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Marcuzzi D, Toigo V, Boldrin M, Chitarin G, Dal Bello S, Grando L, Luchetta A, Pasqualotto R, Pavei M, Serianni G, Zanotto L, Agnello R, Agostinetti P, Agostini M, Aprile D, Barbisan M, Battistella M, Berton G, Bigi M, Brombin M, Candela V, Candeloro V, Canton A, Casagrande R, Cavallini C, Cavazzana R, Cordaro L, Cruz N, Dalla Palma M, Dan M, De Lorenzi A, Delogu R, De Muri M, De Nardi M, Denizeau S, Fadone M, Fellin F, Ferro A, Gaio E, Gasparrini C, Gnesotto F, Jain P, La Rosa A, Lopez-Bruna D, Lorenzini R, Maistrello A, Manduchi G, Manfrin S, Marconato N, Mario I, Martini G, Milazzo R, Patton T, Peruzzo S, Pilan N, Pimazzoni A, Poggi C, Pomaro N, Pouradier-Duteil B, Recchia M, Rigoni-Garola A, Rizzetto D, Rizzolo A, Santoro F, Sartori E, Segalini B, Shepherd A, Siragusa M, Sonato P, Sottocornola A, Spada E, Spagnolo S, Spolaore M, Taliercio C, Tinti P, Tomsič P, Trevisan L, Ugoletti M, Valente M, Valisa M, Veronese F, Vignando M, Zaccaria P, Zagorski R, Zaniol B, Zaupa M, Zuin M, Cavenago M, Boilson D, Rotti C, Decamps H, Geli F, Sharma A, Veltri P, Zacks J, Simon M, Paolucci F, Garbuglia A, Gutierrez D, Masiello A, Mico G, Labate C, Readman P, Bragulat E, Bailly-Maitre L, Gomez G, Kouzmenko G, Albajar F, Kashiwagi M, Tobari H, Kojima A, Murayama M, Hatakeyama S, Oshita E, Maejima T, Shibata N, Yamashita Y, Watanabe K, Singh N, Singh M, Dhola H, Fantz U, Heinemann B, Wimmer C, Wünderlich D, Tsumori K, Croci G, Gorini G, Muraro A, Rebai M, Tardocchi M, Giacomelli L, Rigamonti D, Taccogna F, Bruno D, Rutigliano M, Longo S, Deambrosis S, Miorin E, Montagner F, Tonti A, Panin F. Lessons learned after three years of SPIDER operation and the first MITICA integrated tests. Fusion Engineering and Design 2023. [DOI: 10.1016/j.fusengdes.2023.113590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
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2
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Putignano O, Croci G, Muraro A, Cancelli S, Caruggi F, Gorini G, Grosso G, Kushoro MH, Marcer G, Nocente M, Cippo EP, Rebai M, Rigamonti D, Tardocchi M. Conceptual design of a GEM (gas electron multiplier) based gas Cherenkov detector for measurement of 17 MeV gamma rays from T(D, γ) 5He in magnetic confinement fusion plasmas. Rev Sci Instrum 2023; 94:013501. [PMID: 36725552 DOI: 10.1063/5.0101761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 11/28/2022] [Indexed: 06/18/2023]
Abstract
The only method for assessing the fusion power throughput of a deuterium-tritium (DT) reactor presently relies on determining the absolute number of 14 MeV neutrons produced in the DT plasma. An independent method, developed and investigated during the recent DT campaign at the Joint European Torus, is based on the absolute counting of 17 MeV gamma rays produced by the competing T(D, γ)5He reaction that features a very weak branching ratio (about 3-6 × 10-6) when compared to the main T(D, n)4He reaction. The state-of-the-art spectrometer used for gamma-ray measurements in magnetic confinement fusion plasmas is LaBr3(Ce) scintillator detectors, although they require significant neutron shielding to extract a relatively weak gamma-ray signal from a much more abundant neutron field. A better approach relies on a gamma-ray detector that is intrinsically insensitive to neutrons. We have advanced the design of a gamma-ray counter based on the Cherenkov effect for gamma-rays whose energy exceeds 11 MeV, optimized to work in the neutron-rich environment of a steady-state, magnetically confined fusion plasma device. The gamma-rays interact with an aluminum window and extract electrons that move into the radiator emitting photons via the Cherenkov effect. Since the Cherenkov light consists of few photons (25 on average) in the far UV band (100-200 nm), a pre-amplifier is required to transport the photons to the neutron-shielded location, which may be a few meters away, where the readout elements of the detector, either a silicon or standard photomultiplier tube, are placed. The present work focuses on the development of a scintillating GEM (Gas Electron Multiplier) based pre-amplifier that acts as a Cherenkov photon pre-amplifier and wavelength shifter. This paper presents the result of a set of Garfield++ simulations developed to find the optimal GEM working parameters. A photon gain of 100 is obtained by biasing a single GEM foil to 1 kV.
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Affiliation(s)
- O Putignano
- Dipartimento di Fisica "G. Occhialini," Università Degli Studi di Milano-Bicocca, Milano, Italy
| | - G Croci
- Dipartimento di Fisica "G. Occhialini," Università Degli Studi di Milano-Bicocca, Milano, Italy
| | - A Muraro
- Istituto per la Scienza e Tecnologia dei Plasmi, CNR, Milano, Italy
| | - S Cancelli
- Dipartimento di Fisica "G. Occhialini," Università Degli Studi di Milano-Bicocca, Milano, Italy
| | - F Caruggi
- Dipartimento di Fisica "G. Occhialini," Università Degli Studi di Milano-Bicocca, Milano, Italy
| | - G Gorini
- Dipartimento di Fisica "G. Occhialini," Università Degli Studi di Milano-Bicocca, Milano, Italy
| | - G Grosso
- Istituto per la Scienza e Tecnologia dei Plasmi, CNR, Milano, Italy
| | - M H Kushoro
- Dipartimento di Fisica "G. Occhialini," Università Degli Studi di Milano-Bicocca, Milano, Italy
| | - G Marcer
- Dipartimento di Fisica "G. Occhialini," Università Degli Studi di Milano-Bicocca, Milano, Italy
| | - M Nocente
- Dipartimento di Fisica "G. Occhialini," Università Degli Studi di Milano-Bicocca, Milano, Italy
| | - E Perelli Cippo
- Istituto per la Scienza e Tecnologia dei Plasmi, CNR, Milano, Italy
| | - M Rebai
- Istituto per la Scienza e Tecnologia dei Plasmi, CNR, Milano, Italy
| | - D Rigamonti
- Istituto per la Scienza e Tecnologia dei Plasmi, CNR, Milano, Italy
| | - M Tardocchi
- Istituto per la Scienza e Tecnologia dei Plasmi, CNR, Milano, Italy
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Tardocchi M, Rebai M, Rigamonti D, Tinguely RA, Caruggi F, Croci G, Dal Molin A, Ghani Z, Giacomelli L, Girolami M, Grosso G, Kushoro M, Marcer G, Mastellone M, Muraro A, Nocente M, Perelli Cippo E, Petruzzo M, Putignano O, Scionti J, Serpente V, Trucchi DM, Mackie S, Saltos AA, De Marchi E, Parisi M, Trotta A, de la Luna E, Garcia J, Kazakov Y, Maslov M, Stancar Z, Gorini G. A high-resolution neutron spectroscopic camera for the SPARC tokamak based on the Jet European Torus deuterium-tritium experience. Rev Sci Instrum 2022; 93:113512. [PMID: 36461481 DOI: 10.1063/5.0101779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 09/19/2022] [Indexed: 06/17/2023]
Abstract
Dedicated nuclear diagnostics have been designed, developed, and built within EUROFUSION enhancement programs in the last ten years for installation at the Joint European Torus and capable of operation in high power Deuterium-Tritium (DT) plasmas. The recent DT Experiment campaign, called DTE2, has been successfully carried out in the second half of 2021 and provides a unique opportunity to evaluate the performance of the new nuclear diagnostics and for an understanding of their behavior in the record high 14 MeV neutron yields (up to 4.7 × 1018 n/s) and total number of neutrons (up to 2 × 1019 n) achieved on a tokamak. In this work, we will focus on the 14 MeV high resolution neutron spectrometers based on artificial diamonds which, for the first time, have extensively been used to measure 14 MeV DT neutron spectra with unprecedented energy resolution (Full Width at Half Maximum of ≈1% at 14 MeV). The work will describe their long-term stability and operation over the DTE2 campaign as well as their performance as neutron spectrometers in terms of achieved energy resolution and high rate capability. This important experience will be used to outline the concept of a spectroscopic neutron camera for the SPARC tokamak. The proposed neutron camera will be the first one to feature the dual capability to measure (i) the 2.5 and 14 MeV neutron emissivity profile via the conventional neutron detectors based on liquid or plastics scintillators and (ii) the 14 MeV neutron spectral emission via the use of high-resolution diamond-based spectrometers. The new opportunities opened by the spectroscopic neutron camera to measure plasma parameters will be discussed.
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Affiliation(s)
- M Tardocchi
- Istituto per la Scienza e Tecnologia dei Plasmi, CNR, Milano, Italy
| | - M Rebai
- Istituto per la Scienza e Tecnologia dei Plasmi, CNR, Milano, Italy
| | - D Rigamonti
- Istituto per la Scienza e Tecnologia dei Plasmi, CNR, Milano, Italy
| | - R A Tinguely
- Plasma Science and Fusion Center, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - F Caruggi
- Università degli Studi di Milano-Bicocca, Milano, Italy
| | - G Croci
- Istituto per la Scienza e Tecnologia dei Plasmi, CNR, Milano, Italy
| | - A Dal Molin
- Istituto per la Scienza e Tecnologia dei Plasmi, CNR, Milano, Italy
| | - Z Ghani
- Culham Centre for Fusion Energy, Abingdon, United Kingdom
| | - L Giacomelli
- Istituto per la Scienza e Tecnologia dei Plasmi, CNR, Milano, Italy
| | - M Girolami
- Istituto di Struttura della Materia, CNR, Montelibretti, Roma, Italy
| | - G Grosso
- Istituto per la Scienza e Tecnologia dei Plasmi, CNR, Milano, Italy
| | - M Kushoro
- Università degli Studi di Milano-Bicocca, Milano, Italy
| | - G Marcer
- Università degli Studi di Milano-Bicocca, Milano, Italy
| | - M Mastellone
- Istituto di Struttura della Materia, CNR, Montelibretti, Roma, Italy
| | - A Muraro
- Istituto per la Scienza e Tecnologia dei Plasmi, CNR, Milano, Italy
| | - M Nocente
- Università degli Studi di Milano-Bicocca, Milano, Italy
| | - E Perelli Cippo
- Istituto per la Scienza e Tecnologia dei Plasmi, CNR, Milano, Italy
| | - M Petruzzo
- Università degli Studi di Milano-Bicocca, Milano, Italy
| | - O Putignano
- Università degli Studi di Milano-Bicocca, Milano, Italy
| | - J Scionti
- Istituto per la Scienza e Tecnologia dei Plasmi, CNR, Milano, Italy
| | - V Serpente
- Istituto di Struttura della Materia, CNR, Montelibretti, Roma, Italy
| | - D M Trucchi
- Istituto di Struttura della Materia, CNR, Montelibretti, Roma, Italy
| | - S Mackie
- Plasma Science and Fusion Center, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - A A Saltos
- Commonwealth Fusion Systems, Cambridge, Massachusetts 02139, USA
| | - E De Marchi
- Magnetic Fusion Energy DE - R&D/MAFE, ENI, Venezia, Italy
| | - M Parisi
- Magnetic Fusion Energy DE - R&D/MAFE, ENI, Venezia, Italy
| | - A Trotta
- Magnetic Fusion Energy DE - R&D/MAFE, ENI, Venezia, Italy
| | - E de la Luna
- Laboratorio Nacional de Fusion CIEMAT, Madrid, Spin
| | - J Garcia
- CEA, IRFM, Saint Paul lez Durance, France
| | - Y Kazakov
- Laboratory for Plasma Physics, LPP ERM/KMS, Brussels, Belgium
| | - M Maslov
- Culham Centre for Fusion Energy, Abingdon, United Kingdom
| | - Z Stancar
- Culham Centre for Fusion Energy, Abingdon, United Kingdom
| | - G Gorini
- Istituto per la Scienza e Tecnologia dei Plasmi, CNR, Milano, Italy
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Marcer G, Khilkevitch E, Shevelev A, Croci G, Dal Molin A, Gorini G, Grosso G, Muraro A, Nocente M, Perelli Cippo E, Putignano O, Rebai M, Rigamonti D, de la Luna E, Garcia J, Kazakov Y, Kiptily V, Maslov M, Nave MFF, Ongena J, Tardocchi M. A new dedicated signal processing system for gamma-ray spectrometers in high power deuterium-tritium plasma scenarios in tokamaks. Rev Sci Instrum 2022; 93:093525. [PMID: 36182521 DOI: 10.1063/5.0101611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 08/19/2022] [Indexed: 06/16/2023]
Abstract
The most performant deuterium-tritium (DT) plasma discharges realized by the Joint European Torus (JET) tokamak in the recent DT campaign have produced neutron yields on the order of 1018 n/s. At such high neutron yields, gamma-ray spectroscopy measurements with scintillators are challenging as events from the neutron-induced background often dominate over the signal, leading to a significant fraction of pileup events and instability of the photodetector gain along with the consequent degradation of the reconstructed spectrum. Here, we describe the solutions adopted for the tangential lanthanum bromide spectrometer installed at JET. A data acquisition system with free streaming mode digitization capabilities for the entire duration of the discharge has been used to solve dead-time related issues and a data reconstruction code with pileup recovery and photodetector gain drift restoration has been implemented for off-line analysis of the data. This work focuses on the acquired data storage and parsing, with a detailed explanation of the pileup recovery and gain drift restoration algorithms.
