health Technology and Services Research, Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Francisco Nuno Rocha Gonçalves
- MEDicina da Comunidade, Informação e Decisão em Saúde (MEDCIDS)-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS@RISE-Centre for Health Technology and Services Research, Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Desirée E Larenas-Linnemann
- Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, Mexico City, Mexico
| | - Alvaro A Cruz
- PROfessionals of Asthma and Respiratory Foundation (Fundaçao ProAR), Federal University of Bahia and GARD/WHO Planning Group, Salvador, Bahia, Brazil
| | - Bilun Gemicioglu
- Department of Pulmonary Diseases, Istanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Istanbul, Turkey; Institute of Pulmonology and Tuberculosis, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Boleslaw Samolinski
- Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University of Warsaw, Warsaw, Poland
| | - Leticia de Las Vecillas
- Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Mattia Giovannini
- Allergy Unit, Meyer Children's Hospital - Istituto di Ricovero e Cura a Carattere Scientifico - IRCCS (Scientific Institute for Hospitalization and Care), Florence, Italy; Department of Health Sciences, University of Florence, Florence, Italy
| | - Maria João Cunha
- Amadeo de Souza-Cardoso Family Health Unit, Tâmega I Health Center Group (Unidade de Saúde Familiar Amadeo de Souza-Cardoso, Agrupamento de Centros de Saúde Tâmega I), Amarante, Portugal
| | - Jorge Rodrigues
- CINTESIS@RISE-Centre for Health Technology and Services Research, Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal; Otorhinolaryngology Department, Sao Joao University Hospital Center (Centro Hospitalar Universitário de Sao João), Porto, Portugal; Unit of Anatomy, Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Violeta Kvedariene
- Institute of Clinical Medicine, Clinic of Chest Diseases and Allergology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania; Institute of Biomedical Sciences, Department of Pathology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Ludger Klimek
- Department of Otolaryngology, Head and Neck Surgery, University Medicine of Mainz (Universitätsmedizin Mainz), Mainz, Germany; Center for Rhinology and Allergology, Wiesbaden, Germany
| | - Oliver Pfaar
- Section of Rhinology and Allergy, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany
| | - Torsten Zuberbier
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany; Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - João A Fonseca
- MEDicina da Comunidade, Informação e Decisão em Saúde (MEDCIDS)-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS@RISE-Centre for Health Technology and Services Research, Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Jean Bousquet
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany; Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Inserm Equipe d'Epidémiologie Respiratoire Intégrative, Centre de Recherche en Epidémiologie et Santé des Populations (CESP), Villejuif, France; Allergic Rhinitis and its Impact on Asthma (ARIA), Montpellier, France; MASK-air, Montpellier, France.
| | - Bernardo Sousa-Pinto
- MEDicina da Comunidade, Informação e Decisão em Saúde (MEDCIDS)-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS@RISE-Centre for Health Technology and Services Research, Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
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Relationship Between Support for Workers With Illness and Work Functioning Impairment in Japan During the COVID-19 Pandemic. J Occup Environ Med 2022; 64:e279-e283. [DOI: 10.1097/jom.0000000000002500] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Müller M, Igarashi A, Hashiguchi K, Kappel M, Paolini F, Yoshisue H, Funakubo M, Sharma H, Okano M. The impact of omalizumab on paid and unpaid work productivity among severe Japanese cedar pollinosis (JCP) patients. J Med Econ 2022; 25:220-229. [PMID: 35072591 DOI: 10.1080/13696998.2022.2033051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
AIMS Japanese cedar pollinosis (JCP) is a form of seasonal allergic rhinitis that affects 38.8% of the Japanese population. Particularly severe and most severe symptoms among JCP patients can lead to impairments of paid work productivity and unpaid work activities. Indeed, the current standard of care (SoC) is not always able to relieve these symptoms. Omalizumab, a novel JCP treatment recently approved in Japan, provides an effective add-on therapy to the SoC. This study estimates the effect of omalizumab on paid and unpaid work activities (i.e. its social impact) in patients with severe and most severe JCP symptoms in Japan. METHODS The impact of omalizumab was estimated through a one-year static cohort model using the Work Productivity and Activity Impairment Allergy Specific (WPAI-AS) questionnaire derived from a clinical trial on omalizumab enrolling patients with severe and most severe JCP symptoms, which had been conducted in Japan. This effect was quantified using Japanese official statistics on employment and time use. The human capital approach and the proxy good approach were employed to monetize paid and unpaid work activities, respectively. A sensitivity analysis was implemented to account for modeling structural uncertainties. RESULTS Our results show that the use of omalizumab might reduce the paid and unpaid work productivity losses due to severe and most severe JCP by nearly one-third. In the severe symptom period of three weeks, 36.6 million hours of lost paid and unpaid work hours could be avoided, which sums up to a monetized productivity loss of 728.3 million USD. CONCLUSIONS Omalizumab could provide substantial benefits in terms of paid and unpaid work activities in patients with severe and most severe JCP. Our results also highlight the importance of considering unpaid work in estimating productivity costs due to poor health.
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Affiliation(s)
- M Müller
- Unit of Health Economics, WifOR Institute, Darmstadt, Hesse, Germany
| | - A Igarashi
- Unit of Public Health and Preventive Medicine, Yokohama City University School of Medicine, Yokohama, Japan
- Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, Japan
| | - K Hashiguchi
- Unit of Otorhinolaryngology, Futaba Clinic, Tokyo, Japan
| | - M Kappel
- Unit of Health Economics, WifOR Institute, Darmstadt, Hesse, Germany
| | - F Paolini
- Unit of Health Economics, WifOR Institute, Darmstadt, Hesse, Germany
| | - H Yoshisue
- Unit of Health Economics, Novartis Pharma K.K, Tokyo, Japan
| | - M Funakubo
- Unit of Health Economics, Novartis Pharma K.K, Tokyo, Japan
| | - H Sharma
- Novartis Corporation Sdn. Bhd, Selangor, Malaysia
| | - M Okano
- School of Medicine, International University of Health and Welfare, Narita, Japan
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Imoto Y, Sakashita M, Hayama M, Nakamaru Y, Suzuki M, Miyabe Y, Yamada T, Saito H, Yonekura S, Kondo K, Higaki T, Kawashima K, Urashima M, Fujieda S. The clinical features of intractable allergic rhinitis based on a questionnaire administered to clinicians. Allergol Int 2021; 70:373-375. [PMID: 33642145 DOI: 10.1016/j.alit.2020.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 12/15/2020] [Accepted: 12/31/2020] [Indexed: 10/22/2022] Open
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Fried J, Yuen E, Li A, Zhang K, Nguyen SA, Gudis DA, Rowan NR, Schlosser RJ. Rhinologic disease and its impact on sleep: a systematic review. Int Forum Allergy Rhinol 2020; 11:1074-1086. [PMID: 33275331 DOI: 10.1002/alr.22740] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 10/28/2020] [Accepted: 11/05/2020] [Indexed: 01/26/2023]
Abstract
BACKGROUND Rhinologic disease can be responsible for systemic symptoms affecting mood, cognition, and sleep. It is unclear whether sleep disturbance in specific rhinologic disorders (chronic rhinosinusitis [CRS], rhinitis, and nasal septal deviation [NSD]) is an obstructive phenomenon or due to other mechanisms. In this review we examine the impact of CRS, rhinitis, and NSD on objective and subjective sleep outcome metrics and draw comparisons to normal controls and patients with known obstructive sleep apnea (OSA). METHODS A systematic review of 4 databases (PubMed, Scopus, Cochrane Library, and Web of Science) was performed. Studies reporting on objective (apnea-hypopnea index [AHI], respiratory disturbance index [RDI], oxygen nadir) and subjective (Epworth Sleepiness Scale [EpSS], Pittsburgh Sleep Quality Index [PSQI], Fatigue Severity Scale [FSS]) sleep parameters and disease-specific patient-reported outcome measures (PROMs; 22-item Sino-Nasal Outcome Test [SNOT-22], Rhinoconjunctivitis Quality of Life Questionnaire [RQLQ], Nasal Obstruction Symptom Evaluation [NOSE]) were included. RESULTS The database search yielded 1414 unique articles, of which 103 were included for analysis. Baseline PROMs were at the high end of normal to abnormal for all 3 conditions: EpSS: CRS (9.8 ± 4.0), rhinitis (9.7 ± 4.3), and NSD (8.9 ± 4.6); and PSQI: CRS (11.0 ± 4.5), rhinitis (6.1 ± 3.7), and NSD (8.6 ± 3.5). Objective measures demonstrated a mild to moderate OSA in the studied diseases: AHI: CRS (10.4 ± 11.5), rhinitis (8.6 ± 8.8), and NSD (13.0 ± 6.9). There were significant differences when compared with reported norms in all measured outcomes (p < 0.001). CONCLUSION Sleep quality is impacted by rhinologic (CRS, rhinitis, NSD) disease. There is likely a mild obstructive component contributing to poor sleep, but other contributing factors may be involved.