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Affiliation(s)
- G Marcer
- Department of Physics, University of Milan-Bicocca, Milan, Italy
| | | | - A Shevelev
- Ioffe Institute, St. Petersburg, Russian Federation
| | - G Croci
- Department of Physics, University of Milan-Bicocca, Milan, Italy
| | - A Dal Molin
- Institute for Plasma Science and Technology, CNR, Milan, Italy
| | - G Gorini
- Department of Physics, University of Milan-Bicocca, Milan, Italy
| | - G Grosso
- Institute for Plasma Science and Technology, CNR, Milan, Italy
| | - A Muraro
- Institute for Plasma Science and Technology, CNR, Milan, Italy
| | - M Nocente
- Department of Physics, University of Milan-Bicocca, Milan, Italy
| | - E Perelli Cippo
- Institute for Plasma Science and Technology, CNR, Milan, Italy
| | - O Putignano
- Department of Physics, University of Milan-Bicocca, Milan, Italy
| | - M Rebai
- Institute for Plasma Science and Technology, CNR, Milan, Italy
| | - D Rigamonti
- Institute for Plasma Science and Technology, CNR, Milan, Italy
| | - E de la Luna
- Laboratorio Nacional de Fusión, CIEMAT, Madrid, Spain
| | - J Garcia
- CEA, IRFM, Saint-Paul-lez-Durance, France
| | - Y Kazakov
- Laboratory for Plasma Physics, ERM/KMS, Brussels, Belgium
| | - V Kiptily
- Culham Centre for Fusion Energy, United Kingdom Atomic Energy Authority, Abingdon, United Kingdom
| | - M Maslov
- Culham Centre for Fusion Energy, United Kingdom Atomic Energy Authority, Abingdon, United Kingdom
| | - M F F Nave
- Associacao EURATOM/IST, Universidade Tecnica de Lisboa, Lisbon, Portugal
| | - J Ongena
- Laboratory for Plasma Physics, ERM/KMS, Brussels, Belgium
| | - M Tardocchi
- Institute for Plasma Science and Technology, CNR, Milan, Italy
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Toigo V, Marcuzzi D, Serianni G, Boldrin M, Chitarin G, Bello SD, Grando L, Luchetta A, Pasqualotto R, Zaccaria P, Zanotto L, Agnello R, Agostinetti P, Agostini M, Antoni V, Aprile D, Barbisan M, Battistella M, Berton G, Bigi M, Brombin M, Candeloro V, Canton A, Casagrande R, Cavallini C, Cavazzana R, Cordaro L, Cruz N, Palma MD, Dan M, De Lorenzi A, Delogu R, De Muri M, Denizeau S, Fadone M, Fellin F, Ferro A, Gaio E, Gasparini F, Gasparrini C, Gnesotto F, Jain P, Krastev P, Lopez-Bruna D, Lorenzini R, Maistrello A, Manduchi G, Manfrin S, Marconato N, Martines E, Martini G, Martini S, Milazzo R, Patton T, Pavei M, Peruzzo S, Pilan N, Pimazzoni A, Poggi C, Pomaro N, Pouradier-Duteil B, Recchia M, Rigoni-Garola A, Rizzolo A, Sartori E, Shepherd A, Siragusa M, Sonato P, Sottocornola A, Spada E, Spagnolo S, Spolaore M, Taliercio C, Terranova D, Tinti P, Tomsič P, Trevisan L, Ugoletti M, Valente M, Vignando M, Zagorski R, Zamengo A, Zaniol B, Zaupa M, Zuin M, Cavenago M, Boilson D, Rotti C, Veltri P, Decamps H, Dremel M, Graceffa J, Geli F, Urbani M, Zacks J, Bonicelli T, Paolucci F, Garbuglia A, Agarici G, Gomez G, Gutierrez D, Kouzmenko G, Labate C, Masiello A, Mico G, Moreno JF, Pilard V, Rousseau A, Simon M, Kashiwagi M, Tobari H, Watanabe K, Maejima T, Kojima A, Oshita E, Yamashita Y, Konno S, Singh M, Chakraborty A, Patel H, Singh N, Fantz U, Bonomo F, Cristofaro S, Heinemann B, Kraus W, Wimmer C, Wünderlich D, Fubiani G, Tsumori K, Croci G, Gorini G, McCormack O, Muraro A, Rebai M, Tardocchi M, Giacomelli L, Rigamonti D, Taccogna F, Bruno D, Rutigliano M, D'Arienzo M, Tonti A, Panin F. On the road to ITER NBIs: SPIDER improvement after first operation and MITICA construction progress. Fusion Engineering and Design 2021. [DOI: 10.1016/j.fusengdes.2021.112622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Maris I, Dölle‐Bierke S, Renaudin J, Lange L, Koehli A, Spindler T, Hourihane J, Scherer K, Nemat K, Kemen C, Neustädter I, Vogelberg C, Reese T, Yildiz I, Szepfalusi Z, Ott H, Straube H, Papadopoulos NG, Hämmerling S, Staden U, Polz M, Mustakov T, Cichocka‐Jarosz E, Cocco R, Fiocchi AG, Fernandez‐Rivas M, Worm M, Grünhagen J, Wittenberg M, Beyer K, Henschel A, Küper S, Möser A, Fuchs T, Ruëff F, Wedi B, Hansen G, Buck T, Büsselberg J, Drägerdt R, Pfeffer L, Dickel H, Körner‐Rettberg C, Merk H, Lehmann S, Bauer A, Nordwig A, Zeil S, Hannapp C, Wagner N, Rietschel E, Hunzelmann N, Huseynow I, Treudler R, Aurich S, Prenzel F, Klimek L, Pfaar O, Reider N, Aberer W, Varga E, Bogatu B, Schmid‐Grendelmeier P, Guggenheim R, Riffelmann F, Kreft B, Kinaciyan K, Hartl L, Ebner C, Horak F, Brehler R, Witte J, Buss M, Hompes S, Bieber T, Gernert S, Bücheler M, Rabe U, Brosi W, Nestoris S, Hawranek T, Lang R, Bruns R, Pföhler C, Eng P, Schweitzer‐Krantz S, Meller S, Rebmann H, Fischer J, Stichtenoth G, Thies S, Gerstlauer M, Utz P, Neustädter I, Klinge J, Volkmuth S, Plank‐Habibi S, Schilling B, Kleinheinz A, Brückner A, Schäkel K, Manolaraki I, Kowalski M, Solarewicz‐Madajek K, Tscheiller S, Seidenberg J, Cardona V, Garcia B, Bilo M, Cabañes Higuero N, Vega Castro A, Poziomkowska‐Gęsicka I, Büsing S, Virchow C, Christoff G, Jappe U, Müller S, Knöpfel F, Correard A, Rogala B, Montoro A, Brandes A, Muraro A, Zimmermann N, Hernandez D, Minale P, Niederwimmer J, Zahel B, Dahdah L, Arasi S, Reissig A, Eitelberger F, Asero R, Hermann F, Zeidler S, Pistauer S, Geißler M, Ensina L, Plaza Martin A, Meister J, Stieglitz S, Hamelmann E. Peanut-induced anaphylaxis in children and adolescents: Data from the European Anaphylaxis Registry. Allergy 2021; 76:1517-1527. [PMID: 33274436 DOI: 10.1111/all.14683] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 10/26/2020] [Accepted: 11/10/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND Peanut allergy has a rising prevalence in high-income countries, affecting 0.5%-1.4% of children. This study aimed to better understand peanut anaphylaxis in comparison to anaphylaxis to other food triggers in European children and adolescents. METHODS Data was sourced from the European Anaphylaxis Registry via an online questionnaire, after in-depth review of food-induced anaphylaxis cases in a tertiary paediatric allergy centre. RESULTS 3514 cases of food anaphylaxis were reported between July 2007 - March 2018, 56% in patients younger than 18 years. Peanut anaphylaxis was recorded in 459 children and adolescents (85% of all peanut anaphylaxis cases). Previous reactions (42% vs. 38%; p = .001), asthma comorbidity (47% vs. 35%; p < .001), relevant cofactors (29% vs. 22%; p = .004) and biphasic reactions (10% vs. 4%; p = .001) were more commonly reported in peanut anaphylaxis. Most cases were labelled as severe anaphylaxis (Ring&Messmer grade III 65% vs. 56% and grade IV 1.1% vs. 0.9%; p = .001). Self-administration of intramuscular adrenaline was low (17% vs. 15%), professional adrenaline administration was higher in non-peanut food anaphylaxis (34% vs. 26%; p = .003). Hospitalization was higher for peanut anaphylaxis (67% vs. 54%; p = .004). CONCLUSIONS The European Anaphylaxis Registry data confirmed peanut as one of the major causes of severe, potentially life-threatening allergic reactions in European children, with some characteristic features e.g., presence of asthma comorbidity and increased rate of biphasic reactions. Usage of intramuscular adrenaline as first-line treatment is low and needs to be improved. The Registry, designed as the largest database on anaphylaxis, allows continuous assessment of this condition.
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Affiliation(s)
- Ioana Maris
- Bon Secours Hospital Cork/Paediatrics and Child HealthUniversity College Cork Cork Ireland
| | - Sabine Dölle‐Bierke
- Division of Allergy and Immunology Department of Dermatology, Venereology and Allergology Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| | | | - Lars Lange
- Department of Paediatrics St. Marien‐Hospital Bonn Germany
| | - Alice Koehli
- Division of Allergology University Children’s Hospital Zurich Zürich Switzerland
| | - Thomas Spindler
- Department of Paediatrics Medical Campus Hochgebirgsklinik Davos Davos Switzerland
| | - Jonathan Hourihane
- Paediatrics and Child Health Royal College of Surgeons in Ireland Dublin Ireland
- Children’s Health Ireland Dublin Ireland
| | | | - Katja Nemat
- Practice for paediatric pneumology and allergology Kinderzentrum Dresden‐Friedrichstadt Dresden Germany
| | - C. Kemen
- Department of Paediatrics Children’s Hospital WILHELMSTIFT Hamburg Germany
| | - Irena Neustädter
- Department of Paediatrics Hallerwiese Cnopfsche Kinderklinik Nuremberg Germany
| | - Christian Vogelberg
- Department of Paediatrics Universitätsklinikum Carl Gustav CarusTechnical University Dresden Germany
| | - Thomas Reese
- Department of Paediatrics Mathias‐Spital Rheine Rheine Germany
| | - Ismail Yildiz
- Department of Paediatrics Friedrich‐Ebert‐Krankenhaus Neumuenster Germany
| | - Zsolt Szepfalusi
- Division of Paediatric Pulmonology, Allergology and Endocrinology Department of Paediatrics and Adolescent Medicine Competence Center Paediatrics Medical University of Vienna Vienna Austria
| | - Hagen Ott
- Division of Paediatric Dermatology and Allergology Epidermolysis bullosa‐Centre HannoverChildren’s Hospital AUF DER BULT Hanover Germany
| | - Helen Straube
- Division of Allergology Darmstädter Kinderkliniken Prinzessin Margaret Darmstadt Germany
| | - Nikolaos G. Papadopoulos
- Allergy Department 2nd Paediatric Clinic National and Kapodistrian University of Athens Athens Greece
- Division of Infection Immunity& Respiratory Medicine University of Manchester Manchester UK
| | - Susanne Hämmerling
- Division of Paediatric Pulmonology and Allergology University Children`s Hospital Heidelberg Heidelberg Germany
| | - Ute Staden
- Paediatric Pneumology & Allergology Medical practice Klettke/Staden Berlin Germany
| | - Michael Polz
- Department of Paediatrics GPR Klinikum Rüsselsheim Germany
| | - Tihomir Mustakov
- Chair of Allergy University Hospital Alexandrovska Sofia Bulgaria
| | - Ewa Cichocka‐Jarosz
- Department of Paediatrics Jagiellonian University Medical College Krakow Poland
| | - Renata Cocco
- Division of Allergy Clinical Immunology and Rheumatology Department of Paediatrics Federal University of São Paulo São Paulo Brazil
| | | | | | - Margitta Worm
- Division of Allergy and Immunology Department of Dermatology, Venereology and Allergology Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
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Abba A, Accorsi C, Agnes P, Alessi E, Amaudruz P, Annovi A, Desages FA, Back S, Badia C, Bagger J, Basile V, Batignani G, Bayo A, Bell B, Beschi M, Biagini D, Bianchi G, Bicelli S, Bishop D, Boccali T, Bombarda A, Bonfanti S, Bonivento WM, Bouchard M, Breviario M, Brice S, Brown R, Calvo-Mozota JM, Camozzi L, Camozzi M, Capra A, Caravati M, Carlini M, Ceccanti A, Celano B, Cela Ruiz JM, Charette C, Cogliati G, Constable M, Crippa C, Croci G, Cudmore S, Dahl CE, Dal Molin A, Daley M, Di Guardo C, D'Avenio G, Davignon O, Del Tutto M, De Ruiter J, Devoto A, Diaz Gomez Maqueo P, Di Francesco F, Dossi M, Druszkiewicz E, Duma C, Elliott E, Farina D, Fernandes C, Ferroni F, Finocchiaro G, Fiorillo G, Ford R, Foti G, Fournier RD, Franco D, Fricbergs C, Gabriele F, Galbiati C, Garcia Abia P, Gargantini A, Giacomelli L, Giacomini F, Giacomini F, Giarratana LS, Gillespie S, Giorgi D, Girma T, Gobui R, Goeldi D, Golf F, Gorel P, Gorini G, Gramellini E, Grosso G, Guescini F, Guetre E, Hackman G, Hadden T, Hawkins W, Hayashi K, Heavey A, Hersak G, Hessey N, Hockin G, Hudson K, Ianni A, Ienzi C, Ippolito V, James CC, Jillings C, Kendziora C, Khan S, Kim E, King M, King S, Kittmer A, Kochanek I, Kowalkowski J, Krücken R, Kushoro M, Kuula S, Laclaustra M, Leblond G, Lee L, Lennarz A, Leyton M, Li X, Liimatainen P, Lim C, Lindner T, Lomonaco T, Lu P, Lubna R, Lukhanin GA, Luzón G, MacDonald M, Magni G, Maharaj R, Manni S, Mapelli C, Margetak P, Martin L, Martin S, Martínez M, Massacret N, McClurg P, McDonald AB, Meazzi E, Migalla R, Mohayai T, Tosatti LM, Monzani G, Moretti C, Morrison B, Mountaniol M, Muraro A, Napoli P, Nati F, Natzke CR, Noble AJ, Norrick A, Olchanski K, Ortiz de Solorzano A, Padula F, Pallavicini M, Palumbo I, Panontin E, Papini N, Parmeggiano L, Parmeggiano S, Patel K, Patel A, Paterno M, Pellegrino C, Pelliccione P, Pesudo V, Pocar A, Pope A, Pordes S, Prelz F, Putignano O, Raaf JL, Ratti C, Razeti M, Razeto A, Reed D, Refsgaard J, Reilly T, Renshaw A, Retriere F, Riccobene E, Rigamonti D, Rizzi A, Rode J, Romualdez J, Russel L, Sablone D, Sala S, Salomoni D, Salvo P, Sandoval A, Sansoucy E, Santorelli R, Savarese C, Scapparone E, Schaubel T, Scorza S, Settimo M, Shaw B, Shawyer S, Sher A, Shi A, Skensved P, Slutsky A, Smith B, Smith NJT, Stenzler A, Straubel C, Stringari P, Suchenek M, Sur B, Tacchino S, Takeuchi L, Tardocchi M, Tartaglia R, Thomas E, Trask D, Tseng J, Tseng L, VanPagee L, Vedia V, Velghe B, Viel S, Visioli A, Viviani L, Vonica D, Wada M, Walter D, Wang H, Wang MHLS, Westerdale S, Wood D, Yates D, Yue S, Zambrano V. The novel Mechanical Ventilator Milano for the COVID-19 pandemic. Phys Fluids (1994) 2021; 33:037122. [PMID: 33897243 PMCID: PMC8060010 DOI: 10.1063/5.0044445] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 02/14/2021] [Indexed: 06/12/2023]
Abstract
This paper presents the Mechanical Ventilator Milano (MVM), a novel intensive therapy mechanical ventilator designed for rapid, large-scale, low-cost production for the COVID-19 pandemic. Free of moving mechanical parts and requiring only a source of compressed oxygen and medical air to operate, the MVM is designed to support the long-term invasive ventilation often required for COVID-19 patients and operates in pressure-regulated ventilation modes, which minimize the risk of furthering lung trauma. The MVM was extensively tested against ISO standards in the laboratory using a breathing simulator, with good agreement between input and measured breathing parameters and performing correctly in response to fault conditions and stability tests. The MVM has obtained Emergency Use Authorization by U.S. Food and Drug Administration (FDA) for use in healthcare settings during the COVID-19 pandemic and Health Canada Medical Device Authorization for Importation or Sale, under Interim Order for Use in Relation to COVID-19. Following these certifications, mass production is ongoing and distribution is under way in several countries. The MVM was designed, tested, prepared for certification, and mass produced in the space of a few months by a unique collaboration of respiratory healthcare professionals and experimental physicists, working with industrial partners, and is an excellent ventilator candidate for this pandemic anywhere in the world.
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Affiliation(s)
- A. Abba
- Nuclear Instruments S.R.L., Como 22045, Italy
| | - C. Accorsi
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | - P. Agnes
- Department of Physics, University of Houston, Houston, Texas 77204, USA
| | - E. Alessi
- Istituto per la Scienza e Tecnologia dei Plasmi, ISTP-CNR, Milano 20125, Italy
| | - P. Amaudruz
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - A. Annovi
- INFN Sezione di Pisa, Pisa 56127, Italy
| | - F. Ardellier Desages
- APC, Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - S. Back
- SNOLAB, Lively, Ontario P3Y 1N2, Canada
| | - C. Badia
- Gran Sasso Science Institute, L'Aquila 67100, Italy
| | - J. Bagger
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - V. Basile
- Istituto di Sistemi e Tecnologie Industriali Intelligenti per il Manifatturiero Avanzato, CNR STIIMA, Milano 20133, Italy
| | | | - A. Bayo
- LSC, Laboratorio Subterráneo de Canfranc, Canfranc-Estación 22880, Spain
| | - B. Bell
- JMP Solutions, London, Ontario N6N 1E2, Canada
| | | | - D. Biagini
- Dipartimento di Chimica e Chimica Industriale, Università di Pisa, Pisa 56124, Italy
| | - G. Bianchi
- Istituto di Sistemi e Tecnologie Industriali Intelligenti per il Manifatturiero Avanzato, CNR STIIMA, Milano 20133, Italy
| | - S. Bicelli
- Camozzi Group S.p.A., Brescia BS 25126, Italy
| | - D. Bishop
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | | | - A. Bombarda
- Dipartimento di Ingegneria Gestionale, dell'Informazione e della Produzione, Università di Bergamo, Bergamo, 24129, Italy
| | - S. Bonfanti
- Dipartimento di Ingegneria Gestionale, dell'Informazione e della Produzione, Università di Bergamo, Bergamo, 24129, Italy
| | | | - M. Bouchard
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - M. Breviario
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | - S. Brice
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - R. Brown
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - J. M. Calvo-Mozota
- LSC, Laboratorio Subterráneo de Canfranc, Canfranc-Estación 22880, Spain
| | - L. Camozzi
- Camozzi Group S.p.A., Brescia BS 25126, Italy
| | - M. Camozzi
- Camozzi Group S.p.A., Brescia BS 25126, Italy
| | - A. Capra
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - M. Caravati
- INFN Sezione di Cagliari, Cagliari 09042, Italy
| | - M. Carlini
- Gran Sasso Science Institute, L'Aquila 67100, Italy
| | | | - B. Celano
- INFN Sezione di Napoli, Napoli 80126, Italy
| | - J. M. Cela Ruiz
- CIEMAT, Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Madrid 28040, Spain
| | - C. Charette
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - G. Cogliati
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | - M. Constable
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - C. Crippa
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | - G. Croci
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano 20126, Italy
| | - S. Cudmore
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | | | - A. Dal Molin
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano 20126, Italy
| | - M. Daley
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - C. Di Guardo
- Dipartimento di Scienze Economiche ed Aziendali, Università degli Studi di Cagliari, Cagliari 09042, Italy
| | - G. D'Avenio
- National Center for Innovative Technologies in Public Health, ISS (Italy National Institute of Health), Roma 00161, Italy
| | - O. Davignon
- Laboratoire Leprince Ringuet, École Polytechnique, Palaiseau, Cedex 91128, France
| | - M. Del Tutto
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - J. De Ruiter
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - A. Devoto
- Dipartimento di Fisica, Università degli Studi di Cagliari, Cagliari 09042, Italy
| | | | - F. Di Francesco
- Dipartimento di Chimica e Chimica Industriale, Università di Pisa, Pisa 56124, Italy
| | - M. Dossi
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | - E. Druszkiewicz
- Department of Physics and Astronomy, University of Rochester, Rochester, New York 14627, USA
| | - C. Duma
- INFN-CNAF, Bologna 40127, Italy
| | - E. Elliott
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - D. Farina
- Istituto per la Scienza e Tecnologia dei Plasmi, ISTP-CNR, Milano 20125, Italy
| | | | | | | | | | - R. Ford
- SNOLAB, Lively, Ontario P3Y 1N2, Canada
| | | | | | - D. Franco
- APC, Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | | | - F. Gabriele
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | | | - P. Garcia Abia
- CIEMAT, Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Madrid 28040, Spain
| | - A. Gargantini
- Dipartimento di Ingegneria Gestionale, dell'Informazione e della Produzione, Università di Bergamo, Bergamo, 24129, Italy
| | - L. Giacomelli
- Istituto per la Scienza e Tecnologia dei Plasmi, ISTP-CNR, Milano 20125, Italy
| | | | | | | | - S. Gillespie
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - D. Giorgi
- Camozzi Group S.p.A., Brescia BS 25126, Italy
| | - T. Girma
- VEXOS, Markham, Ontario L3R 9X6, Canada
| | - R. Gobui
- VEXOS, Markham, Ontario L3R 9X6, Canada
| | | | - F. Golf
- Department of Physics and Astronomy, University of Nebraska-Lincoln, Lincoln, Nebraska 68508, USA
| | - P. Gorel
- SNOLAB, Lively, Ontario P3Y 1N2, Canada
| | - G. Gorini
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano 20126, Italy
| | - E. Gramellini
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - G. Grosso
- Istituto per la Scienza e Tecnologia dei Plasmi, ISTP-CNR, Milano 20125, Italy
| | - F. Guescini
- Max-Planck-Institut für Physik (Werner-Heisenberg-Institut), 80805 München, Germany
| | - E. Guetre
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - G. Hackman
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - T. Hadden
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | | | - K. Hayashi
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - A. Heavey
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - G. Hersak
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - N. Hessey
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - G. Hockin
- JMP Solutions, London, Ontario N6N 1E2, Canada
| | - K. Hudson
- VEXOS, Markham, Ontario L3R 9X6, Canada
| | - A. Ianni
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - C. Ienzi
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | | | - C. C. James
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | | | - C. Kendziora
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - S. Khan
- VEXOS, Markham, Ontario L3R 9X6, Canada
| | - E. Kim
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - M. King
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - S. King
- JMP Solutions, London, Ontario N6N 1E2, Canada
| | - A. Kittmer
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - I. Kochanek
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - J. Kowalkowski
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | | | - M. Kushoro
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano 20126, Italy
| | - S. Kuula
- SNOLAB, Lively, Ontario P3Y 1N2, Canada
| | | | - G. Leblond
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - L. Lee
- Department of APT, Faculty of Medicine, University of British Columbia, Vancouver V5Z 1M9, Canada
| | - A. Lennarz
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - M. Leyton
- INFN Sezione di Napoli, Napoli 80126, Italy
| | - X. Li
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | | | - C. Lim
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - T. Lindner
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - T. Lomonaco
- Dipartimento di Chimica e Chimica Industriale, Università di Pisa, Pisa 56124, Italy
| | - P. Lu
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - R. Lubna
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - G. A. Lukhanin
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - G. Luzón
- CAPA (Centro de Astropartículas y Física de Altas Energías), Universidad de Zaragoza, Zaragoza 50009, Spain
| | - M. MacDonald
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - G. Magni
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | - R. Maharaj
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - S. Manni
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - C. Mapelli
- Dipartimento di Meccanica, Politecnico di Milano, Milano 20156, Italy
| | - P. Margetak
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - L. Martin
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - S. Martin
- VEXOS, Markham, Ontario L3R 9X6, Canada
| | | | - N. Massacret
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - P. McClurg
- Department of Respiratory and Anaesthesia Technology, Vanier College, Montréal, Quebec H4L 3X9, Canada
| | | | - E. Meazzi
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | | | - T. Mohayai
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - L. M. Tosatti
- Istituto di Sistemi e Tecnologie Industriali Intelligenti per il Manifatturiero Avanzato, CNR STIIMA, Milano 20133, Italy
| | - G. Monzani
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | - C. Moretti
- Dipartimento di Pediatria, Sapienza Università di Roma, Roma 00185, Italy
| | | | | | - A. Muraro
- Istituto per la Scienza e Tecnologia dei Plasmi, ISTP-CNR, Milano 20125, Italy
| | - P. Napoli
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | - F. Nati
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano 20126, Italy
| | - C. R. Natzke
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | | | - A. Norrick
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - K. Olchanski
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - A. Ortiz de Solorzano
- CAPA (Centro de Astropartículas y Física de Altas Energías), Universidad de Zaragoza, Zaragoza 50009, Spain
| | - F. Padula
- School of Civil and Mechanical Engineering, Curtin University, Perth (Washington), Australia
| | | | - I. Palumbo
- Azienda Ospedaliera San Gerardo, Monza 20900, Italy
| | - E. Panontin
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano 20126, Italy
| | - N. Papini
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | | | | | - K. Patel
- VEXOS, Markham, Ontario L3R 9X6, Canada
| | - A. Patel
- VEXOS, Markham, Ontario L3R 9X6, Canada
| | - M. Paterno
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | | | | | | | - A. Pocar
- Amherst Center for Fundamental Interactions and Physics Department, University of Massachusetts, Amherst, Massachusetts 01003, USA
| | - A. Pope
- JMP Solutions, London, Ontario N6N 1E2, Canada
| | - S. Pordes
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - F. Prelz
- INFN Sezione di Milano, Milano 20133, Italy
| | - O. Putignano
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano 20126, Italy
| | - J. L. Raaf
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - C. Ratti
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | - M. Razeti
- INFN Sezione di Cagliari, Cagliari 09042, Italy
| | - A. Razeto
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - D. Reed
- Equilibar L.L.C., Fletcher, North Carolina 28732, USA
| | - J. Refsgaard
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - T. Reilly
- VEXOS, Markham, Ontario L3R 9X6, Canada
| | - A. Renshaw
- Department of Physics, University of Houston, Houston, Texas 77204, USA
| | - F. Retriere
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - E. Riccobene
- Dipartimento di Informatica, Universitá degli Studi di Milano, Milano 20122, Italy
| | - D. Rigamonti
- Istituto per la Scienza e Tecnologia dei Plasmi, ISTP-CNR, Milano 20125, Italy
| | | | | | - J. Romualdez
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - L. Russel
- JMP Solutions, London, Ontario N6N 1E2, Canada
| | - D. Sablone
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - S. Sala
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | | | - P. Salvo
- Istituto di Fisiologia Clinica del CNR, IFC-CNR, Pisa 56124, Italy
| | | | - E. Sansoucy
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - R. Santorelli
- CIEMAT, Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Madrid 28040, Spain
| | - C. Savarese
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | | | - T. Schaubel
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - S. Scorza
- SNOLAB, Lively, Ontario P3Y 1N2, Canada
| | - M. Settimo
- SUBATECH, IMT Atlantique, Université de Nantes, CNRS-IN2P3, Nantes 44300, France
| | - B. Shaw
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - S. Shawyer
- JMP Solutions, London, Ontario N6N 1E2, Canada
| | - A. Sher
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - A. Shi
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | | | - A. Slutsky
- St. Michael's Hospital, Unity Health Toronto, Ontario M5B 1W8, Canada
| | - B. Smith
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | | | - A. Stenzler
- 12th Man Technologies, Garden Grove, California 92841, USA
| | - C. Straubel
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - P. Stringari
- MINES ParisTech, PSL University, CTP-Centre of Thermodynamics of Processes, 77300 Fontainebleau, France
| | - M. Suchenek
- AstroCeNT, Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, Warsaw 00-614, Poland
| | - B. Sur
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | | | - L. Takeuchi
- Department of Medicine, University of British Columbia, Vancouver, British Columbia V6T 1Z4, Canada
| | - M. Tardocchi
- Istituto per la Scienza e Tecnologia dei Plasmi, ISTP-CNR, Milano 20125, Italy
| | - R. Tartaglia
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - E. Thomas
- Arthur B. McDonald Canadian Astroparticle Research Institute, Kingston, Ontario K7L 3N6, Canada
| | - D. Trask
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - J. Tseng
- Department of Physics, University of Oxford, The Denys Wilkinson Building, Keble Road, Oxford OX1 3RH, United Kingdom
| | - L. Tseng
- VEXOS, Markham, Ontario L3R 9X6, Canada
| | - L. VanPagee
- JMP Solutions, London, Ontario N6N 1E2, Canada
| | - V. Vedia
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - B. Velghe
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | | | - A. Visioli
- Dipartimento di Ingegneria Meccanica e Industriale, Università degli Studi di Brescia, Brescia 25123, Italy
| | - L. Viviani
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | - D. Vonica
- VEXOS, Markham, Ontario L3R 9X6, Canada
| | - M. Wada
- AstroCeNT, Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, Warsaw 00-614, Poland
| | - D. Walter
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - H. Wang
- Physics and Astronomy Department, University of California, Los Angeles, California 90095, USA
| | - M. H. L. S. Wang
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | | | - D. Wood
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - D. Yates
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - S. Yue
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - V. Zambrano
- CAPA (Centro de Astropartículas y Física de Altas Energías), Universidad de Zaragoza, Zaragoza 50009, Spain