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Affiliation(s)
- Jacob Fried
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC
| | - Erick Yuen
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC
| | - Andraia Li
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC
| | - Kathy Zhang
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC
| | - Shaun A Nguyen
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC
| | - David A Gudis
- Department of Otolaryngology-Head and Neck Surgery, Columbia University Irving Medical Center, New York, NY
| | - Nicholas R Rowan
- Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Rodney J Schlosser
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC
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Okubo K, Okano M, Sato N, Tamaki Y, Suzuki H, Uddin A, Fogel R. Add-On Omalizumab for Inadequately Controlled Severe Pollinosis Despite Standard-of-Care: A Randomized Study. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2020; 8:3130-3140.e2. [PMID: 32422373 DOI: 10.1016/j.jaip.2020.04.068] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 04/29/2020] [Accepted: 04/29/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Cedar pollinosis (CP), a common form of seasonal allergic rhinitis (AR), is a substantial medical problem in Japan due to its high prevalence and severe symptoms. Omalizumab (anti-IgE therapy) has previously proven to be effective in CP/AR, but no studies for inadequately controlled severe CP/AR despite standard-of-care (SoC) have been conducted. OBJECTIVE To determine the efficacy of omalizumab added to SoC in patients with inadequately controlled severe CP in a randomized, double-blinded, placebo-controlled, phase III study. METHODS Adult/adolescent patients with severe CP whose symptoms were inadequately controlled despite nasal corticosteroids plus 1 or more oral medications in the previous 2 seasons were randomized to receive omalizumab (n = 162) or placebo (n = 175). All patients received concomitant antihistamines and nasal corticosteroids as SoC. The primary endpoint was the mean nasal symptom score during the severe symptom period. Secondary endpoints included mean ocular symptom score, quality of life (QoL), and safety. RESULTS The SoC + omalizumab treatment had statistically significantly and clinically important lower nasal (least squares mean difference, -1.03, P < .001) and ocular (-0.87, P < .001) symptom scores compared with SoC + placebo, respectively. Differences in scores for individual components of nasal and ocular symptoms were also statistically and clinically significant. SoC + omalizumab also improved QoL scores as overall and in all domains. No unexpected safety signals were observed. CONCLUSIONS In patients with severe CP, omalizumab added to SoC demonstrated consistent efficacy in improving symptoms and QoL, and was well tolerated. These results indicate that omalizumab could be a promising therapeutic option for severe CP/AR.
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Affiliation(s)
- Kimihiro Okubo
- Department of Otolaryngology, Nippon Medical School, Tokyo, Japan.
| | - Mitsuhiro Okano
- Department of Otorhinolaryngology, International University of Health and Welfare School of Medicine, Narita, Japan
| | | | | | | | - Alkaz Uddin
- Novartis Pharmaceuticals Corporation, East Hanover, NJ
| | - Robert Fogel
- Novartis Pharmaceuticals Corporation, East Hanover, NJ
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Okubo K, Uchida E, Terahara T, Akiyama K, Kobayashi S, Tanaka Y. Efficacy and safety of the emedastine patch, a novel transdermal drug delivery system for allergic rhinitis: Phase III, multicenter, randomized, double-blinded, placebo-controlled, parallel-group comparative study in patients with seasonal allergic rhinitis. Allergol Int 2018; 67:371-379. [PMID: 29395965 DOI: 10.1016/j.alit.2017.12.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 11/21/2017] [Accepted: 12/08/2017] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND The emedastine patch was developed in Japan as the first transdermal drug delivery system of emedastine difumarate for allergic rhinitis. METHODS A multicenter, randomized, double-blind, placebo-controlled, parallel-group comparison was conducted in patients with seasonal allergic rhinitis. Patients were administered Emedastine patches (4 or 8 mg), placebo, or levocetirizine hydrochloride (5 mg tablet) once daily for 2 weeks (double-dummy technique). The primary objective was superiority to placebo by the change of the total nasal symptom score (sneezing, rhinorrhea, and nasal congestion) in Week 2. Levocetirizine was a reference drug and not a comparator in this study. RESULTS A total of 1276 patients were randomized to receive the 4 mg emedastine patch (n = 384), 8 mg emedastine patch (n = 382), placebo (n = 384), or levocetirizine (n = 126). The least squares mean (LSM) of the change from baseline of the total nasal symptom score (TNSS) in Week 2 was significantly larger in both emedastine patch groups than in the placebo group (adjusted p < 0.0001). In secondary analysis, LSM of the change in the TNSS was -1.20, -1.49, -0.44, and -1.32 in the 4 mg emedastine patch, 8 mg patch, placebo, and levocetirizine, respectively. Reductions in the number of episodes and scores of individual nasal symptoms were all significantly larger throughout the day in the emedastine patch groups than the placebo group (all p < 0.05). No clinically significant safety problems occurred. CONCLUSIONS The emedastine patch (4 and 8 mg) effectively and safely controlled symptoms of seasonal allergic rhinitis with sustained action throughout the day. STUDY REGISTRATION JapicCTI-153092.
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Türkmen Ö, Ay Şenyiğit Z, Baloğlu E. Formulation and evaluation of fexofenadine hydrochloride orally disintegrating tablets for pediatric use. J Drug Deliv Sci Technol 2018. [DOI: 10.1016/j.jddst.2017.10.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Vandenplas O, Vinnikov D, Blanc PD, Agache I, Bachert C, Bewick M, Cardell LO, Cullinan P, Demoly P, Descatha A, Fonseca J, Haahtela T, Hellings PW, Jamart J, Jantunen J, Kalayci Ö, Price D, Samolinski B, Sastre J, Tian L, Valero AL, Zhang X, Bousquet J. Impact of Rhinitis on Work Productivity: A Systematic Review. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2017; 6:1274-1286.e9. [PMID: 29017832 DOI: 10.1016/j.jaip.2017.09.002] [Citation(s) in RCA: 110] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 08/02/2017] [Accepted: 09/06/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND Allergic rhinitis (AR) is increasingly acknowledged as having a substantial socioeconomic impact associated with impaired work productivity, although available information remains fragmented. OBJECTIVE This systematic review summarizes recently available information to provide a quantitative estimate of the burden of AR on work productivity including lost work time (ie, absenteeism) and reduced performance while working (ie, presenteeism). METHODS A Medline search retrieved original studies from 2005 to 2015 pertaining to the impact of AR on work productivity. A pooled analysis of results was carried out with studies reporting data collected through the validated Work Productivity and Activity Impairment (WPAI) questionnaire. RESULTS The search identified 19 observational surveys and 9 interventional studies. Six studies reported economic evaluations. Pooled analysis of WPAI-based studies found an estimated 3.6% (95% confidence interval [CI], 2.4; 4.8%) missed work time and 35.9% (95% CI, 29.7; 42.1%) had impairment in at-work performance due to AR. Economic evaluations indicated that indirect costs associated with lost work productivity are the principal contributor to the total AR costs and result mainly from impaired presenteeism. The severity of AR symptoms was the most consistent disease-related factor associated with a greater impact of AR on work productivity, although ocular symptoms and sleep disturbances may independently affect work productivity. Overall, the pharmacologic treatment of AR showed a beneficial effect on work productivity. CONCLUSIONS This systematic review provides summary estimates of the magnitude of work productivity impairment due to AR and identifies its main determinant factors. This information may help guide both clinicians and health policy makers.
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Affiliation(s)
- Olivier Vandenplas
- Department of Chest Medicine, Centre Hospitalier Universitaire UCL Namur, Université Catholique de Louvain, Yvoir, Belgium.
| | - Denis Vinnikov
- Department of Biostatistics and Evidence-Based Medicine, Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - Paul D Blanc
- Division of Occupational and Environmental Medicine, Department of Medicine, University of California San Francisco, San Francisco, Calif
| | - Ioana Agache
- Faculty of Medicine, Transylvania University, Brasov, Romania
| | - Claus Bachert
- Upper Airways Research Laboratory, ENT Department, Ghent University Hospital, Ghent, Belgium
| | | | - Lars-Olaf Cardell
- Department of Ear, Nose and Throat Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Paul Cullinan
- Department of Occupational and Environmental Medicine, Royal Brompton Hospital and Imperial College (NHLI), London, UK
| | - Pascal Demoly
- Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France
| | - Alexis Descatha
- AP-HP, Occupational Health Department, Unité de pathologie professionnelle, University Hospital of West Suburb of Paris, Poincaré, Garches, and Versailles St-Quentin University, INSERM, Villejuif, France
| | - Joao Fonseca
- Center for Health Technology and Services Research-CINTESIS, Faculdade de Medicina, Universidade do Porto; and Allergy Unit, CUF Porto Instituto & Hospital, Porto, Portugal
| | - Tari Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - Peter W Hellings
- Laboratory of Clinical Immunology, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - Jacques Jamart
- Scientific Support Unit, Centre Hospitalier Universitaire UCL Namur, Université Catholique de Louvain, Yvoir, Belgium
| | - Juha Jantunen
- South Karelia Allergy and Environment Institute, Imatra, Finland
| | - Ömer Kalayci
- Pediatric Allergy and Asthma Unit, Hacettepe University School of Medicine, Ankara, Turkey
| | - David Price
- Observational and Pragmatic Research Institute, Singapore, Singapore; Optimum Patient Care, Cambridge, UK; Academic Centre of Primary Care, University of Aberdeen, Aberdeen, UK
| | - Boleslaw Samolinski
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - Joaquin Sastre
- Allergy Department, Fundacion Jimenez Diaz, Universidad Autonoma de Madrid, CIBER de Enfermedades Respiratorias (CIBERES), Institute Carlos III, Madrid, Spain
| | - Longxiu Tian
- Ross School of Business, University of Michigan, Ann Arbor, Mich
| | - Antonio L Valero
- Pneumology and Allergy Department Hospital Clínic, Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain
| | | | - Jean Bousquet
- MACVIA-France, Contre les MAladies Chroniques pour un VIeillissement Actif en France European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France; INSERM, VIMA: Ageing and chronic diseases Epidemiological and public health approaches, U1168, Paris, France; UVSQ, UMR-S 1168, Université Versailles St-Quentin-en-Yvelines, Versailles, France
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Devillier P, Bousquet J, Salvator H, Naline E, Grassin-Delyle S, de Beaumont O. In allergic rhinitis, work, classroom and activity impairments are weakly related to other outcome measures. Clin Exp Allergy 2016; 46:1456-1464. [DOI: 10.1111/cea.12801] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 07/18/2016] [Accepted: 08/09/2016] [Indexed: 11/28/2022]
Affiliation(s)
- P. Devillier
- UPRES EA 220; Université de Versailles Saint-Quentin; Suresnes France
- Clinical Pharmacology Unit; Department of Airway Diseases; Foch Hospital; Suresnes France
| | - J. Bousquet
- INSERM, VIMA: Ageing and Chronic Diseases; Epidemiological and Public Health Approaches, U1168; Paris France
- UMR-S 1168; Université de Versailles Saint-Quentin; Versailles France
| | - H. Salvator
- UPRES EA 220; Université de Versailles Saint-Quentin; Suresnes France
- Clinical Pharmacology Unit; Department of Airway Diseases; Foch Hospital; Suresnes France
| | - E. Naline
- UPRES EA 220; Université de Versailles Saint-Quentin; Suresnes France
- Clinical Pharmacology Unit; Department of Airway Diseases; Foch Hospital; Suresnes France
| | - S. Grassin-Delyle
- Clinical Pharmacology Unit; Department of Airway Diseases; Foch Hospital; Suresnes France
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Roger A, Arcalá Campillo E, Torres MC, Millan C, Jáuregui I, Mohedano E, Liñan S, Verdu P, Rubira N, Santaolalla M, González P, Orovitg A, Villarrubia E. Reduced work/academic performance and quality of life in patients with allergic rhinitis and impact of allergen immunotherapy. Allergy Asthma Clin Immunol 2016; 12:40. [PMID: 27525014 PMCID: PMC4982204 DOI: 10.1186/s13223-016-0146-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 08/01/2016] [Indexed: 11/10/2022] Open
Abstract
Background Allergic rhinitis (AR) is characterised by burdensome nasal and/or ocular symptoms. This inflammatory disease can be debilitating and thus result in considerable health-related and economic consequences. Methods In a cross-sectional study, adult subjects with AR (N = 683) completed three allergy-specific questionnaires that assessed the impact of AR on the work/academic performance, daily activities, health-related quality of life (HRQOL), and satisfaction with allergen immunotherapy (AIT). Regression analyses were used to examine the associations between several clinical variables and the patient-reported outcomes. Results Total loss of productivity was 21.0 and 21.2 % for employed and student patients, respectively, whereas the impairment of daily activities was 22.0 %. The mean overall HRQOL score was 1.94 ± 1.29 (on the scale of 0–6 points). Global score for satisfaction with AIT was 65.5 ± 24.8 (on a 0–100 scale). Simple regression analysis found statistically significant associations between loss of work and academic productivity, impairment of daily activities and the type and severity of AR. AIT was a protective factor. The persistent and more severe types of AR and lack of AIT contributed to the worsening of HRQOL. Conclusions AR (the persistent and more severe form of the disease) has an impact on functional characteristics of adult patients in Spain. AIT might reduce the effect of this disease on the work/academic performance and HRQOL. Trial registration Retrospectively registered
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Affiliation(s)
- A Roger
- Allergy Unit, Germans Trias i Pujol Hospital, Badalona, Spain
| | | | - M C Torres
- Unidad de Alergia, Hospital Casa de Salud, Valencia, Spain
| | - C Millan
- Unidad de Alergia, Hospital Jerez de la Frontera, Jerez de la Frontera, Spain
| | - I Jáuregui
- Servicio de Alergia, Hospital Universitario de Basurto, Bilbao, Spain
| | - E Mohedano
- Servicio de Alergia, Hospital Universitario de Fuenlabrada, Fuenlabrada, Spain
| | - S Liñan
- Neumología Pediátrica, Hospital de Nens de Barcelona, Barcelona, Spain
| | - P Verdu
- Servicio de Alergia, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - N Rubira
- Unidad de Alergia, Centro Sanitario C Mora, Sant Cugat, Barcelona, Spain
| | - M Santaolalla
- Servicio de Alergia, Hospital Universitario de Sanchinarro, Madrid, Spain
| | - P González
- Servicio de Alergia, Hospital General Universitario de Alicante, Alicante, Spain
| | - A Orovitg
- Unidad de Alergia, Hospital Viamed Santa Angela de la Cruz, Seville, Spain
| | - E Villarrubia
- Health Outcomes Research Department, 3D Health Research, Balmes 152 6º 2ª, 08008 Barcelona, Spain
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12
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Konishi S, Ng CFS, Stickley A, Nishihata S, Shinsugi C, Ueda K, Takami A, Watanabe C. Particulate matter modifies the association between airborne pollen and daily medical consultations for pollinosis in Tokyo. THE SCIENCE OF THE TOTAL ENVIRONMENT 2014; 499:125-132. [PMID: 25181044 DOI: 10.1016/j.scitotenv.2014.08.045] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Revised: 07/21/2014] [Accepted: 08/15/2014] [Indexed: 06/03/2023]
Abstract
Pollen from Japanese cedar (sugi) and cypress (hinoki) trees is responsible for the growing prevalence of allergic rhinitis, especially pollinosis in Japan. Previous studies have suggested that air pollutants enhance the allergic response to pollen in susceptible individuals. We conducted a time-stratified case-crossover study to examine the potential modifying effects of PM2.5 and suspended particulate matter (SPM) on the association between pollen concentration and daily consultations for pollinosis. A total of 11,713 daily pollinosis cases (International Classification of Diseases, ICD-10, J30.1) from January to May, 2001-2011, were obtained from a clinic in Chiyoda, Tokyo. Daily pollen counts and the daily mean values of air pollutants (PM2.5, SPM, SO2, NO2, CO, and O3) were collected from monitoring stations across Tokyo. The effects of pollen were stratified by the level of PM2.5 and SPM to examine the interaction effect of pollen and particulate pollutants. We found a statistically significant interaction between pollen concentration and PM2.5/SPM. On days with a high level of PM2.5 (>95th percentile), an interquartile increase in the mean cumulative pollen count (an average of 28 pollen grains per cm(2) during lag-days 0 to 5) corresponded to a 10.30% (95%CI: 8.48%-12.16%) increase in daily new pollinosis cases, compared to 8.04% (95%CI: 7.28%-8.81%) on days with a moderate level of PM2.5 (5th-95th percentile). This interaction persisted when different percentile cut-offs were used and was robust to the inclusion of other air pollutants. A similar interaction pattern was observed between SPM and pollen when a less extreme cut-off for SPM was used to stratify the effect of pollen. Our study showed the acute effect of pollen was greater when the concentration of air particulate pollutant, specifically PM2.5 and SPM, was higher. These findings are consistent with the notion that particulate air pollution may act as an adjuvant that promotes allergic disease (i.e. pollinosis).