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Bédard A, Antó JM, Fonseca JA, Arnavielhe S, Bachert C, Bedbrook A, Bindslev‐Jensen C, Bosnic‐Anticevich S, Cardona V, Cruz AA, Fokkens WJ, Garcia‐Aymerich J, Hellings PW, Ivancevich JC, Klimek L, Kuna P, Kvedariene V, Larenas‐Linnemann D, Melén E, Monti R, Mösges R, Mullol J, Papadopoulos NG, Pham‐Thi N, Samolinski B, Tomazic PV, Toppila‐Salmi S, Ventura MT, Yorgancioglu A, Bousquet J, Pfaar O, Basagaña X, Aberer W, Agache I, Akdis CA, Akdis M, Aliberti MR, Almeida R, Amat F, Angles R, Annesi‐Maesano I, Ansotegui IJ, Anto JM, Arnavielle S, Asayag E, Asarnoj A, Arshad H, Avolio F, Bacci E, Baiardini I, Barbara C, Barbagallo M, Baroni I, Barreto BA, Bateman ED, Bedolla‐Barajas M, Bewick M, Beghé B, Bel EH, Bergmann KC, Bennoor KS, Benson M, Bertorello L, Białoszewski AZ, Bieber T, Bialek S, Bjermer L, Blain H, Blasi F, Blua A, Bochenska Marciniak M, Bogus‐Buczynska I, Boner AL, Bonini M, Bonini S, Bosse I, Bouchard J, Boulet LP, Bourret R, Bousquet PJ, Braido F, Briedis V, Brightling CE, Brozek J, Bucca C, Buhl R, Buonaiuto R, Panaitescu C, Burguete Cabañas MT, Burte E, Bush A, Caballero‐Fonseca F, Caillaud D, Caimmi D, Calderon MA, Camargos PAM, Camuzat T, Canfora G, Canonica GW, Carlsen KH, Carreiro‐Martins P, Carriazo AM, Carr W, Cartier C, Casale T, Castellano G, Cecchi L, Cepeda AM, Chavannes NH, Chen Y, Chiron R, Chivato T, Chkhartishvili E, Chuchalin AG, Chung KF, Ciaravolo MM, Ciceran A, Cingi C, Ciprandi G, Carvalho Coehlo AC, Colas L, Colgan E, Coll J, Conforti D, Constantinidis J, Correia de Sousa J, Cortés‐Grimaldo RM, Corti F, Costa E, Costa‐Dominguez MC, Courbis AL, Cox L, Crescenzo M, Custovic A, Czarlewski W, Dahlen SE, D'Amato G, Dario C, da Silva J, Dauvilliers Y, Darsow U, De Blay F, De Carlo G, Dedeu T, de Fátima Emerson M, De Feo G, De Vries G, De Martino B, Motta Rubini NP, Deleanu D, Denburg JA, Devillier P, Di Capua Ercolano S, Di Carluccio N, Didier A, Dokic D, Dominguez‐Silva MG, Douagui H, Dray G, Dubakiene R, Durham SR, Du Toit G, Dykewicz MS, El‐Gamal Y, Eklund P, Eller E, Emuzyte R, Farrell J, Farsi A, Ferreira de Mello J, Ferrero J, Fink‐Wagner A, Fiocchi A, Fontaine JF, Forti S, Fuentes‐Perez JM, Gálvez‐Romero JL, Gamkrelidze A, García‐Cobas CY, Garcia‐Cruz MH, Gemicioğlu B, Genova S, Christoff G, Gereda JE, Gerth van Wijk R, Gomez RM, Gómez‐Vera J, González Diaz S, Gotua M, Grisle I, Guidacci M, Guldemond NA, Gutter Z, Guzmán MA, Haahtela T, Hajjam J, Hernández L, Hourihane JO, Huerta‐Villalobos YR, Humbert M, Iaccarino G, Illario M, Ispayeva Z, Jares EJ, Jassem E, Johnston SL, Joos G, Jung KS, Just J, Jutel M, Kaidashev I, Kalayci O, Kalyoncu AF, Karjalainen J, Kardas P, Keil T, Keith PK, Khaitov M, Khaltaev N, Kleine‐Tebbe J, Kowalski ML, Kuitunen M, Kull I, Kupczyk M, Krzych‐Fałta E, Lacwik P, Laune D, Lauri D, Lavrut J, Le LTT, Lessa M, Levato G, Li J, Lieberman P, Lipiec A, Lipworth B, Lodrup Carlsen KC, Louis R, Lourenço O, Luna‐Pech JA, Magnan A, Mahboub B, Maier D, Mair A, Majer I, Malva J, Mandajieva E, Manning P, De Manuel Keenoy E, Marshall GD, Masjedi MR, Maspero JF, Mathieu‐Dupas E, Matta Campos JJ, Matos AL, Maurer M, Mavale‐Manuel S, Mayora O, Meco C, Medina‐Avalos MA, Melo‐Gomes E, Meltzer EO, Menditto E, Mercier J, Miculinic N, Mihaltan F, Milenkovic B, Moda G, Mogica‐Martinez MD, Mohammad Y, Momas I, Montefort S, Mora Bogado D, Morais‐Almeida M, Morato‐Castro FF, Mota‐Pinto A, Moura Santo P, Münter L, Muraro A, Murray R, Naclerio R, Nadif R, Nalin M, Napoli L, Namazova‐Baranova L, Neffen H, Niedeberger V, Nekam K, Neou A, Nieto A, Nogueira‐Silva L, Nogues M, Novellino E, Nyembue TD, O'Hehir RE, Odzhakova C, Ohta K, Okamoto Y, Okubo K, Onorato GL, Ortega Cisneros M, Ouedraogo S, Pali‐Schöll I, Palkonen S, Panzner P, Park HS, Papi A, Passalacqua G, Paulino E, Pawankar R, Pedersen S, Pépin JL, Pereira AM, Persico M, Phillips J, Picard R, Pigearias B, Pin I, Pitsios C, Plavec D, Pohl W, Popov TA, Portejoie F, Potter P, Pozzi AC, Price D, Prokopakis EP, Puy R, Pugin B, Pulido Ross RE, Przemecka M, Rabe KF, Raciborski F, Rajabian‐Soderlund R, Reitsma S, Ribeirinho I, Rimmer J, Rivero‐Yeverino D, Rizzo JA, Rizzo MC, Robalo‐Cordeiro C, Rodenas F, Rodo X, Rodriguez Gonzalez M, Rodriguez‐Mañas L, Rolland C, Rodrigues Valle S, Roman Rodriguez M, Romano A, Rodriguez‐Zagal E, Rolla G, Roller‐Wirnsberger RE, Romano M, Rosado‐Pinto J, Rosario N, Rottem M, Ryan D, Sagara H, Salimäki J, Sanchez‐Borges M, Sastre‐Dominguez J, Scadding GK, Schunemann HJ, Scichilone N, Schmid‐Grendelmeier P, Sarquis Serpa F, Shamai S, Sheikh A, Sierra M, Simons FER, Siroux V, Sisul JC, Skrindo I, Solé D, Somekh D, Sondermann M, Sooronbaev T, Sova M, Sorensen M, Sorlini M, Spranger O, Stellato C, Stelmach R, Stukas R, Sunyer J, Strozek J, Szylling A, Tebyriçá JN, Thibaudon M, To T, Todo‐Bom A, Trama U, Triggiani M, Suppli Ulrik C, Urrutia‐Pereira M, Valenta R, Valero A, Valiulis A, Valovirta E, van Eerd M, van Ganse E, van Hage M, Vandenplas O, Vezzani G, Vasankari T, Vatrella A, Verissimo MT, Viart F, Viegi G, Vicheva D, Vontetsianos T, Wagenmann M, Walker S, Wallace D, Wang DY, Waserman S, Werfel T, Westman M, Wickman M, Williams DM, Williams S, Wilson N, Wright J, Wroczynski P, Yakovliev P, Yawn BP, Yiallouros PK, Yusuf OM, Zar HJ, Zhang L, Zhong N, Zernotti ME, Zhanat I, Zidarn M, Zuberbier T, Zubrinich C, Zurkuhlen A. Correlation between work impairment, scores of rhinitis severity and asthma using the MASK-air ® App. Allergy 2020; 75:1672-1688. [PMID: 31995656 DOI: 10.1111/all.14204] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 11/23/2019] [Accepted: 12/05/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND In allergic rhinitis, a relevant outcome providing information on the effectiveness of interventions is needed. In MASK-air (Mobile Airways Sentinel Network), a visual analogue scale (VAS) for work is used as a relevant outcome. This study aimed to assess the performance of the work VAS work by comparing VAS work with other VAS measurements and symptom-medication scores obtained concurrently. METHODS All consecutive MASK-air users in 23 countries from 1 June 2016 to 31 October 2018 were included (14 189 users; 205 904 days). Geolocalized users self-assessed daily symptom control using the touchscreen functionality on their smart phone to click on VAS scores (ranging from 0 to 100) for overall symptoms (global), nose, eyes, asthma and work. Two symptom-medication scores were used: the modified EAACI CSMS score and the MASK control score for rhinitis. To assess data quality, the intra-individual response variability (IRV) index was calculated. RESULTS A strong correlation was observed between VAS work and other VAS. The highest levels for correlation with VAS work and variance explained in VAS work were found with VAS global, followed by VAS nose, eye and asthma. In comparison with VAS global, the mCSMS and MASK control score showed a lower correlation with VAS work. Results are unlikely to be explained by a low quality of data arising from repeated VAS measures. CONCLUSIONS VAS work correlates with other outcomes (VAS global, nose, eye and asthma) but less well with a symptom-medication score. VAS work should be considered as a potentially useful AR outcome in intervention studies.
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9
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Mahler V, Mentzer D, Bonertz A, Muraro A, Eigenmann P, Bousquet J, Halken S, Pfaar O, Jutel M, Wahn U, Vieths S, Kaul S. Allergen Immunotherapy (AIT) in children: a vulnerable population with its own rights and legislation - summary of EMA-initiated multi-stakeholder meeting on Allergen Immunotherapy (AIT) for children, held at Paul-Ehrlich-Institut, Langen, Germany, 16.1.2019. Clin Transl Allergy 2020; 10:28. [PMID: 32612805 PMCID: PMC7325268 DOI: 10.1186/s13601-020-00327-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 05/30/2020] [Indexed: 12/15/2022] Open
Abstract
Concerning development of medicinal products, children belong to a so-called "special population" for which additional legislation applies: Regulation (EC) No 1901/2006 on medicinal products for paediatric use sets up a system of requirements, rewards and incentives to ensure that medicinal products are researched, developed and authorized to meet the therapeutic needs of children. Allergen Immunotherapy (AIT) is believed to contain a strong potential for immunomodulatory effects inducing sustained clinical efficacy after cessation of treatment (disease modifying effect) and thereby may prevent the progression of the atopic march towards asthma manifestation. However, to this day only few data on long-term effects in general exist and even fewer in children. These are predominantly data from open studies, which are strongly influenced in their validity by the known placebo effect of AIT. Furthermore, there are no studies allowing for the conclusion that efficacy in adults are mirrored by a similar efficacy in children and thus, up to now, it is not possible to extrapolate data from adults to children. The Paediatric Committee (PDCO)-European Medicines Agency's (EMA) scientific committee responsible for activities on medicines for children-initiated a Multi-Stakeholder Meeting on AIT for Children held at the Paul-Ehrlich-Institut in Langen, Germany, to provide a platform for discussion and exchange of thoughts to this topic between allergy experts from academia, regulators and AIT-manufacturers. The consented meeting minutes, conclusions and participants are presented.
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Affiliation(s)
- V Mahler
- Paul-Ehrlich-Institut, Paul-Ehrlich-Str. 51-59, 63225 Langen, Germany
| | - D Mentzer
- Paul-Ehrlich-Institut, Paul-Ehrlich-Str. 51-59, 63225 Langen, Germany
| | - A Bonertz
- Paul-Ehrlich-Institut, Paul-Ehrlich-Str. 51-59, 63225 Langen, Germany
| | - A Muraro
- Food Allergy Referral Centre Veneto Region, Department of Women and Child Health, Padua General University Hospital, Padua, Italy
| | - P Eigenmann
- Pediatric Allergy Unit, University Hospitals of Geneva, Geneva, Switzerland
| | - J Bousquet
- Charité, Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Comprehensive Allergy Center, Department of Dermatology and Allergy, Berlin, Germany.,University Hospital Montpellier, Montpellier, France.,MACVIA-France, Montpellier, France
| | - S Halken
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - O Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Phillipps-Universität Marburg, Marburg, Germany
| | - M Jutel
- Department of Clinical Immunology, Wrocław Medical University, Wrocław, Poland.,ALL-MED Medical Research Institute, Wrocław, Poland
| | - U Wahn
- Pediatric Department, Charité, Berlin, Germany
| | - S Vieths
- Paul-Ehrlich-Institut, Paul-Ehrlich-Str. 51-59, 63225 Langen, Germany
| | - S Kaul
- Paul-Ehrlich-Institut, Paul-Ehrlich-Str. 51-59, 63225 Langen, Germany
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10
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Tanno LK, Simons FER, Sanchez-Borges M, Cardona V, Moon HB, Calderon MA, Sisul JC, Muraro A, Casale T, Demoly P. Applying prevention concepts to anaphylaxis: A call for worldwide availability of adrenaline auto-injectors. Clin Exp Allergy 2019; 47:1108-1114. [PMID: 28856836 DOI: 10.1111/cea.12973] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- L K Tanno
- Hospital Sírio Libanês, São Paulo, Brazil.,University Hospital of Montpellier, Montpellier, France.,Sorbonne Universités, UPMC Paris 06, UMR-S 1136, IPLESP, Equipe EPAR, Paris, France
| | - F E R Simons
- Section of Allergy & Clinical Immunology, Department of Pediatrics & Child Health, University of Manitoba, Winnipeg, Canada
| | - M Sanchez-Borges
- Allergy and Clinical Immunology Department, Centro Medico Docente La Trinidad, Caracas, Venezuela
| | - V Cardona
- Allergy Section, Department of Internal Medicine, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - H-B Moon
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan, Seoul, Korea
| | - M A Calderon
- Section of Allergy and Clinical Immunology, Imperial College London, National Heart and Lung Institute, Royal Brompton Hospital, London, UK
| | - J C Sisul
- Latinalerican Society of Allergy, Asthma and Immunology, Villarica, Paraguay.,American College of Allergy, Asthma and Immunology, Villarica, Paraguay
| | - A Muraro
- European Academy of Allergy and Clinical Immunology, Padua, Italy.,Department of Women and Child Health, Food Allergy Referral Centre Veneto Region, Padua General University Hospital, Padua, Italy
| | - T Casale
- American Academy of Allergy Asthma and Immunology, Tampa, FL, USA.,Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - P Demoly
- University Hospital of Montpellier, Montpellier, France.,Sorbonne Universités, UPMC Paris 06, UMR-S 1136, IPLESP, Equipe EPAR, Paris, France
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11
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Wollenberg A, Barbarot S, Bieber T, Christen-Zaech S, Deleuran M, Fink-Wagner A, Gieler U, Girolomoni G, Lau S, Muraro A, Czarnecka-Operacz M, Schäfer T, Schmid-Grendelmeier P, Simon D, Szalai Z, Szepietowski JC, Taïeb A, Torrelo A, Werfel T, Ring J. Consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part II. J Eur Acad Dermatol Venereol 2018; 32:850-878. [PMID: 29878606 DOI: 10.1111/jdv.14888] [Citation(s) in RCA: 413] [Impact Index Per Article: 68.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 01/29/2018] [Indexed: 12/17/2022]
Abstract
This guideline was developed as a joint interdisciplinary European project, including physicians from all relevant disciplines as well as patients. It is a consensus-based guideline, taking available evidence from other guidelines, systematic reviews and published studies into account. This second part of the guideline covers antimicrobial therapy, systemic treatment, allergen-specific immunotherapy, complementary medicine, psychosomatic counselling and educational interventions, whereas the first part covers methods, patient perspective, general measures and avoidance strategies, basic emollient treatment and bathing, dietary intervention, topical anti-inflammatory therapy, phototherapy and antipruritic therapy. Management of AE must consider the individual clinical variability of the disease. Systemic immunosuppressive treatment with cyclosporine, methotrexate, azathioprine and mycophenolic acid is established option for severe refractory cases, and widely available. Biologicals targeting the T helper 2 pathway such as dupilumab may be a safe and effective, disease-modifying alternative when available. Oral drugs such as JAK inhibitors and histamine 4 receptor antagonists are in development. Microbial colonization and superinfection may cause disease exacerbation and can require additional antimicrobial treatment. Allergen-specific immunotherapy with aeroallergens may be considered in selected cases. Psychosomatic counselling is recommended especially in stress-induced exacerbations. Therapeutic patient education ('Eczema school') is recommended for children and adult patients. General measures, basic emollient treatment, bathing, dietary intervention, topical anti-inflammatory therapy, phototherapy and antipruritic therapy have been addressed in the first part of the guideline.