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Affiliation(s)
- Shoko Konishi
- Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan; Department of Anthropology, University of Washington, Box 353100, Seattle, WA 98195-3100, USA.
| | - Chris Fook Sheng Ng
- Environmental Epidemiology Section, Center for Environmental Health Sciences, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki, 305-8506, Japan
| | - Andrew Stickley
- Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Shinichi Nishihata
- Nishihata Ear, Nose and Throat Clinic, 2-10-1 Yuraku-cho, Chiyoda-ku, Tokyo, 100-0006, Japan
| | - Chisa Shinsugi
- Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Kayo Ueda
- Environmental Epidemiology Section, Center for Environmental Health Sciences, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki, 305-8506, Japan
| | - Akinori Takami
- Center for Regional Environmental Research, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba-City, Ibaraki 305-8506, Japan
| | - Chiho Watanabe
- Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
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13
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Bando H, Sugiura H, Ohkusa Y, Akahane M, Sano T, Jojima N, Okabe N, Imamura T. Association between first airborne cedar pollen level peak and pollinosis symptom onset: a web-based survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2014; 25:104-113. [PMID: 24720339 DOI: 10.1080/09603123.2014.903904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Cedar pollinosis in Japan affects nearly 25 % of Japanese citizens. To develop a treatment for cedar pollinosis, it is necessary to understand the relationship between the time of its occurrence and the amount of airborne cedar pollen. In the spring of 2009, we conducted daily Internet-based epidemiologic surveys, which included 1453 individuals. We examined the relationship between initial date of onset of pollinosis symptoms and daily amount of airborne cedar pollen to which subjects were exposed. Approximately 35.2 % of the subjects experienced the onset of pollinosis during a one-week interval in which the middle day coincided with the peak pollen count. The odds ratio for this one-week time interval was 4.03 (95 % confidence interval: 3.34-4.86). The predicted date of the cedar pollen peak can be used to determine the appropriate date for initiation of self-medication with anti-allergy drugs and thus avoid development of sustained and severe pollinosis.
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Affiliation(s)
- Harumi Bando
- a Faculty of Nursing , Nara Medical University , Kashihara , Japan
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14
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Hosoya K, Masuno S, Hashiguchi K, Okubo K. Placebo-controlled study with OHIO chamber of prophylactic pranlukast for children with Japanese cedar pollinosis: TOPIC-J III study. J Drug Assess 2014; 3:51-9. [PMID: 27536454 PMCID: PMC4937631 DOI: 10.3109/21556660.2014.960969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2014] [Indexed: 12/02/2022] Open
Abstract
Objective This double-blind, placebo-controlled comparative study was designed to investigate whether pranlukast dry syrup, a leukotriene receptor antagonist, has a protective effect against priming, controlled pollen exposure, and natural pollen exposure in children with Japanese cedar pollinosis. Research design and methods Thirty children aged 12–15 years with Japanese cedar pollinosis (positive skin test for Japanese cedar pollen), who had suffered from pollinosis for at least 2 years and developed severe nasal obstruction when exposed to Japanese cedar pollen, were enrolled in this study. They were randomly allocated to treatment with pranlukast or placebo orally after breakfast and dinner for 8 weeks during the Japanese cedar pollen season. Soon after the start of the pollen season, all subjects underwent a challenge by exposure for 3 h to Japanese cedar pollen (8000 grains/m3) in an artificial exposure chamber (OHIO chamber). Clinical trial registration The University Hospital Medical Information Network in Japan (UMIN000009840). Main outcome measures The effect of pranlukast was evaluated using self-rating of nasal symptoms by the subjects and measurement of eosinophil cationic protein in nasal discharge specimens. Results Scores for the symptoms of pollinosis were lower in the pranlukast group than in the placebo group during treatment in the priming state, as well as after controlled pollen exposure and natural pollen exposure. Pranlukast significantly improved the score for nasal obstruction, compared with placebo. A correlation was found between changes of the scores for symptoms of pollinosis and changes of the eosinophil cationic protein level. Conclusions These results confirm a protective effect of pranlukast against both priming and challenge (controlled and natural) with Japanese cedar pollen. The present findings suggested that pranlukast dry syrup may be useful for prophylaxis against pollinosis in children.
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Affiliation(s)
- Kei Hosoya
- Department of Otorhinolaryngology, Nippon Medical School, TokyoJapan
| | - Satoru Masuno
- Department of Otorhinolaryngology, Nippon Medical School, TokyoJapan
| | | | - Kimihiro Okubo
- Department of Otorhinolaryngology, Nippon Medical School, TokyoJapan
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15
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Yano C, Saeki H, Ishiji T, Ishiuji Y, Sato J, Tofuku Y, Nakagawa H. Impact of disease severity on work productivity and activity impairment in Japanese patients with atopic dermatitis. J Dermatol 2013; 40:736-9. [PMID: 23834561 DOI: 10.1111/1346-8138.12220] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Accepted: 05/26/2013] [Indexed: 11/25/2022]
Abstract
Atopic dermatitis (AD) is a common inflammatory skin disease that is characterized by chronic and persisting pruritic and eczematous lesions. There has been no study of work productivity and activity in AD patients in relation to disease severity. The purpose of this study was to examine the impact of disease severity on work productivity and activity impairment (WPAI) in adult AD patients using the Japanese version of the questionnaire. Data were collected from 112 AD patients who visited the Jikei University Hospital. Outcomes as measured by the questionnaire included employment status, total work productivity impairment (TWPI) and total activity impairment (TAI). We investigated the correlation between TWPI or TAI scores and severity scoring of AD (SCORAD) for disease severity and dermatology life quality index (DLQI) for quality of life impairment. Both TWPI and TAI scores were significantly correlated with the SCORAD and DLQI scores (P < 0.001), indicating disease severity is significantly associated with WPAI in Japanese adult AD patients. Further studies are necessary to evaluate the effects of treatments on WPAI for severe AD patients.
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Affiliation(s)
- Chizuko Yano
- Department of Dermatology, The Jikei University School of Medicine, Tokyo, Japan
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16
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de la Hoz Caballer B, Rodríguez M, Fraj J, Cerecedo I, Antolín-Amérigo D, Colás C. Allergic rhinitis and its impact on work productivity in primary care practice and a comparison with other common diseases: the Cross-sectional study to evAluate work Productivity in allergic Rhinitis compared with other common dIseases (CAPRI) study. Am J Rhinol Allergy 2013; 26:390-4. [PMID: 23168153 DOI: 10.2500/ajra.2012.26.3799] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Allergic rhinitis (AR) is a highly prevalent allergic disease and also counts among the 10 most frequent reasons for medical consultation. Its impact on quality of life (QoL) and work productivity has been established but comparisons with other diseases are rare in the literature. The aim of this study was to evaluate the impact of AR in health-related QoL (HRQoL) and work productivity in primary care patients, compared with other prevalent diseases such as hypertension, diabetes mellitus (DM) type II, and symptomatic depression. METHODS Six hundred sixteen patients were included in a multicenter cross-sectional observational study. A generic HRQoL questionnaire, 36-item Short Form, and a specific questionnaire, "Work Productivity and Activity Impairment" were handed out to measure QoL and work productivity impact of the diseases. To assess clinical severity with a comparable scale between diseases Clinical Global Impression (CGI) had been used. RESULTS Symptomatic depression was found to produce the greatest impairment on work productivity with a decrease of 59.5%, with significant differences compared with AR, hypertension, and DM type II (p < 0.05). Symptomatic depression was found to produce the highest negative impact on daily activities with a statistically significant reduction of 59.4% (p < 0.05) compared with AR (26.6% decrease), hypertension (8.8% decrease), and DM (16.7% decrease) patients. Differences between AR and DM or hypertension were also significant (p < 0.05). Restriction on daily activities for AR was 27.8%, which is significantly higher (p < 0.05) than hypertension (19.8% decrease) but not DM (25.7% decrease). Depression had the highest impairment on daily activities (59.4%), compared with the remaining three groups (p < 0.05). CONCLUSION AR impairs work productivity in a greater magnitude than hypertension and DM type II.