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Affiliation(s)
- A Wollenberg
- Department Dermatology and Allergy, Ludwig-Maximilian University, Munich, Germany.,Klinik Thalkirchner Straße, Munich, Germany
| | - S Barbarot
- Department of Dermatology, Centre Hospitalier Universitaire CHU Nantes, Nantes, France
| | - T Bieber
- Department of Dermatology and Allergy, Christine Kühne-Center for Allergy Research and Education, University Bonn, Bonn, Germany
| | - S Christen-Zaech
- Pediatric Dermatology Unit, Departments of Dermatology and Pediatrics, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - M Deleuran
- Department Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | - A Fink-Wagner
- European Federation of Allergy and Airways Diseases Patients' Associations (EFA), Global Allergy and Asthma Patient Platform (GAAPP), Konstanz, Germany
| | - U Gieler
- Department of Dermatology, University of Gießen and Marburg GmbH, Gießen, Germany.,Department of Psychosomatics and Psychotherapy, University of Gießen and Marburg GmbH, Gießen, Germany
| | - G Girolomoni
- Department of Medicine, Section of Dermatology, University of Verona, Verona, Italy
| | - S Lau
- Pediatric Pneumology and Immunology, Universitätsmedizin Berlin, Berlin, Germany
| | - A Muraro
- Centro di Specializzazione Regionale per lo Studio e la Cura delle Allergie e delle Intolleranze Alimentari presso l'Azienda Ospedaliera, Università di Padova, Padova, Italy
| | | | - T Schäfer
- Dermatological Practice, Immenstadt, Germany
| | - P Schmid-Grendelmeier
- Allergy Unit, Department of Dermatology, University of Zurich, Zurich, Switzerland.,Christine Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | - D Simon
- Department Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Z Szalai
- Department of Dermatology, Heim Pál Children's Hospital, Budapest, Hungary
| | - J C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - A Taïeb
- Department of Dermatology & Pediatric Dermatology, Hôpital St André, Bordeaux, France
| | - A Torrelo
- Department of Dermatology, Hospital Niño Jesus, Madrid, Spain
| | - T Werfel
- Department Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - J Ring
- Christine Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Switzerland.,Department Dermatology and Allergy Biederstein, Technische Universität München, Munich, Germany
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12
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Wollenberg A, Barbarot S, Bieber T, Christen-Zaech S, Deleuran M, Fink-Wagner A, Gieler U, Girolomoni G, Lau S, Muraro A, Czarnecka-Operacz M, Schäfer T, Schmid-Grendelmeier P, Simon D, Szalai Z, Szepietowski JC, Taïeb A, Torrelo A, Werfel T, Ring J. Consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part I. J Eur Acad Dermatol Venereol 2018; 32:657-682. [PMID: 29676534 DOI: 10.1111/jdv.14891] [Citation(s) in RCA: 496] [Impact Index Per Article: 82.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Accepted: 01/29/2018] [Indexed: 12/12/2022]
Abstract
This guideline was developed as a joint interdisciplinary European project, including physicians from all relevant disciplines as well as patients. It is a consensus-based guideline, taking available evidence from other guidelines, systematic reviews and published studies into account. This first part of the guideline covers methods, patient perspective, general measures and avoidance strategies, basic emollient treatment and bathing, dietary intervention, topical anti-inflammatory therapy, phototherapy and antipruritic therapy, whereas the second part covers antimicrobial therapy, systemic treatment, allergen-specific immunotherapy, complementary medicine, psychosomatic counselling and educational interventions. Management of AE must consider the individual clinical variability of the disease; highly standardized treatment rules are not recommended. Basic therapy is focused on treatment of disturbed barrier function by hydrating and lubricating topical treatment, besides further avoidance of specific and unspecific provocation factors. Topical anti-inflammatory treatment based on glucocorticosteroids and calcineurin inhibitors is used for flare management and for proactive therapy for long-term control. Topical corticosteroids remain the mainstay of therapy, whereas tacrolimus and pimecrolimus are preferred in sensitive skin areas and for long-term use. Topical phosphodiesterase inhibitors may be a treatment alternative when available. Adjuvant therapy includes UV irradiation, preferably with UVB 311 nm or UVA1. Pruritus is targeted with the majority of the recommended therapies, but some patients may need additional antipruritic therapy. Antimicrobial therapy, systemic anti-inflammatory treatment, immunotherapy, complementary medicine and educational intervention will be addressed in part II of the guideline.
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Affiliation(s)
- A Wollenberg
- Department Dermatology and Allergy, Ludwig-Maximilian University, Munich, Germany.,Klinik Thalkirchner Straße, Munich, Germany
| | - S Barbarot
- Department of Dermatology, Centre Hospitalier Universitaire CHU Nantes, Nantes, France
| | - T Bieber
- Department of Dermatology and Allergy, Christine Kühne-Center for Allergy Research and Education, University Bonn, Bonn, Germany
| | - S Christen-Zaech
- Pediatric Dermatology Unit, Departments of Dermatology and Pediatrics, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - M Deleuran
- Department Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | - A Fink-Wagner
- European Federation of Allergy and Airways Diseases Patients' Associations (EFA), Global Allergy and Asthma Patient Platform (GAAPP), Konstanz, Germany
| | - U Gieler
- Department of Dermatology, University of Gießen and Marburg GmbH, Gießen, Germany.,Department of Psychosomatics and Psychotherapy, University of Gießen and Marburg GmbH, Gießen, Germany
| | - G Girolomoni
- Department of Medicine, Section of Dermatology, University of Verona, Verona, Italy
| | - S Lau
- Pediatric Pneumology and Immunology, Universitätsmedizin Berlin, Berlin, Germany
| | - A Muraro
- Centro di Specializzazione Regionale per lo Studio e la Cura delle Allergie e delle Intolleranze Alimentari presso l'Azienda Ospedaliera, Università di Padova, Padova, Italy
| | | | - T Schäfer
- Dermatological Practice, Immenstadt, Germany
| | - P Schmid-Grendelmeier
- Allergy Unit, Department of Dermatology, University of Zurich, Zurich, Switzerland.,Christine Kühne Center for Allergy Research and Education CK-CARE, Davos, Switzerland
| | - D Simon
- Department Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Z Szalai
- Department of Dermatology, Heim Pál Children's Hospital, Budapest, Hungary
| | - J C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - A Taïeb
- Department of Dermatology and Pediatric Dermatology, Hôpital St André, Bordeaux, France
| | - A Torrelo
- Department of Dermatology, Hospital Niño Jesus, Madrid, Spain
| | - T Werfel
- Department Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - J Ring
- Christine Kühne Center for Allergy Research and Education CK-CARE, Davos, Switzerland.,Department Dermatology and Allergy Biederstein, Technische Universität München, Munich, Germany
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13
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Rebai M, Bertalot L, Brichard B, Brolatti G, Croci G, Esposito B, Fernandes A, Giacomelli L, Gorini G, Krasilnikov V, Lengar I, Marocco D, Muraro A, Nocente M, Pereira RC, Perelli Cippo E, Rigamonti D, Rzadkiewicz J, Sousa J, Tardocchi M. Design of gamma-ray spectrometers optimized for fast particle studies at ITER. Rev Sci Instrum 2018; 89:10I126. [PMID: 30399810 DOI: 10.1063/1.5038963] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 06/01/2018] [Indexed: 06/08/2023]
Abstract
A set of gamma ray spectrometers has been designed for ITER within the Radial Gamma Ray Spectrometer (RGRS) project. The aim of this project is designing a system, integrated with the ITER radial neutron camera, which is able to measure the gamma-rays emitted from the plasma with a good energy resolution (about 1.5% at 4.44 MeV) and at high counting rates (in excess of 1 MHz). The RGRS will be able to operate both in the D phase and in the full-power DT phase and will measure gamma rays from (i) reactions between fast ions, such as α particles, and light impurities and (ii) bremsstrahlung emission generated by runaway electron interactions with both plasma bulk and tokamak walls. The RGRS detectors are arranged in nine lines of sights (able to cover a radial region with r < a/3), each featuring a large LaBr3 scintillator crystal. Due to the high neutron flux and magnetic field, several solutions have been adopted to guarantee a good signal to background ratio and MHz counting rate capabilities. The RGRS is capable to combine space and energy distribution measurements of α particles and runaway electrons, which will help the study of the fast particle physics in a burning plasma.
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Affiliation(s)
- M Rebai
- Istituto di Fisica del Plasma, Consiglio Nazionale delle Ricerche, Milano, Italy
| | - L Bertalot
- ITER Organization, Saint Paul Lez Durance Cedex, France
| | | | - G Brolatti
- ENEA C. R. Frascati, Dipartimento FSN, Frascati, Italy
| | - G Croci
- Dipartimento di Fisica "G. Occhialini," Università di Milano-Bicocca, Milano, Italy
| | - B Esposito
- ENEA C. R. Frascati, Dipartimento FSN, Frascati, Italy
| | - A Fernandes
- Instituto de Plasmas e Fusão Nuclear, Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisboa, Portugal
| | - L Giacomelli
- Istituto di Fisica del Plasma, Consiglio Nazionale delle Ricerche, Milano, Italy
| | - G Gorini
- Istituto di Fisica del Plasma, Consiglio Nazionale delle Ricerche, Milano, Italy
| | - V Krasilnikov
- ITER Organization, Saint Paul Lez Durance Cedex, France
| | - I Lengar
- Jozef Stefan Institute, Ljubljana, Slovenia
| | - D Marocco
- ENEA C. R. Frascati, Dipartimento FSN, Frascati, Italy
| | - A Muraro
- Istituto di Fisica del Plasma, Consiglio Nazionale delle Ricerche, Milano, Italy
| | - M Nocente
- Dipartimento di Fisica "G. Occhialini," Università di Milano-Bicocca, Milano, Italy
| | - R C Pereira
- Instituto de Plasmas e Fusão Nuclear, Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisboa, Portugal
| | - E Perelli Cippo
- Istituto di Fisica del Plasma, Consiglio Nazionale delle Ricerche, Milano, Italy
| | - D Rigamonti
- Istituto di Fisica del Plasma, Consiglio Nazionale delle Ricerche, Milano, Italy
| | - J Rzadkiewicz
- National Center for Nuclear Research, NCBJ, Swierk, Warsaw, Poland
| | - J Sousa
- Instituto de Plasmas e Fusão Nuclear, Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisboa, Portugal
| | - M Tardocchi
- Istituto di Fisica del Plasma, Consiglio Nazionale delle Ricerche, Milano, Italy
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14
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Dal Molin A, Martinelli L, Nocente M, Rigamonti D, Abba A, Giacomelli L, Gorini G, Lvovskiy A, Muraro A, Tardocchi M. Development of a new compact gamma-ray spectrometer optimised for runaway electron measurements. Rev Sci Instrum 2018; 89:10I134. [PMID: 30399979 DOI: 10.1063/1.5038803] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Accepted: 06/25/2018] [Indexed: 06/08/2023]
Abstract
A new compact gamma-ray spectrometer was developed in order to optimise the measurement of bremsstrahlung radiation emitted from runaway electrons in the MeV range. The detector is based on a cerium doped lutetium-yttrium oxyorthosilicate (LYSO:Ce) scintillator coupled to a silicon photomultiplier and is insensitive to magnetic fields. A dedicated electronic board was developed to optimise the signal readout as well as for online control of the device. The detector combines a dynamic range up to 10 MeV with moderate energy non-linearity, counting rate capabilities in excess of 1 MHz, and an energy resolution that extrapolates to a few % in the MeV range, thus meeting the requirements for its application to runaway electron studies by bremsstrahlung measurements in the gamma-ray energy range.
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Affiliation(s)
- A Dal Molin
- Dipartimento di Fisica "G. Occhialini," Università degli Studi di Milano-Bicocca, Milano, Italy
| | - L Martinelli
- Dipartimento di Fisica "G. Occhialini," Università degli Studi di Milano-Bicocca, Milano, Italy
| | - M Nocente
- Dipartimento di Fisica "G. Occhialini," Università degli Studi di Milano-Bicocca, Milano, Italy
| | - D Rigamonti
- Istituto di Fisica del Plasma "P. Caldirola," CNR, Milano, Italy
| | - A Abba
- Nuclear Instruments, Lambrugo, Italy
| | - L Giacomelli
- Istituto di Fisica del Plasma "P. Caldirola," CNR, Milano, Italy
| | - G Gorini
- Dipartimento di Fisica "G. Occhialini," Università degli Studi di Milano-Bicocca, Milano, Italy
| | - A Lvovskiy
- Oak Ridge Associated Universities, Oak Ridge, Tennessee 37831, USA
| | - A Muraro
- Istituto di Fisica del Plasma "P. Caldirola," CNR, Milano, Italy
| | - M Tardocchi
- Istituto di Fisica del Plasma "P. Caldirola," CNR, Milano, Italy
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15
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Feng S, Nocente M, Wünderlich D, Bonomo F, Croci G, Fantz U, Heinemann B, Kraus W, Mario I, Muraro A, Pasqualotto R, Rebai M, Tardocchi M, Gorini G. Neutron measurements at the ELISE neutral beam test facility and implications for neutron based diagnostics at SPIDER. Rev Sci Instrum 2018; 89:10I139. [PMID: 30399769 DOI: 10.1063/1.5036823] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 07/03/2018] [Indexed: 06/08/2023]
Abstract
Along the route to the development of a neutral beam injector for ITER, the Padua based Source for Production of Ion of Deuterium Extracted from Rf plasma (SPIDER) and megavolt ITER injector and concept advancement facilities will make use of neutron diagnostics to quantify the homogeneity of the neutral beam profile by measuring the map of the neutron emission from the beam dump with the close-contact neutron emission surface mapping (CNESM) system. Neutrons are here produced from beam-target reactions between the deuterium beam and the deuterons previously adsorbed in the calorimeter. In order to aid the interpretation of the diagnostic data, a dedicated experiment on neutron emission from beam-target reactions with beam parameters approaching those expected at SPIDER has been performed at the Extraction from a Large Ion Source Experiment (ELISE) neutral beam test facility. The time trace of neutron emission has been measured using a calibrated liquid scintillator detector at increasing power densities on the target. Compared to calculations based on the local mixing model, a systematic discrepancy was observed exceeding the statistical accuracy of the measurements and increasing as a linear function of the power density. The data are used to derive an empirical temperature dependent correction for applications to neutron measurements at SPIDER.