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Affiliation(s)
- Belén de la Hoz Caballer
- Department of Allergy, Belén de la Hoz Caballer, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
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17
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Affiliation(s)
- Priyanka Vashisht
- Creighton University, Allergy Immunology/Internal Medicine,
601 N 30th Street, Omaha, Omaha, NE 68131, USA
| | - Thomas Casale
- Creighton University, Allergy and Immunology,
601 N 30th Street, Omaha, NE 68131, USA
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18
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Yonekura S, Okamoto Y, Horiguchi S, Okubo K, Gotoh M, Konno A, Okuda M. Early intervention for Japanese cedar and cypress pollinosis. ACTA ACUST UNITED AC 2012. [DOI: 10.1111/j.1472-9733.2011.01157.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- S. Yonekura
- Department of Otolaryngology, Head and Neck Surgery; Graduate School of Medicine; Chiba University; Chiba; Japan
| | - Y. Okamoto
- Department of Otolaryngology, Head and Neck Surgery; Graduate School of Medicine; Chiba University; Chiba; Japan
| | - S. Horiguchi
- Department of Otolaryngology, Head and Neck Surgery; Graduate School of Medicine; Chiba University; Chiba; Japan
| | - K. Okubo
- Department of Otolaryngology; Nippon Medical School; Tokyo; Japan
| | - M. Gotoh
- Department of Otolaryngology; Nippon Medical School; Tokyo; Japan
| | - A. Konno
- Otolaryngology Unit; South Tohoku General Hospital; Fukushima; Japan
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19
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Takahashi G, Matsuzaki Z, Okamoto A, Ito E, Matsuoka T, Nakayama T, Masuyama K. A randomized control trail of stepwise treatment with fluticasone propionate nasal spray and fexofenadine hydrochloride tablet for seasonal allergic rhinitis. Allergol Int 2012; 61:155-62. [PMID: 22189593 DOI: 10.2332/allergolint.11-oa-0342] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2011] [Accepted: 08/05/2011] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND In Japan, oral antihistamines are frequently used as the initial treatment for seasonal allergic rhinitis (SAR), and intranasal steroids are added when nasal symptoms worsen. This study aimed to evaluate whether starting treatment with fluticasone propionate nasal spray (FP) from the beginning of pollinosis symptoms and adding fexofenadine hydrochloride tablet (FEX) when SAR is aggravated could achieve improved amelioration of nasal symptoms throughout the pollen season in comparison with a treatment that involves starting with FEX and later adding FP. METHODS In this pragmatic, randomized, open-label, parallel-group trial, 51 Japanese cedar pollinosis patients (age, 16-85 years) were randomly divided and administered FP 100 mcg twice daily as an initial drug with FEX 60 mg twice daily as an additional drug and the same treatment in the reverse order. Nasal symptoms were evaluated in a daily dairy using a 4-point scale. The primary outcome was area under curve of the line representing the daily total nasal symptom score in the pollen season on a graph. RESULTS Initial treatment with FP was significantly (P = 0.0015) more effective than initial treatment with FEX in improving the primary outcome. The average daily total nasal symptom score in the initial treatment with FP group was better than that in the initial treatment with FEX group throughout the pollen season. CONCLUSIONS Initiating treatment with FP and adding FEX might lead to improved outcomes for nasal symptoms in comparison with the same drugs administered in the reverse order.
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Affiliation(s)
- Goro Takahashi
- Department of Otolaryngology, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan. gr−
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20
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Suzuki Y, Inoue T, Yamamoto A, Sugimoto Y. Prophylactic effects of the histamine H1 receptor antagonist epinastine and the dual thromboxane A2 receptor and chemoattractant receptor-homologous molecule expressed on Th2 cells antagonist ramatroban on allergic rhinitis model in mice. Biol Pharm Bull 2011; 34:507-10. [PMID: 21467637 DOI: 10.1248/bpb.34.507] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The prophylactic use of anti-allergic drugs has been proposed to be effective in the treatment of seasonal allergic rhinitis in humans. However, there is little information regarding the prophylactic effect of thromboxane A(2) (TXA(2)) receptor antagonist on allergic rhinitis. Recent studies revealed that a TXA(2) receptor antagonist ramatroban could block the prostaglandin D(2) (PGD(2)) receptor and chemoattractant receptor-homologous molecule expressed on Th2 cells (CRTH2). In the present study, we investigated the prophylactic effects of the histamine H(1) receptor antagonist epinastine and the TXA(2) receptor antagonist ramatroban and seratrodast on mouse models of allergic rhinitis. Female BALB/c mice were sensitized by an intraperitoneal injection of ovalbumin and alum on days 0, 5, 14 and 21. Seven days later, mice were sensitized by intranasal application of ovalbumin thrice a week. Drugs were administered once a day from day 22. The severity of allergic rhinitis was assessed by determining the extent of 2 nasal allergic symptoms (sneezing and nasal rubbing). Histamine sensitivity and eosinophil infiltration into the nasal mucosa were also determined. Epinastine and ramatroban significantly reduced nasal symptoms and the number of eosinophils in the nasal mucosa. Seratrodast showed no effect on nasal symptoms and eosinophil infiltration into the nasal mucosa. In addition, histamine sensitivity was reduced by epinastine and ramatroban. These results indicate that epinastine and ramatroban induce the prophylactic effect on allergic rhinitis.
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Affiliation(s)
- Yuh Suzuki
- Department of Medicinal Pharmacology, Division of Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Tsushima-naka, Kita-ku, Japan
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21
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Gotoh M, Suzuki H, Okubo K. Delay of onset of symptoms of Japanese cedar pollinosis by treatment with a leukotriene receptor antagonist. Allergol Int 2011; 60:483-9. [PMID: 21778814 DOI: 10.2332/allergolint.10-oa-0285] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2010] [Accepted: 02/25/2011] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Leukotriene receptor antagonists (LTRAs) are effective for prophylactic treatment of pollinosis based on studies showing that administration of LTRAs prior to or at the start of the pollen season reduces symptoms and QOL disturbance at the peak of pollen dispersal. Two goals of prophylactic treatment of pollinosis are use of fewer types of drugs and delay of onset of symptoms and impairement of QOL. Therefore, this study was performed to determine if pranlukast, a LTRA, met these goals in treatment of pollinosis. METHODS Pranlukast or placebo was administered to patients who visited our hospital immediately before the start of Japanese cedar pollen dispersal. The study was performed for 4 weeks as a double blind randomized trial. Subsequently, all patients were given pranlukast for a further 4 weeks from the peak until the end of pollen dispersal. The incidence of symptoms and use of concomitant drugs were investigated from daily nasal allergy records kept by patients. QOL was evaluated using the JRQLQ questionnaire. RESULTS In the double blind period of the study, the percentage of patients who used concomitant drugs for nasal symptoms was significantly lower in the pranlukast group compared to the placebo group. Development of nasal symptoms (sneezing, runny nose and nasal congestion) and disturbance of daily activities were significantly delayed in the pranlukast group. No serious adverse reactions occurred in the pranlukast group and no patient withdrew from treatment with pranlukast. CONCLUSIONS Pranlukast is effective for prophylactic treatment of pollinosis.
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Affiliation(s)
- Minoru Gotoh
- Department of Otorhinolaryngology, Nippon Medical School, Tokyo, Japan.
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22
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Murota H, Kitaba S, Tani M, Wataya-Kaneda M, Azukizawa H, Tanemura A, Umegaki N, Terao M, Kotobuki Y, Katayama I. Impact of sedative and non-sedative antihistamines on the impaired productivity and quality of life in patients with pruritic skin diseases. Allergol Int 2010; 59:345-54. [PMID: 20864795 DOI: 10.2332/allergolint.10-oa-0182] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2010] [Accepted: 03/23/2010] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The impairment that pruritic skin diseases have on patient productivity at work, in the classroom, and in daily activities is substantial and needs to be characterized. The objective of this study was to determine how pruritic skin diseases impact patient productivity and quality of life (QOL), in order to improve the measurement of these endpoints to allow the influence of treatment options including sedative and non-sedative antihistamines to be analyzed. METHODS The impact of pruritic skin diseases and the effect of antihistamine therapy on work, classroom, and daily productivity were evaluated using the Work Productivity Assessment Index-Allergy Specific Questionnaire. The intensity of itch and patient QOL were assessed using a visual analogue scale and Skindex-16, respectively. RESULTS Pruritic skin diseases resulted in significant impairment of work, classroom, and daily productivity. The severity of overall work impairment in atopic dermatitis (AD), urticaria, and prurigo was higher than for other diseases analyzed. However, classroom activity was more adversely affected in patients with urticaria relative to other diseases. All pruritic diseases in this study negatively impacted daily activity to a similar degree. Impaired productivity was significantly improved in patients taking non-sedative antihistamines for 1 month, and the improvements correlated with the alleviation of itch and improved QOL. CONCLUSIONS These results indicate that pruritic skin diseases reduce patient productivity at work, in the classroom, and during daily activities, and that non-sedative antihistamines may offer an advantage over sedative antihistamines for alleviating certain negative consequences of these skin diseases.
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Murota H, Kitaba S, Tani M, Wataya-Kaneda M, Katayama I. Effects of nonsedative antihistamines on productivity of patients with pruritic skin diseases. Allergy 2010; 65:929-30. [PMID: 19889115 DOI: 10.1111/j.1398-9995.2009.02262.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- H Murota
- Department of Dermatology Course of Integrated Medicine, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
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24
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Hashimoto M, Sato EF, Hiramoto K, Kasahara E, Inoue M. Role of the hypothalamo-pituitary-adrenal axis in the modulation of pollinosis induced by pollen antigens. Allergol Int 2010; 59:201-6. [PMID: 20299824 DOI: 10.2332/allergolint.09-oa-0133] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2009] [Accepted: 10/27/2009] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND To clarify the mechanism of stress-induced modification of allergic diseases, we studied the effect of restraint stress on plasma levels of cytokines and the symptoms of pollinosis in mice. METHODS The effects of restraint stress and the role of the hypothalamo-pituitary-adrenal axis (HPA-axis) in the development of pollen antigen-induced pollinosis were studied in control, hypophysectomized, adrenalectomized or ACTH-administered mice. Twenty days after sensitization, animals were subjected to mild restraint stress for 3 hours, and plasma levels of IFN-gamma, IL-10, and IgE were measured. We analyzed the incidence of sneezing and nasal rubbing in the sensitized animals. RESULTS Plasma levels of IL-10 and IgE increased in the sensitized animals with a concomitant increase in the incidence of sneezing and nasal rubbing. The increases in plasma IgE, IL-10 and the incidence of sneezing and nasal rubbing were suppressed by restraint stress. Adrenalectomy increased IFN-gamma, inhibited the increase in plasma IL-10 and IgE, and suppressed the incidence of sneezing. In contrast, hypophysectomy increased plasma levels of IL-10, IFN-gamma, and IgE and the incidence of sneezing. Intraperitoneal administration of ACTH decreased IL-10 in plasma but increased IFN-gamma and suppressed the incidence of nasal rubbing. CONCLUSIONS The present findings show that the HPA-axis and ACTH play important roles in the regulation of plasma cytokines and IgE thereby modulating symptoms of pollinosis. The results also suggest that a mild restraint stress suppresses the increase in Th2-dependent cytokines and IgE to reduce the symptoms of pollinosis.
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MESH Headings
- Adrenalectomy
- Adrenocorticotropic Hormone/administration & dosage
- Animals
- Antigens, Plant/immunology
- Hypophysectomy
- Hypothalamo-Hypophyseal System/drug effects
- Hypothalamo-Hypophyseal System/immunology
- Hypothalamo-Hypophyseal System/surgery
- Immunoglobulin E/blood
- Interferon-gamma/blood
- Interleukin-10/blood
- Male
- Mice
- Mice, Inbred Strains
- Pituitary-Adrenal System/drug effects
- Pituitary-Adrenal System/immunology
- Pituitary-Adrenal System/surgery
- Pollen/adverse effects
- Restraint, Physical
- Rhinitis
- Rhinitis, Allergic, Seasonal/blood
- Rhinitis, Allergic, Seasonal/immunology
- Rhinitis, Allergic, Seasonal/physiopathology
- Rhinitis, Allergic, Seasonal/surgery
- Stress, Physiological/immunology
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Affiliation(s)
- Maki Hashimoto
- Department of Biochemistry and Molecular Pathology, Osaka City University Medical School, Osaka, Japan
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Fujisawa T, Nagao M, Hiraguchi Y, Hosoki K, Tokuda R, Usui S, Masuda S, Shinoda M, Hashiguchi A, Yamaguchi M. Biomarkers for allergen immunotherapy in cedar pollinosis. Allergol Int 2009; 58:163-70. [PMID: 19390237 DOI: 10.2332/allergolint.09-rai-0097] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2009] [Indexed: 12/13/2022] Open
Abstract
To initiate, monitor, and complete effective immunotherapy, biomarkers to predict and visualize the immune responses are needed. First, we need to identify the right candidate for immunotherapy. Secondly, the immune responses induced by immunotherapy should be monitored. For the first objective, analysis of polymorphisms of candidate genes may be helpful, but still be in development. Regarding biomarkers for immune responsese, there are numerous reports that evaluate immunotherapy-induced immune changes such as suppression of effector cells, deviation to Th1 cytokine production, and induction of regulatory T cells. No standardized methods, however, have been established. Among them, a functional assay of blocking IgG activity, the IgE-facilitated allergen binding assay, may be useful. We quantitated induced expression of an activation marker, CD203c, on basophils and found that the assay efficiently predicts sensitivity to particular allergen and severity of the allergen-induced symptoms. In patients who received rush immunotherapy for Japanese cedar pollinosis, reduction in CD203c expression after the therapy was observed, suggesting the utility of the test for monitoring immunotherapy.
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Affiliation(s)
- Takao Fujisawa
- Institute for Clinical Research, Mie National Hospital, Mie, Japan.
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Hashiguchi K, Tang H, Fujita T, Suematsu K, Gotoh M, Okubo K. Bepotastine besilate OD tablets suppress nasal symptoms caused by Japanese cedar pollen exposure in an artificial exposure chamber (OHIO Chamber). Expert Opin Pharmacother 2009; 10:523-9. [PMID: 19216705 DOI: 10.1517/14656560902758368] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To investigate the efficacy and safety of bepotastine, we conducted a randomized, investigator-blind, placebo-controlled and parallel study to evaluate the allergic symptoms and the cognitive function of the subjects with Japanese cedar (JC) pollinosis in response to JC pollen exposure in an artificial exposure chamber. METHODS Twenty-four volunteers with JC pollinosis were enrolled in this study. The subjects were randomly divided into two groups: a bepotastine group and a placebo group (12 subjects each). Subjects received either a 10-mg bepotastine OD (orally disintegrating) tablet or a placebo 10 min before entering the chamber for a 3-h exposure. The nasal and ocular symptoms were evaluated by each patient at regular intervals. The amount of nasal discharge was measured and the number of sneezes recorded. To evaluate the cognitive function, a digit cancellation test (D-CAT), in which the subjects have to eliminate certain numbers within a fixed time, was conducted. RESULTS Twelve subjects in the placebo group developed nasal and/or ocular symptoms, whereas six subjects in the bepotastine group showed none of the symptoms during exposure. Mean secretion weights and number of sneezes were significantly lower in the bepotastine group than in the placebo group. In D-CAT, no deterioration of work performance was observed in the bepotastine group. No adverse effects were observed in either group. CONCLUSION Bepotastine treatment is effective and well tolerated in patients with allergen-induced symptoms exposed to JC pollen in an exposure chamber.
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Update on prescription and over-the-counter histamine inverse agonists in rhinitis therapy. Curr Allergy Asthma Rep 2009; 9:140-8. [PMID: 19210904 DOI: 10.1007/s11882-009-0021-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Allergic rhinitis (AR) is associated with histamine-mediated physiologic events. The currently used histamine antagonists are all inverse agonists that bind and inactivate histamine H1 receptors. Second-generation antihistamines are much more H1-receptor selective with less central nervous system penetration than first-generation agents. Antihistamines typically are more effective in seasonal than perennial AR and do not demonstrate significant relief of nasal congestion. The recent availability of some second-generation antihistamines as over-the-counter products clearly places them as the preferred first-line treatment for mild to moderate AR based on safety when compared with first-generation over-the-counter antihistamines. The remaining prescription-only second-generation antihistamines, fexofenadine, desloratadine, and levocetirizine, all have unique attributes. Antihistamines in oral, intranasal, or intraocular formulations will likely remain among the mainstays of allergy therapeutics.
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Sashihara T, Ikegami S, Sueki N, Yamaji T, Kino K, Taketomo N, Gotoh M, Okubo K. Oral administration of heat-killed Lactobacillus gasseri OLL2809 reduces cedar pollen antigen-induced peritoneal eosinophilia in Mice. Allergol Int 2008; 57:397-403. [PMID: 18946235 DOI: 10.2332/allergolint.o-08-541] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2008] [Accepted: 06/04/2008] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Lactobacillus gasseri OLL2809 strongly stimulates the production of interleukin (IL)-12 (p70) by innate immune cells. Thus, it is expected to ameliorate allergic diseases. We investigated whether the oral administration of heat-killed L. gasseri OLL2809 suppressed eosinophilia in cedar pollen antigen-challenged mice. METHODS BALB/c mice sensitized with Japanese cedar pollen extract were intraperitoneally challenged with the same extract. The mice were orally given heat-killed L. gasseri OLL2809 at doses of 0.5, 1, or 2mg/day throughout the experimental period (21 d). After 24 hours of the challenge, the eosinophil number and cytokine levels in the peritoneal lavage fluid and the serum antigen-specific IgG levels were determined. RESULTS On administering varying amounts of heat-killed L. gasseri OLL2809, the number of eosinophils among the total number of cells was significantly reduced in all groups. In addition, the eosinophil number significantly decreased, and the eosinophil-suppression rate significantly increased by 44% in the 2-mg group. Although the serum immunoglobulin (Ig) G2a and IgG1 levels were not affected, the IgG2a/IgG1 ratio increased significantly in the 2-mg group compared with that of the control group. Furthermore, the administration of heat-killed L. gasseri OLL2809 resulted in the induction of IL-2 and reduction in granulocyte-macrophage colony-stimulating factor levels in peritoneal lavage fluid. CONCLUSIONS We demonstrated that the oral administration of heat-killed L. gasseri OLL2809 suppresses eosinophilia via the modulation of Th1/Th2 balance. These observations suggested that heat-killed L. gasseri OLL2809 might potentially ameliorate the increased number of eosinophils in patients with Japanese cedar pollinosis.