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Affiliation(s)
- S Feng
- Dipartimento di Fisica "G. Occhialini," Università di Milano-Bicocca, Milano, Italy
| | - M Nocente
- Dipartimento di Fisica "G. Occhialini," Università di Milano-Bicocca, Milano, Italy
| | - D Wünderlich
- Max Planck Institut für Plasmaphysik, Garching, Germany
| | - F Bonomo
- Max Planck Institut für Plasmaphysik, Garching, Germany
| | - G Croci
- Dipartimento di Fisica "G. Occhialini," Università di Milano-Bicocca, Milano, Italy
| | - U Fantz
- Max Planck Institut für Plasmaphysik, Garching, Germany
| | - B Heinemann
- Max Planck Institut für Plasmaphysik, Garching, Germany
| | - W Kraus
- Max Planck Institut für Plasmaphysik, Garching, Germany
| | - I Mario
- Max Planck Institut für Plasmaphysik, Garching, Germany
| | - A Muraro
- Istituto di Fisica del Plasma "P. Caldirola," Consiglio Nazionale delle Ricerche, Milano, Italy
| | | | - M Rebai
- Istituto di Fisica del Plasma "P. Caldirola," Consiglio Nazionale delle Ricerche, Milano, Italy
| | - M Tardocchi
- Istituto di Fisica del Plasma "P. Caldirola," Consiglio Nazionale delle Ricerche, Milano, Italy
| | - G Gorini
- Dipartimento di Fisica "G. Occhialini," Università di Milano-Bicocca, Milano, Italy
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16
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Muraro A, Fernandez-Rivas M, Beyer K, Cardona V, Clark A, Eller E, Hourihane JO, Jutel M, Sheikh A, Agache I, Allen KJ, Angier E, Ballmer-Weber B, Bilò MB, Bindslev-Jensen C, Camargo CA, Cianferoni A, DunnGalvin A, Eigenmann PA, Halken S, Hoffmann-Sommergruber K, Lau S, Nilsson C, Poulsen LK, Rueff F, Spergel J, Sturm G, Timmermans F, Torres MJ, Turner P, van Ree R, Wickman M, Worm M, Mills ENC, Roberts G. The urgent need for a harmonized severity scoring system for acute allergic reactions. Allergy 2018; 73:1792-1800. [PMID: 29331045 DOI: 10.1111/all.13408] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2017] [Indexed: 11/29/2022]
Abstract
The accurate assessment and communication of the severity of acute allergic reactions are important to patients, clinicians, researchers, the food industry, and public health and regulatory authorities. Severity has different meanings to different stakeholders with patients and clinicians rating the significance of particular symptoms very differently. Many severity scoring systems have been generated, most focusing on the severity of reactions following exposure to a limited group of allergens. They are heterogeneous in format, none has used an accepted developmental approach, and none has been validated. Their wide range of outcome formats has led to difficulties with interpretation and application. Therefore, there is a persisting need for an appropriately developed and validated severity scoring system for allergic reactions that work across the range of allergenic triggers and address the needs of different stakeholder groups. We propose a novel approach to develop and then validate a harmonized scoring system for acute allergic reactions, based on a data-driven method that is informed by clinical and patient experience and other stakeholders' perspectives. We envisage two formats: (i) a numerical score giving a continuum from mild to severe reactions that are clinically meaningful and are useful for allergy healthcare professionals and researchers, and (ii) a three-grade-based ordinal format that is simple enough to be used and understood by other professionals and patients. Testing of reliability and validity of the new approach in a range of settings and populations will allow eventual implementation of a standardized scoring system in clinical studies and routine practice.
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17
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Augé J, Vent J, Agache I, Airaksinen L, Campo Mozo P, Chaker A, Cingi C, Durham S, Fokkens W, Gevaert P, Giotakis A, Hellings P, Herknerova M, Hox V, Klimek L, La Melia C, Mullol J, Muluk NB, Muraro A, Naito K, Pfaar O, Riechelmann H, Rondon C, Rudenko M, Samolinski B, Tasca I, Tomazic P, Vogt K, Wagenmann M, Yeryomenko G, Zhang L, Mösges R. EAACI Position paper on the standardization of nasal allergen challenges. Allergy 2018; 73:1597-1608. [PMID: 29377177 DOI: 10.1111/all.13416] [Citation(s) in RCA: 119] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2017] [Indexed: 12/12/2022]
Abstract
Nasal allergen challenge (NAC) is an important tool to diagnose allergic rhinitis. In daily clinical routine, experimentally, or when measuring therapeutic success clinically, nasal allergen challenge is fundamental. It is further one of the key diagnostic tools when initiating specific allergen immunotherapy. So far, national recommendations offered guidance on its execution; however, international divergence left many questions unanswered. These differences in the literature caused EAACI to initiate a task force to answer unmet needs and find a consensus in executing nasal allergen challenge. On the basis of a systematic review containing nasal allergen challenges of the past years, task force members reviewed evidence, discussed open issues, and studied variations of several subjective and objective assessment parameters to propose a standardized way of a nasal allergen challenge procedure in clinical practice. Besides an update on indications, contraindications, and preparations for the test procedure, main recommendations are a bilaterally challenge with standardized allergens, with a spray device offering 0.1 mL per nostril. A systematic catalogue for positivity criteria is given for the variety of established subjective and objective assessment methods as well as a schedule for the challenge procedure. The task force recommends a unified protocol for NAC for daily clinical practice, aiming at eliminating the previous difficulty of comparing NAC results due to unmet needs.
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Affiliation(s)
- J. Augé
- Department of Otorhinolaryngology, Head and Neck Surgery; University of Cologne Medical Center; Cologne Germany
- Institute of Medical Statistics and Computational Biology; Faculty of Medicine; University of Cologne; Cologne Germany
| | - J. Vent
- Department of Otorhinolaryngology, Head and Neck Surgery; University of Cologne Medical Center; Cologne Germany
- Institute of Medical Statistics and Computational Biology; Faculty of Medicine; University of Cologne; Cologne Germany
- Department of Otorhinolaryngology, Head and Neck Surgery; Universitätsmedizin Mannheim, Medical Faculty Mannheim; Heidelberg University; Mannheim Germany
| | - I. Agache
- Transylvania University Brasov; Faculty of Medicine; Department of Allergy and Clinical Immunology; Brasov Romania
| | - L. Airaksinen
- Health and Work Ability; Finnish Institute of Occupational Health; Helsinki Finland
| | - P. Campo Mozo
- Allergy Unit; IBIMA-Regional University Hospital of Málaga, ARADyAL; Málaga Spain
| | - A. Chaker
- Department of Otolaryngology; Center of Allergy and Environment (ZAUM); Klinikum rechts der Isar; Technical University Munich; Munich Germany
| | - C. Cingi
- ENT Department; Faculty of Medicine; Eskisehir Osmangazi University; Eskisehir Turkey
| | - S. Durham
- Allergy and Clinical Immunology; Imperial College; NHLI; London UK
| | - W. Fokkens
- Otorhinolaryngology; Academic Medical Centre; Amsterdam The Netherlands
| | - P. Gevaert
- Otorhinolaryngology; Ghent University; Ghent Belgium
| | - A. Giotakis
- Department of Otorhinolaryngology - Head and Neck Surgery; Medical University of Innsbruck; Medizinische Universitat Innsbruck; Innsbruck Austria
| | - P. Hellings
- Department of Otorhinolaryngology; Cliniques Universitaires Saint-Luc; Brussels Belgium
| | - M. Herknerova
- Alergologie a klinická imunologie; Nemocnice na Homolce; Prague Czech Republic
| | - V. Hox
- Department of Otorhinolaryngology; Cliniques Universitaires Saint-Luc; Brussels Belgium
| | - L. Klimek
- Center for Rhinology and Allergology; Wiesbaden Germany
| | - C. La Melia
- Department of ENT; Azienda Ausl di Imola; Imola Italy
| | - J. Mullol
- Clinical and Experimental Immunoallergy; Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS); Barcelona Spain
- Department of ORL; Hospital Clínic de Barcelona; Universitat de Barcelona; Barcelona Spain
- Centro de Investigaciones Biomédicas en Red de Enfermedades Respiratorias (CIBERES); Barcelona Spain
| | - N. B. Muluk
- Department of Otorhinolaryngology; Medical Faculty; Kirikkale University; Kirikkale Turkey
| | - A. Muraro
- Department of Pediatrics; Referral Centre for Food Allergy; Padua General University Hospital; Padua Italy
| | - K. Naito
- Fujita Health University, Otolaryngology; 1-98 Denngakugakubo, Kutukake-cho; Toyoake city Aichi Prefecture Japan
| | - O. Pfaar
- Center for Rhinology and Allergology; Wiesbaden Germany
- Department of Otorhinolaryngology, Head and Neck Surgery; Universitätsmedizin Mannheim, Medical Faculty Mannheim; Heidelberg University; Mannheim Germany
| | - H. Riechelmann
- Department of Otorhinolaryngology - Head and Neck Surgery; Medical University of Innsbruck; Medizinische Universitat Innsbruck; Innsbruck Austria
| | - C. Rondon
- Allergy Unit; IBIMA-Regional University Hospital of Málaga, ARADyAL; Málaga Spain
| | - M. Rudenko
- London Allergy and Immunology Centre; London UK
| | - B. Samolinski
- Department of Prevention of Envinronmental Hazards and Allergology; Medical University of Warsaw; Poland
| | - I. Tasca
- Department of ENT; Azienda Ausl di Imola; Imola Italy
| | - P. Tomazic
- Department of General Otorhinolaryngology, Head and Neck Surgery; Medical University of Graz; Graz Austria
| | - K. Vogt
- Faculty of Medicine; University of Latvia; Riga Latvia
| | - M. Wagenmann
- Department of Otorhinolaryngology; Düsseldorf University Hospital (UKD); Düsseldorf Germany
| | - G. Yeryomenko
- Kharkiv National Medical University; Kharkiv Ukraine
| | - L. Zhang
- Department of Otolaryngology Head and Neck Surgery; Beijing TongRen Hospital; Capital Medical University; Beijing China
| | - R. Mösges
- Institute of Medical Statistics and Computational Biology; Faculty of Medicine; University of Cologne; Cologne Germany
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18
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Worm M, Francuzik W, Renaudin J, Bilo MB, Cardona V, Scherer Hofmeier K, Köhli A, Bauer A, Christoff G, Cichocka‐Jarosz E, Hawranek T, Hourihane JO, Lange L, Mahler V, Muraro A, Papadopoulos NG, Pföhler C, Poziomkowska‐Gęsicka I, Ruëff F, Spindler T, Treudler R, Fernandez‐Rivas M, Dölle S. Factors increasing the risk for a severe reaction in anaphylaxis: An analysis of data from The European Anaphylaxis Registry. Allergy 2018; 73:1322-1330. [PMID: 29318637 DOI: 10.1111/all.13380] [Citation(s) in RCA: 129] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Preventive measures to decrease the frequency and intensity of anaphylactic events are essential to provide optimal care for allergic patients. Aggravating factors may trigger or increase the severity of anaphylaxis and therefore need to be recognized and avoided. OBJECTIVE To identify and prioritize factors associated with an increased risk of developing severe anaphylaxis. METHODS Data from the Anaphylaxis Registry (122 centers in 11 European countries) were used in logistic regression models considering existing severity grading systems, elicitors, and symptoms to identify the relative risk of factors on the severity of anaphylaxis. RESULTS We identified higher age and concomitant mastocytosis (OR: 3.1, CI: 2.6-3.7) as the most important predictors for an increased risk of severe anaphylaxis. Vigorous physical exercise (OR: 1.5, CI: 1.3-1.7), male sex (OR: 1.2, CI: 1.1-1.3), and psychological burden (OR: 1.4, CI: 1.2-1.6) were more often associated with severe reactions. Additionally, intake of beta-blockers (OR: 1.9, CI: 1.5-2.2) and ACE-I (OR: 1.28, CI: 1.05, 1.51) in temporal proximity to allergen exposition was identified as an important factor in logistic regression analysis. CONCLUSION Our data suggest it may be possible to identify patients who require intensified preventive measures due to their relatively higher risk for severe anaphylaxis by considering endogenous and exogenous factors.