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Affiliation(s)
- Toshihiro Sashihara
- Division of Research and Development, Meiji Dairies Corporation, Kanagawa, Japan.
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Axelrod D, Bielory L. Fexofenadine hydrochloride in the treatment of allergic disease: a review. J Asthma Allergy 2008; 1:19-29. [PMID: 21436982 PMCID: PMC3121339 DOI: 10.2147/jaa.s3092] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Fexofenadine is a selective, non-sedating H1 receptor antagonist, marketed in the United States since 2000. The FDA approved an oral suspension in 2006, for the treatment of seasonal allergic rhinitis and chronic idiopathic urticaria in children. The tablet, capsule, and oral suspension are bioequivalent. Although fexofenadine does not use P450 CYP 3A4 it does interact with a number of drugs at P-glycoprotein and organic anion transporter polypeptides. The risk of toxicity from other drugs may increase with the administration of fexofenadine. Orange and grapefruit juices reduce the bioavailability of fexofenadine. Fexofenadine has been shown to have an impact on inflammatory mediators, other than histamine, such as decreasing the production of LTC4, LTD4, LTE4, PGE2, and PGF2α; inhibiting cyclo-oxygenase 2, thromboxane; limiting iNOS generation of NO; decreasing cytokine levels (ICAM-1, ELAM-1, VCAM-1, RANTES, I-TAC, MDC, TARC, MMP-2, MMP-9, tryptase); and diminishing eosinophil adherence, chemotaxis, and opsonization of particles. These effects may provide benefit to some of the inflammatory responses of an acute allergic reaction and provide a basis for future development of H1 antagonists with stronger anti-inflammatory effects. These studies also support the contention that fexofenadine is effective for the treatment of allergic rhinits and chronic idiopathic urticaria.
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Baiardini I, Braido F, Tarantini F, Porcu A, Bonini S, Bousquet PJ, Zuberbier T, Demoly P, Canonica GW. ARIA-suggested drugs for allergic rhinitis: what impact on quality of life? A GA2LEN review. Allergy 2008; 63:660-9. [PMID: 18445183 DOI: 10.1111/j.1398-9995.2008.01649.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Allergic diseases constitute a global health problem, as they have an increasing economic and social impact and, especially, they can deeply interfere with the patients' daily life, being a cause of physical and emotional discomfort. This is why the health-related quality-of-life (HRQoL) has become increasingly important in health care research; in fact, the assessment of the impact the disease and its treatment have on patients, provides a more comprehensive approach in outcome evaluation. Numerous validated questionnaires are available and many studies have been performed evaluating HRQoL in people affected by allergic rhinitis (AR), thus testifying a great interest in this topic. The aims of the present review are: to examine the scientific literature of the last 3 years dealing with the impact of AR treatments suggested by allergic rhinitis and its impact on asthma guidelines on patients' QoL, and to identify the unexplored or not-fully-investigated areas concerning this issue.
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Affiliation(s)
- I Baiardini
- Allergy & Respiratory Diseases, DIMI - University of Genoa, Genoa, Italy
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Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A, Zuberbier T, Baena-Cagnani CE, Canonica GW, van Weel C, Agache I, Aït-Khaled N, Bachert C, Blaiss MS, Bonini S, Boulet LP, Bousquet PJ, Camargos P, Carlsen KH, Chen Y, Custovic A, Dahl R, Demoly P, Douagui H, Durham SR, van Wijk RG, Kalayci O, Kaliner MA, Kim YY, Kowalski ML, Kuna P, Le LTT, Lemiere C, Li J, Lockey RF, Mavale-Manuel S, Meltzer EO, Mohammad Y, Mullol J, Naclerio R, O'Hehir RE, Ohta K, Ouedraogo S, Palkonen S, Papadopoulos N, Passalacqua G, Pawankar R, Popov TA, Rabe KF, Rosado-Pinto J, Scadding GK, Simons FER, Toskala E, Valovirta E, van Cauwenberge P, Wang DY, Wickman M, Yawn BP, Yorgancioglu A, Yusuf OM, Zar H, Annesi-Maesano I, Bateman ED, Ben Kheder A, Boakye DA, Bouchard J, Burney P, Busse WW, Chan-Yeung M, Chavannes NH, Chuchalin A, Dolen WK, Emuzyte R, Grouse L, Humbert M, Jackson C, Johnston SL, Keith PK, Kemp JP, Klossek JM, Larenas-Linnemann D, Lipworth B, Malo JL, Marshall GD, Naspitz C, Nekam K, Niggemann B, Nizankowska-Mogilnicka E, Okamoto Y, Orru MP, Potter P, Price D, Stoloff SW, Vandenplas O, Viegi G, Williams D. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy 2008; 63 Suppl 86:8-160. [PMID: 18331513 DOI: 10.1111/j.1398-9995.2007.01620.x] [Citation(s) in RCA: 3049] [Impact Index Per Article: 190.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
MESH Headings
- Adolescent
- Asthma/epidemiology
- Asthma/etiology
- Asthma/therapy
- Child
- Global Health
- Humans
- Prevalence
- Rhinitis, Allergic, Perennial/complications
- Rhinitis, Allergic, Perennial/diagnosis
- Rhinitis, Allergic, Perennial/epidemiology
- Rhinitis, Allergic, Perennial/therapy
- Rhinitis, Allergic, Seasonal/complications
- Rhinitis, Allergic, Seasonal/diagnosis
- Rhinitis, Allergic, Seasonal/epidemiology
- Rhinitis, Allergic, Seasonal/therapy
- Risk Factors
- World Health Organization
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Affiliation(s)
- J Bousquet
- University Hospital and INSERM, Hôpital Arnaud de Villeneuve, Montpellier, France
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Nagakura T, Ogino S, Okubo K, Sato N, Takahashi M, Ishikawa T. Omalizumab is more effective than suplatast tosilate in the treatment of Japanese cedar pollen-induced seasonal allergic rhinitis. Clin Exp Allergy 2007; 38:329-37. [PMID: 18070163 DOI: 10.1111/j.1365-2222.2007.02894.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Seasonal allergic rhinitis (SAR) induced by Japanese cedar pollens is a major problem in Japan. Omalizumab, a humanized monoclonal anti-IgE antibody, improves symptoms associated with SAR, but a comparative study with an anti-allergy drug has not yet been conducted. OBJECTIVE To compare the efficacy and safety of omalizumab with suplatast tosilate, a selective T-helper type 2 (Th2) cytokine inhibitor, in patients with Japanese cedar pollen-induced SAR. METHODS A randomized, double-blind, double-dummy study was conducted in 308 Japanese patients with a history of moderate-to-severe SAR who showed a CAP-RAST value (> or =2+) specifically to Japanese cedar pollens. Patients were treated for 12 weeks with omalizumab plus placebo of suplatast tosilate or suplatast tosilate plus placebo of omalizumab. RESULTS The mean daily nasal symptom medication scores (sum of the daily nasal symptom severity score and daily nasal rescue medication score) were significantly lower in the omalizumab group than in the suplatast tosilate group during three evaluation periods (P<0.001). The omalizumab group also had significantly lower mean daily nasal severity scores, each of the mean daily nasal and ocular symptom severity scores (sneezing, runny nose, stuffy nose, itchy nose, itchy eyes, watery eyes, and red eyes). Omalizumab reduced rescue medication requirements, and the proportion of days with any rescue medication use in the omalizumab group was significantly lower. Serum-free IgE levels markedly decreased in the omalizumab group and it was associated with clinical efficacy. The adverse reaction profiles were similar between the two groups. The overall incidence of injection site reactions was higher in the omalizumab group than in the suplatast tosilate group, but all these events were of mild degree. No anti-omalizumab antibodies were detected. CONCLUSION Omalizumab showed significantly greater improvements than suplatast tosilate in the treatment of SAR induced by Japanese cedar pollens.
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Affiliation(s)
- T Nagakura
- The Allergy and Internal Medicine, Yoga Allergy Clinic, Tokyo, Japan.