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Affiliation(s)
- M. Worm
- Department of Dermatology and Allergology Charite‐Universitätsmedizin Berlin Berlin Germany
| | - W. Francuzik
- Department of Dermatology and Allergology Charite‐Universitätsmedizin Berlin Berlin Germany
| | - J.‐M. Renaudin
- Allergy Vigilance Network University Hospital Nancy Nancy France
| | - M. B. Bilo
- Department of Internal Medicine/Allergy Unit University Hospital Ospedali Riuniti Ancona Italy
| | - V. Cardona
- Allergy Section, Department of Internal Medicine Hospital Universitari Vall d'Hebron Barcelona Spain
| | | | - A. Köhli
- Division of Allergology University Children's Hospital Zurich Switzerland
| | - A. Bauer
- Department of Dermatology University Allergy Center University Hospital Carl Gustav Carus Technical University Dresden Dresden Germany
| | - G. Christoff
- Faculty of Public Health Medical University‐Sofia Sofia Bulgaria
- Tokuda Medical Centre Allergy Out‐patient Clinic Sofia Bulgaria
| | - E. Cichocka‐Jarosz
- Department of Pediatrics Jagiellonian University Medical College Krakow Poland
| | - T. Hawranek
- Department of Dermatology Paracelsus Private Medical University Salzburg Salzburg Austria
| | | | - L. Lange
- Department of Pediatrics St. Marien‐Hospital Bonn Germany
| | - V. Mahler
- Department of Dermatology University Hospital of Erlangen Friedrich‐Alexander‐University Erlangen Erlangen Germany
| | - A. Muraro
- Department of Mother and Child Health Padua General University Hospital Padua Italy
| | | | - C. Pföhler
- Department of Dermatology Saarland University Hospital Homburg/Saar Germany
| | | | - F. Ruëff
- Department of Dermatology and Allergology Klinikum der Universität München München Germany
| | - T. Spindler
- Department of Pediatric Pneumology and Allergology Lung Centre South‐West Wangen Germany
| | - R. Treudler
- Department of Dermatology, Venerology and Allergology LICA‐Comprehensive Allergy Center Universität Leipzig Leipzig Germany
| | | | - S. Dölle
- Department of Dermatology and Allergology Charite‐Universitätsmedizin Berlin Berlin Germany
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19
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Muraro A, Roberts G, Halken S, Agache I, Angier E, Fernandez-Rivas M, Gerth van Wijk R, Jutel M, Lau S, Pajno G, Pfaar O, Ryan D, Sturm GJ, van Ree R, Varga EM, Bachert C, Calderon M, Canonica GW, Durham SR, Malling HJ, Wahn U, Sheikh A. EAACI guidelines on allergen immunotherapy: Executive statement. Allergy 2018; 73:739-743. [PMID: 29380390 DOI: 10.1111/all.13420] [Citation(s) in RCA: 100] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- A. Muraro
- Department of Women and Child Health; Referral Centre for Food Allergy Diagnosis and Treatment Veneto Region; University of Padua; Padua Italy
| | - G. Roberts
- The David Hide Asthma and Allergy Research Centre; St Mary's Hospital; Newport Isle of Wight UK
- NIHR Biomedical Research Centre; University Hospital Southampton NHS Foundation Trust; Southampton UK
- Clinical and Experimental Sciences and Human Development in Health Academic Units; Faculty of Medicine; University of Southampton; Southampton UK
| | - S. Halken
- Hans Christian Andersen Children's Hospital; Odense University Hospital; Odense Denmark
| | - I. Agache
- Faculty of Medicine; Department of Allergy and Clinical Immunology; Transylvania University Brasov; Brasov Romania
| | - E. Angier
- Faculty of Medicine; Primary Care and Population Science; University of Southampton; Southampton UK
| | | | - R. Gerth van Wijk
- Section of Allergology; Department of Internal Medicine; Erasmus Medical Center; Otterdam the Netherlands
| | - M. Jutel
- ALL-MED Medical Research Institute; Wroclaw Medical University; Wroclaw Poland
| | - S. Lau
- Department of Pediatric Pneumology and Immunology; Charité Universitätsmedizin; Berlin Germany
| | - G. Pajno
- Department of Pediatrics; Allergy Unit; University of Messina; Messina Italy
| | - O. Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery; Universitätsmedizin Mannheim; Medical Faculty Mannheim; Heidelberg University; Mannheim Germany
- Center for Rhinology and Allergology; Wiesbaden Germany
| | - D. Ryan
- Usher Institute of Population Health Sciences and Informatics; University of Edinburgh Medical School; Edinburgh UK
| | - G. J. Sturm
- Department of Dermatology and Venerology; Medical University of Graz; Graz Austria
- Outpatient Allergy Clinic Reumannplaz; Vienna Austria
| | - R. van Ree
- Departments of Experimental Immunology and of Otorhinolaryngology; Academic Medical Center; University of Amsterdam; Amsterdam the Netherlands
| | - E.-M. Varga
- Department of Paediatric and Adolescent Medicine, Respiratory and Allergic Disease Division; Medical University of Graz; Graz Austria
| | - C. Bachert
- Upper Airways Research Laboratory and ENT-Department; University Hospital Ghent; Ghent Belgium
| | - M. Calderon
- Allergy and Clinical Immunology; National Heart and Lung Institute; Imperial College London; London UK
| | - G. W. Canonica
- Personalized Medicine Asthma & Allergy Clinic; Humanitas University and Research Hospital; Milano Italy
| | - S. R. Durham
- Allergy and Clinical Immunology; National Heart and Lung Institute; Imperial College London; London UK
| | - H. J. Malling
- Danish Allergy Centre; University of Copenhagen; Copenhagen Denmark
| | - U. Wahn
- Department for Pediatric Pneumology and Immunology; Charité Universitätsmedizin; Berlin Germany
| | - A. Sheikh
- Asthma UK Centre for Applied Research; Usher Institute of Population Health Sciences and Informatics; The University of Edinburgh; Edinburgh UK
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20
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Sturm GJ, Varga EM, Roberts G, Mosbech H, Bilò MB, Akdis CA, Antolín-Amérigo D, Cichocka-Jarosz E, Gawlik R, Jakob T, Kosnik M, Lange J, Mingomataj E, Mitsias DI, Ollert M, Oude Elberink JNG, Pfaar O, Pitsios C, Pravettoni V, Ruëff F, Sin BA, Agache I, Angier E, Arasi S, Calderón MA, Fernandez-Rivas M, Halken S, Jutel M, Lau S, Pajno GB, van Ree R, Ryan D, Spranger O, van Wijk RG, Dhami S, Zaman H, Sheikh A, Muraro A. EAACI guidelines on allergen immunotherapy: Hymenoptera venom allergy. Allergy 2018; 73:744-764. [PMID: 28748641 DOI: 10.1111/all.13262] [Citation(s) in RCA: 232] [Impact Index Per Article: 38.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2017] [Indexed: 01/27/2023]
Abstract
Hymenoptera venom allergy is a potentially life-threatening allergic reaction following a honeybee, vespid, or ant sting. Systemic-allergic sting reactions have been reported in up to 7.5% of adults and up to 3.4% of children. They can be mild and restricted to the skin or moderate to severe with a risk of life-threatening anaphylaxis. Patients should carry an emergency kit containing an adrenaline autoinjector, H1 -antihistamines, and corticosteroids depending on the severity of their previous sting reaction(s). The only treatment to prevent further systemic sting reactions is venom immunotherapy. This guideline has been prepared by the European Academy of Allergy and Clinical Immunology's (EAACI) Taskforce on Venom Immunotherapy as part of the EAACI Guidelines on Allergen Immunotherapy initiative. The guideline aims to provide evidence-based recommendations for the use of venom immunotherapy, has been informed by a formal systematic review and meta-analysis and produced using the Appraisal of Guidelines for Research and Evaluation (AGREE II) approach. The process included representation from a range of stakeholders. Venom immunotherapy is indicated in venom-allergic children and adults to prevent further moderate-to-severe systemic sting reactions. Venom immunotherapy is also recommended in adults with only generalized skin reactions as it results in significant improvements in quality of life compared to carrying an adrenaline autoinjector. This guideline aims to give practical advice on performing venom immunotherapy. Key sections cover general considerations before initiating venom immunotherapy, evidence-based clinical recommendations, risk factors for adverse events and for relapse of systemic sting reaction, and a summary of gaps in the evidence.
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21
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Bonertz A, Roberts G, Slater JE, Bridgewater J, Rabin RL, Hoefnagel M, Timon M, Pini C, Pfaar O, Sheikh A, Ryan D, Akdis C, Goldstein J, Poulsen LK, van Ree R, Rhyner C, Barber D, Palomares O, Pawankar R, Hamerlijnk D, Klimek L, Agache I, Angier E, Casale T, Fernandez-Rivas M, Halken S, Jutel M, Lau S, Pajno G, Sturm G, Varga EM, Gerth van Wijk R, Bonini S, Muraro A, Vieths S. Allergen manufacturing and quality aspects for allergen immunotherapy in Europe and the United States: An analysis from the EAACI AIT Guidelines Project. Allergy 2018; 73:816-826. [PMID: 29150848 DOI: 10.1111/all.13357] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2017] [Indexed: 11/28/2022]
Abstract
Adequate quality is essential for any medicinal product to be eligible for marketing. Quality includes verification of the identity, content and purity of a medicinal product in combination with a specified production process and its control. Allergen products derived from natural sources require particular considerations to ensure adequate quality. Here, we describe key aspects of the documentation on manufacturing and quality aspects for allergen immunotherapy products in the European Union and the United States. In some key parts, requirements in these areas are harmonized while other fields are regulated separately between both regions. Essential differences are found in the use of Reference Preparations, or the requirement to apply standardized assays for potency determination. As the types of products available are different in specific regions, regulatory guidance for such products may also be available in one specific region only, such as for allergoids in the European Union. Region-specific issues and priorities are a result of this. As allergen products derived from natural sources are inherently variable in their qualitative and quantitative composition, these products present special challenges to balance the variability and ensuring batch-to-batch consistency. Advancements in scientific knowledge on specific allergens and their role in allergic disease will consequentially find representation in future regulatory guidelines.
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Affiliation(s)
| | - G. Roberts
- University of Southampton; Southampton UK
- University Hospital Southampton NHS Foundation Trust; Southampton UK
- David Hide Asthma and Allergy Research Centre; Newport UK
| | - J. E. Slater
- US Food and Drug Administration; Silver Spring MD USA
| | | | - R. L. Rabin
- US Food and Drug Administration; Silver Spring MD USA
| | - M. Hoefnagel
- CBG-MEB (Medicines Evaluation Board); Utrecht The Netherlands
| | - M. Timon
- Division of Biological Products; Advanced Therapies and Biotechnology; Agencia Española de Medicamentos y Productos Sanitarios (AEMPS); Madrid Spain
| | - C. Pini
- Istituto Superiore di Sanità; Rome Italy
| | - O. Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery; Medical Faculty Mannheim; Universitätsmedizin Mannheim; Heidelberg University; Mannheim Germany
- Center for Rhinology and Allergology; Wiesbaden Germany
| | - A. Sheikh
- The University of Edinburgh; Scotland UK
| | - D. Ryan
- Usher Institute of Population Health Sciences and Informatics; University of Edinburgh Medical School; Edinburgh UK
- Asthma UK Centre for Applied Research; The University of Edinburgh; Edinburgh UK
| | - C. Akdis
- Swiss Institute of Allergy and Asthma Research; University Zurich; Davos Switzerland
| | - J. Goldstein
- Division of Allergy, Immunology and Transplantation; National Institute of Allergy and Infectious Diseases; National Institutes of Health; Bethesda MD USA
| | - L. K. Poulsen
- Allergy Clinic; Copenhagen University Hospital at Gentofte; Copenhagen Denmark
| | - R. van Ree
- Departments of Experimental Immunology and of Otorhinolaryngology; Academic Medical Center; University of Amsterdam; Amsterdam The Netherlands
| | - C. Rhyner
- Swiss Institute of Allergy and Asthma Research; University Zurich; Davos Switzerland
| | - D. Barber
- Universidad CEU San Pablo; Madrid Spain
| | - O. Palomares
- Department of Biochemistry and Molecular Biology; School of Chemistry; Complutense University of Madrid (UCM); Madrid Spain
| | | | - D. Hamerlijnk
- Patient advocacy Group; Dutch Lung Foundation; Amersfoort The Netherlands
| | - L. Klimek
- Center for Rhinology and Allergology; Wiesbaden Germany
| | - I. Agache
- Faculty of Medicine; Department of Allergy and Clinical Immunology; Transylvania University Brasov; Brasov Romania
| | - E. Angier
- Sheffield Teaching Hospital; Sheffield UK
| | - T. Casale
- University of South Florida; Tampa FL USA
| | | | - S. Halken
- Hans Christian Andersen Childrens Hospital; Odense University Hospital; Odense Denmark
| | - M. Jutel
- Wroclaw Medical University; Department of Clinical Immunology; Wroclaw Poland
- ALL-MED Medical Research Institute; Wroclaw Poland
| | - S. Lau
- Department for Pediatric Pneumology and Immunology; Charité Universitätsmedizin; Berlin Germany
| | - G. Pajno
- Department of Pediatrics and Allergy Unit; University of Messina; Messina Italy
| | - G. Sturm
- Department of Dermatology and Venerology; Medical University of Graz; Graz Austria
- Outpatient Allergy Clinic Reumannplatz; Vienna Austria
| | | | | | - S. Bonini
- University of Campania Luigi Vanvitelli; IFT-CNR; Naples and Rome Italy
| | - A. Muraro
- Padua University Hospital; Padua Italy
| | - S. Vieths
- Paul-Ehrlich-Institut; Langen Germany
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Pajno GB, Fernandez-Rivas M, Arasi S, Roberts G, Akdis CA, Alvaro-Lozano M, Beyer K, Bindslev-Jensen C, Burks W, Ebisawa M, Eigenmann P, Knol E, Nadeau KC, Poulsen LK, van Ree R, Santos AF, du Toit G, Dhami S, Nurmatov U, Boloh Y, Makela M, O'Mahony L, Papadopoulos N, Sackesen C, Agache I, Angier E, Halken S, Jutel M, Lau S, Pfaar O, Ryan D, Sturm G, Varga EM, van Wijk RG, Sheikh A, Muraro A. EAACI Guidelines on allergen immunotherapy: IgE-mediated food allergy. Allergy 2018; 73:799-815. [PMID: 29205393 DOI: 10.1111/all.13319] [Citation(s) in RCA: 325] [Impact Index Per Article: 54.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2017] [Indexed: 02/05/2023]
Abstract
Food allergy can result in considerable morbidity, impairment of quality of life, and healthcare expenditure. There is therefore interest in novel strategies for its treatment, particularly food allergen immunotherapy (FA-AIT) through the oral (OIT), sublingual (SLIT), or epicutaneous (EPIT) routes. This Guideline, prepared by the European Academy of Allergy and Clinical Immunology (EAACI) Task Force on Allergen Immunotherapy for IgE-mediated Food Allergy, aims to provide evidence-based recommendations for active treatment of IgE-mediated food allergy with FA-AIT. Immunotherapy relies on the delivery of gradually increasing doses of specific allergen to increase the threshold of reaction while on therapy (also known as desensitization) and ultimately to achieve post-discontinuation effectiveness (also known as tolerance or sustained unresponsiveness). Oral FA-AIT has most frequently been assessed: here, the allergen is either immediately swallowed (OIT) or held under the tongue for a period of time (SLIT). Overall, trials have found substantial benefit for patients undergoing either OIT or SLIT with respect to efficacy during treatment, particularly for cow's milk, hen's egg, and peanut allergies. A benefit post-discontinuation is also suggested, but not confirmed. Adverse events during FA-AIT have been frequently reported, but few subjects discontinue FA-AIT as a result of these. Taking into account the current evidence, FA-AIT should only be performed in research centers or in clinical centers with an extensive experience in FA-AIT. Patients and their families should be provided with information about the use of FA-AIT for IgE-mediated food allergy to allow them to make an informed decision about the therapy.