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Milgrom H, Kittner B, Lanier R, Hampel FC. Safety and tolerability of fexofenadine for the treatment of allergic rhinitis in children 2 to 5 years old. Ann Allergy Asthma Immunol 2007; 99:358-63. [PMID: 17941284 DOI: 10.1016/s1081-1206(10)60553-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND The safety of fexofenadine has been examined extensively in adults and school-age children. However, the safety of fexofenadine in children younger than 6 years has not been reported to date. OBJECTIVE To compare the safety and tolerability of twice-daily fexofenadine hydrochloride, 30 mg, and placebo in preschool children aged 2 to 5 years with allergic rhinitis. METHODS This was a multicenter, double-blind, randomized, placebo-controlled, parallel-group study, conducted between February 29, 2000, and June 14, 2001. Participants were randomized to either fexofenadine hydrochloride, 30 mg, or placebo twice daily for a 2-week period. To facilitate dosing, capsule content was mixed with applesauce (approximately 10 mL). Safety assessments depended on date of entry into the study because of an amendment to the protocol. Before the amendment, assessments included physical examination, vital signs reporting (oral temperature, heart rate, and respiratory rate), and adverse event (AE) reporting. After the amendment, safety assessments included laboratory testing (blood chemistry and hematology profiles), physical examination, 12-lead electrocardiography, and vital signs (oral temperature, blood pressure, heart rate, and respiratory rate) and AE reporting. RESULTS Treatment-emergent AEs were observed in 116 of 231 participants receiving placebo and 111 of 222 receiving fexofenadine. These AEs were possibly related to study medication in 19 (8.2%) and 21 (9.5%) of the participants receiving placebo and fexofenadine, respectively, and most frequently involved the digestive system. No clinically relevant differences in laboratory measures, vital signs, and physical examinations were observed. CONCLUSIONS The findings show that fexofenadine hydrochloride, 30 mg, is well tolerated and has a good safety profile in children aged 2 to 5 years with allergic rhinitis.
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Affiliation(s)
- Henry Milgrom
- Department of Pediatrics, University of Colorado Health Sciences Center, National Jewish Medical and Research Center, Denver 80206, USA.
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Yamashita M, Arakida M. [Concept analysis of presenteeism and its possible applications in Japanese occupational health]. SANGYŌ EISEIGAKU ZASSHI = JOURNAL OF OCCUPATIONAL HEALTH 2007; 48:201-13. [PMID: 17170514 DOI: 10.1539/sangyoeisei.48.201] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purposes of this systematic review were to define the concept of presenteeism in accordance with Rodgers' concept analysis methods and to examine the possibility of applying the concept to Japanese occupational health. Using presenteeism as a search term, articles were selected from the MEDLINE, PsycINFO and Japana Centra Revuo Medicina databases. The definitions, antecedents, and consequences of presenteeism were extracted from the selected articles and were examined in order to determine how presenteeism was used in the literature. A total of forty-four articles published from 1955 to 2005 were selected for analysis. Based on the extracted definitions, four attributes of presenteeism were identified, and presenteeism was defined as "a self-rated measurable loss of work performance due to health problems in the workplace." Antecedents of presenteeism were classified into occupational and personal factors. These factors affected the decisions of workers with health problems regarding whether or not to go to work. Consequences of presenteeism were the aggravation of quality of life and health status, increases in health-related costs, adverse effects on colleagues, increases in occupational accidents, and deterioration of the quality of products and services. Therefore, the reduction of presenteeism is considered to be an important challenge for occupational health professionals. Possible applications of the concept of presenteeism in Japanese occupational health are the following: 1) measurement of presenteeism and examination of its related factors, 2) identification of factors that discourage workers from taking adequate sickness absenteeism, and 3) design of occupational health activity plans and the evaluation of such activities. In order to measure presenteeism in Japan, it is necessary to introduce Euro-American instruments suitable for the purpose of measuring presenteeism and to develop new measures. Occupational health professionals can incorporate assessments of presenteeism in their occupational health activities by considering not only the individual state of presenteeism, but also the state of the entire organization and interaction among workers' health problems, occupational factors, and personal factors. Moreover, if the loss of work performance due to presenteeism is converted to financial loss, it is considered that the necessity and the validity of workplace-based health activities will be clarified.
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Affiliation(s)
- Miku Yamashita
- Department of Health Promotion Science, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
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Okubo K, Ogino S, Nagakura T, Ishikawa T. Omalizumab is effective and safe in the treatment of Japanese cedar pollen-induced seasonal allergic rhinitis. Allergol Int 2006; 55:379-86. [PMID: 17130680 DOI: 10.2332/allergolint.55.379] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2005] [Accepted: 04/17/2006] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Seasonal allergic rhinitis (SAR) induced by Japanese cedar pollen is a substantial problem in Japan. Omalizumab, a novel humanized monoclonal anti-immunoglobulin E (IgE) antibody, has already been proven to reduce symptoms associated with SAR. We investigated the safety and efficacy of omalizumab in the treatment of patients with Japanese cedar pollen-induced SAR compared to placebo. METHODS A randomized, placebo-controlled, double-blind study was conducted in 100 Japanese patients with a history of moderate-to-severe SAR induced by Japanese cedar pollens. Omalizumab (150, 225, 300, or 375mg) or placebo was administered subcutaneously every 2 or 4 weeks based on serum total IgE and body weight at baseline. The primary efficacy variable was the mean of daily nasal symptom medication scores (sum of the daily nasal symptom severity score and daily nasal rescue medication score) during the treatment period. Secondary efficacy variables included the daily ocular symptom medication score and related variables. RESULTS Primary and all secondary efficacy variable scores were significantly lower in the omalizumab group than in the placebo group (P < .01). Serum free IgE levels markedly decreased in the omalizumab group and were associated with clinical efficacy. The overall incidence of injection site reactions was higher in the omalizumab group than in the placebo group; however, the adverse reaction profile was similar between the two groups when excluding injection site reactions. No anti-omalizumab antibodies were detected. CONCLUSIONS Omalizumab was effective and safe in the treatment of SAR induced by Japanese cedar pollen.
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MESH Headings
- Adult
- Antibodies, Anti-Idiotypic/adverse effects
- Antibodies, Anti-Idiotypic/immunology
- Antibodies, Anti-Idiotypic/therapeutic use
- Antibodies, Monoclonal/adverse effects
- Antibodies, Monoclonal/immunology
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal, Humanized
- Cryptomeria
- Double-Blind Method
- Erythema/chemically induced
- Female
- Humans
- Immunoglobulin E/blood
- Japan/epidemiology
- Male
- Middle Aged
- Omalizumab
- Pain/chemically induced
- Pollen/adverse effects
- Pollen/immunology
- Rhinitis, Allergic, Seasonal/drug therapy
- Rhinitis, Allergic, Seasonal/epidemiology
- Severity of Illness Index
- Treatment Outcome
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Affiliation(s)
- Kimihiro Okubo
- The Department of Otorhinolaryngology, Nippon Medical School, Tokyo, Japan.
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Abstract
Because of its bothersome symptoms, allergic rhinitis (AR) is 1 of the top 10 reasons for patient visits to primary care physicians. This highly prevalent disease also results in loss of productivity, both at work and in school. Oral antihistamines are one of the most frequently prescribed medications for the management of AR and, with several agents available, it is important to discern the specific benefits and detriments of each. To assess the differences in efficacy and safety factors among antihistamines, the Individual therapeutic window of each agent can be used as a comparative reference tool because it defines the dose range over which an antihistamine is efficacious and free of adverse effects. As such, the therapeutic window includes both undesired effects, such as sedation, and desired properties, such as rapid onset of action, long duration of efficacy, broad age range of applicability, and potential to Improve quality of life. Therefore, agents with broad therapeutic windows, based on both efficacy and safety, are expected to be more favorable; this therapeutic window should be understood by the primary care physician when prescribing a medication.
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Affiliation(s)
- Eli O Meltzer
- Allergy and Asthma Medical Group and Research Center, 9610 Granite Ridge Dr, Suite B, San Diego, CA 92123, USA.
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Baiardini I, Fumagalli F, Braido F, Pasquali M, Canonica GW. Antiallergic drugs and quality of life. Expert Rev Pharmacoecon Outcomes Res 2005; 5:437-45. [PMID: 19807261 DOI: 10.1586/14737167.5.4.437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Allergic diseases represent a global health problem with a substantial impact on medical costs and socioeconomic outcomes. Furthermore, as well documented in the recent literature, these pathologies also have negative consequences on the functional, emotional and psychosocial aspects of daily life. Using validated and standardized tools, it is possible to evaluate individual outcomes. At present, the health-related quality of life parameter is used in clinical trials, population studies and public health, providing a comprehensive picture of both the disease and its treatment on the quality of life. While many studies have addressed this topic in respiratory allergy, further studies are needed to explore the use of health-related quality of life both before and after treatment in other allergic conditions such as dermatitis, eczema, urticaria and food allergy.
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Affiliation(s)
- Ilaria Baiardini
- Allergy and Respiratory Diseases, DIMI, University of Genoa, Pad. Maragliano, L.go R. Benzi 10, 16132 Genoa, Italy.
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