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23
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Roberts G, Pfaar O, Akdis CA, Ansotegui IJ, Durham SR, Gerth van Wijk R, Halken S, Larenas-Linnemann D, Pawankar R, Pitsios C, Sheikh A, Worm M, Arasi S, Calderon MA, Cingi C, Dhami S, Fauquert JL, Hamelmann E, Hellings P, Jacobsen L, Knol E, Lin SY, Maggina P, Mösges R, Oude Elberink JNG, Pajno G, Pastorello EA, Penagos M, Rotiroti G, Schmidt-Weber CB, Timmermans F, Tsilochristou O, Varga EM, Wilkinson JN, Williams A, Zhang L, Agache I, Angier E, Fernandez-Rivas M, Jutel M, Lau S, van Ree R, Ryan D, Sturm GJ, Muraro A. EAACI Guidelines on Allergen Immunotherapy: Allergic rhinoconjunctivitis. Allergy 2018; 73:765-798. [PMID: 28940458 DOI: 10.1111/all.13317] [Citation(s) in RCA: 391] [Impact Index Per Article: 65.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2017] [Indexed: 12/12/2022]
Abstract
Allergic rhinoconjunctivitis (AR) is an allergic disorder of the nose and eyes affecting about a fifth of the general population. Symptoms of AR can be controlled with allergen avoidance measures and pharmacotherapy. However, many patients continue to have ongoing symptoms and an impaired quality of life; pharmacotherapy may also induce some side-effects. Allergen immunotherapy (AIT) represents the only currently available treatment that targets the underlying pathophysiology, and it may have a disease-modifying effect. Either the subcutaneous (SCIT) or sublingual (SLIT) routes may be used. This Guideline has been prepared by the European Academy of Allergy and Clinical Immunology's (EAACI) Taskforce on AIT for AR and is part of the EAACI presidential project "EAACI Guidelines on Allergen Immunotherapy." It aims to provide evidence-based clinical recommendations and has been informed by a formal systematic review and meta-analysis. Its generation has followed the Appraisal of Guidelines for Research and Evaluation (AGREE II) approach. The process included involvement of the full range of stakeholders. In general, broad evidence for the clinical efficacy of AIT for AR exists but a product-specific evaluation of evidence is recommended. In general, SCIT and SLIT are recommended for both seasonal and perennial AR for its short-term benefit. The strongest evidence for long-term benefit is documented for grass AIT (especially for the grass tablets) where long-term benefit is seen. To achieve long-term efficacy, it is recommended that a minimum of 3 years of therapy is used. Many gaps in the evidence base exist, particularly around long-term benefit and use in children.
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Ryan D, Gerth van Wijk R, Angier E, Kristiansen M, Zaman H, Sheikh A, Cardona V, Vidal C, Warner A, Agache I, Arasi S, Fernandez-Rivas M, Halken S, Jutel M, Lau S, Pajno G, Pfaar O, Roberts G, Sturm G, Varga EM, Van Ree R, Muraro A. Challenges in the implementation of the EAACI AIT guidelines: A situational analysis of current provision of allergen immunotherapy. Allergy 2018; 73:827-836. [PMID: 28850687 DOI: 10.1111/all.13264] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2017] [Indexed: 12/30/2022]
Abstract
PURPOSE The European Academy of Allergy and Clinical Immunology (EAACI) has produced Guidelines on Allergen Immunotherapy (AIT). We sought to gauge the preparedness of primary care to participate in the delivery of AIT in Europe. METHODS We undertook a mixed-methods, situational analysis. This involved a purposeful literature search and two surveys: one to primary care clinicians and the other to a wider group of stakeholders across Europe. RESULTS The 10 papers identified all pointed out gaps or deficiencies in allergy care provision in primary care. The surveys also highlighted similar concerns, particularly in relation to concerns about lack of knowledge, skills, infrastructural weaknesses, reimbursement policies and communication with specialists as barriers to evidence-based care. Almost all countries (92%) reported the availability of AIT. In spite of that, only 28% and 44% of the countries reported the availability of guidelines for primary care physicians and specialists, respectively. Agreed pathways between specialists and primary care physicians were reported as existing in 32%-48% of countries. Reimbursement appeared to be an important barrier as AIT was only fully reimbursed in 32% of countries. Additionally, 44% of respondents considered accessibility to AIT and 36% stating patient costs were barriers. CONCLUSIONS Successful working with primary care providers is essential to scaling-up AIT provision in Europe, but to achieve this, the identified barriers must be overcome. Development of primary care interpretation of guidelines to aid patient selection, establishment of disease management pathways and collaboration with specialist groups are required as a matter of urgency.
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Affiliation(s)
- D. Ryan
- Asthma UK Centre for Applied Research; Usher Institute of Population Health Sciences and Informatics; The University of Edinburgh Medical School; Edinburgh UK
| | - R. Gerth van Wijk
- Allergy Section; Department of Internal Medicine; Erasmus MC; Rotterdam The Netherlands
| | - E. Angier
- GPwSI in Allergy; Department of Clinical Immunology and Allergy; Northern General Hospital; Sheffield UK
| | - M. Kristiansen
- Section for Health Services Research; Department of Public Health; University of Copenhagen; Copenhagen K Denmark
| | - H. Zaman
- Senior Lecturer in Pharmacy Practice; Faculty of Life Sciences; School of Pharmacy and Medical Sciences; University of Bradford; Bradford UK
| | - A. Sheikh
- Asthma UK Centre for Applied Research; Usher Institute of Population Health Sciences and Informatics; The University of Edinburgh Medical School; Edinburgh UK
| | - V. Cardona
- Allergy Section; Department of Internal Medicine; Hospital Vall d'Hebron; Barcelona Spain
| | - C. Vidal
- Allergy Department and Faculty of Medicine; Complejo Hospitalario Universitario de Santiago; Santiago de Compostela University; Santigo Spain
| | - A. Warner
- Head of Clinical Services, Allergy UK; Planwell House; LEFA Business Park; Sidcup Kent UK
| | - I. Agache
- Faculty of Medicine; Department of Allergy and Clinical Immunology; Transylvania University Brasov; Brasov Romania
| | - S. Arasi
- Allergy Unit; Department of Pediatrics; University of Messina; Messina Italy
- Department of Pediatric Pneumology and Immunology; Charité Universitätsmedizin; Berlin Germany
| | | | - S. Halken
- Hans Christian Andersen Children's Hospital; Odense University Hospital; Odense Denmark
| | - M. Jutel
- Wroclaw Medical University; ALL-MED Medical Research Institute; Wrocław Poland
| | - S. Lau
- Department of Pediatric Pneumology and Immunology; Charité Universitätsmedizin; Berlin Germany
| | - G. Pajno
- Allergy Unit; Department of Pediatrics; University of Messina; Messina Italy
| | - O. Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery; Universitätsmedizin Mannheim; Medical Faculty Mannheim; Heidelberg University; Mannheim Germany
- Center for Rhinology and Allergology; Wiesbaden Germany
| | - G. Roberts
- The David Hide Asthma and Allergy Research Centre; St Mary's Hospital; Newport Isle of Wight UK
- NIHR Respiratory Biomedical Research Unit; University Hospital Southampton NHS Foundation Trust; Southampton UK
- Faculty of Medicine; University of Southampton; Southampton UK
| | - G. Sturm
- Department of Dermatology and Venerology; Medical University of Graz; Graz Austria
- Outpatient Allergy Clinic Reumannplatz; Vienna Austria
| | - E. M. Varga
- Department of Paediatric and Adolescent Medicine; Respiratory and Allergic Disease Division; Medical University of Graz; Graz Austria
| | - R. Van Ree
- Departments of Experimental Immunology and of Otorhinolaryngology; Academic Medical Center; University of Amsterdam; Amsterdam The Netherlands
| | - A. Muraro
- Department of Mother and Child Health; The Referral Centre for Food Allergy Diagnosis and Treatment Veneto Region; University of Padua; Padua Italy
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25
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Scuri M, Vestbo J, Papi A, Corradi M, Spinola M, Montagna I, Francisco C, Cohuet G, Vezzoli S, Muraro A, Petruzzelli S, Singh D. Association of Incident Pneumonia and Exacerbations with Extrafine Triple Therapy in One Single Inhaler in COPD. Pneumologie 2018. [DOI: 10.1055/s-0037-1619369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- M Scuri
- Chiesi Pharmaceuticals Parma
| | | | | | | | | | | | | | | | | | | | | | - D Singh
- The University of Manchester
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26
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Singh D, Fabbri L, Papi A, Vezzoli S, Muraro A, Petruzzelli S, Scuri M, Vestbo J. Extrafine triple therapy reduces exacerbations in GOLD B COPD patients: post-hoc analysis of TRILOGY and TRINITY. Pneumologie 2018. [DOI: 10.1055/s-0037-1619368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- D Singh
- Centre for Respiratory, Medicine and Allergy,University of Manchester
| | - L Fabbri
- Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena
| | - A Papi
- Research Centre on Asthma and Copd,University of Ferrara
| | - S Vezzoli
- Global Clinical Development, Chiesi, Farmaceutici Spa, Parma
| | - A Muraro
- Global Clinical Development, Chiesi, Farmaceutici Spa, Parma
| | - S Petruzzelli
- Global Clinical Development, Chiesi, Farmaceutici Spa, Parma
| | - M Scuri
- Global Clinical Development, Chiesi, Farmaceutici Spa, Parma
| | - J Vestbo
- Centre for Respiratory, Medicine and Allergy,University of Manchester
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27
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Scuri M, Spinola M, Vezzoli S, Muraro A, Petruzzelli S, Vestbo J. Efficacy of CHF5993, A Novel Triple Extrafine Combination Treatment in COPD Patients at High Risk of Exacerbations: A Sub Group Analysis of the TRINITY Study. Pneumologie 2018. [DOI: 10.1055/s-0037-1619353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- M Scuri
- Chiesi Pharmaceuticals, Parma
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28
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Cardona V, Demoly P, Dreborg S, Kalpaklioglu AF, Klimek L, Muraro A, Pfaar O, Popov TA, Hoffmann HJ. Current practice of allergy diagnosis and the potential impact of regulation in Europe. Allergy 2018; 73:323-327. [PMID: 28905404 DOI: 10.1111/all.13306] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2017] [Indexed: 01/16/2023]
Abstract
In the European Union (EU), the regulatory framework regarding diagnostic allergen extracts is currently in the process of being implemented at the national level. Due to these regulations, the initial and periodic renewal expenses for the registration of diagnostic allergen extracts may render extract production unprofitable. Consequently, many extracts may be at risk of removal from the market. The current survey, which was conducted by a task force of the European Academy of Allergy and Clinical Immunology, aimed to assess the current practice of allergy diagnosis in Europe. This survey revealed that skin tests continue to be the main diagnostic procedure and are used as the first option in almost two-third of all types of allergic diseases and in 90% of individuals suffering from respiratory allergies. Therefore, there is a need to ensure the availability of high-quality allergen extracts to maintain the common diagnostic procedures used by EU professionals. To reach this goal, it is necessary to align efforts and establish active partnerships between manufacturers, relevant scientific societies, consumer organizations and authorities to maintain the availability of these diagnostic tools.
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Affiliation(s)
- V. Cardona
- Allergy Section; Department of Internal Medicine; Hospital Universitari Vall d'Hebron; Barcelona Spain
| | - P. Demoly
- UPMC Paris 06, UMR-S 1136, IPLESP, Equipe EPAR; Département de Pneumologie et Addictologie; Hôpital Arnaud de Villeneuve; CHRU de Montpellier and Sorbonnes Universités; Paris France
| | - S. Dreborg
- Section on Child and Adolescent Allergology; Women's and Children's Health; Academic Hospital; University of Uppsala; Uppsala Sweden
| | - A. F. Kalpaklioglu
- Department of Immunology and Allergic Diseases; Kirikkale University Hospital; Kirikkale Turkey
| | - L. Klimek
- Centre for Rhinology and Allergology; Wiesbaden Germany
| | - A. Muraro
- Food Allergy Referral Centre Veneto Region; Department of Women and Child Health; Padua General University Hospital; Padua Italy
| | - O. Pfaar
- Centre for Rhinology and Allergology; Wiesbaden Germany
- Department of Otorhinolaryngology; Head and Neck Surgery; Universitätsmedizin Mannheim; Medical Faculty Mannheim; Heidelberg University; Mannheim Germany
| | - T. A. Popov
- Clinic of Allergy and Asthma; Medical University; Sofia Bulgaria
| | - H. J. Hoffmann
- Department of Respiratory Diseases and Allergy; Department of Clinical Medicine; Aarhus University; Aarhus C Denmark
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29
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Asaria M, Dhami S, van Ree R, Gerth van Wijk R, Muraro A, Roberts G, Sheikh A. Health economic analysis of allergen immunotherapy for the management of allergic rhinitis, asthma, food allergy and venom allergy: A systematic overview. Allergy 2018; 73:269-283. [PMID: 28718981 DOI: 10.1111/all.13254] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2017] [Indexed: 01/22/2023]
Abstract
BACKGROUND The European Academy of Allergy and Clinical Immunology (EAACI) is developing guidelines for allergen immunotherapy (AIT) for the management of allergic rhinitis, allergic asthma, IgE-mediated food allergy and venom allergy. To inform the development of clinical recommendations, we undertook systematic reviews to critically assess evidence on the effectiveness, safety and cost-effectiveness of AIT for these conditions. This study focusses on synthesizing data and gaps in the evidence on the cost-effectiveness of AIT for these conditions. METHODS We produced summaries of evidence in each domain, and then, synthesized findings on health economic data identified from four recent systematic reviews on allergic rhinitis, asthma, food allergy and venom allergy, respectively. The quality of these studies was independently assessed using the Critical Appraisal Skills Programme tool for health economic evaluations. RESULTS Twenty-three studies satisfied our inclusion criteria. Of these, 19 studies investigated the cost-effectiveness of AIT in allergic rhinitis, of which seven were based on data from randomized controlled trials with economic evaluations conducted from a health system perspective. This body of evidence suggested that sublingual immunotherapy (SLIT) and subcutaneous immunotherapy (SCIT) would be considered cost-effective using the (English) National Institute for Health and Clinical Excellence (NICE) cost-effectiveness threshold of £20 000/quality-adjusted life year (QALY). However, the quality of the studies and the general lack of attention to characterizing uncertainty and handling missing data should be taken into account when interpreting these results. For asthma, there were three eligible studies, all of which had significant methodological limitations; these suggested that SLIT, when used in patients with both asthma and allergic rhinitis, may be cost-effective with an incremental cost-effectiveness ratio (ICER) of £10 726 per QALY. We found one economic modelling study for venom allergy which, despite being based largely on expert opinion and plausible assumptions, suggested that AIT for bee and wasp venom allergy is only likely to be cost-effective for very high-risk groups who may be exposed to multiple exposures to venom/year (eg bee keepers). We found no eligible studies investigating the cost-effectiveness of AIT for food allergy. CONCLUSIONS Overall, the evidence to support the cost-effectiveness of AIT is limited and of low methodological quality, but suggests that AIT may be cost-effective for people with allergic rhinitis with or without asthma and in high-risk subgroups for venom allergy. We were unable to draw any conclusions on the cost-effectiveness of AIT for food allergy.
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Affiliation(s)
- M. Asaria
- Centre for Health Economics; University of York; York UK
| | - S. Dhami
- Evidence-Based Health Care Ltd; Edinburgh UK
| | - R. van Ree
- Departments of Experimental Immunology and of Otorhinolaryngology; Academic Medical Center; University of Amsterdam; Amsterdam The Netherlands
| | - R. Gerth van Wijk
- Section of Allergology; Department of Internal Medicine; Erasmus MC; Rotterdam The Netherlands
| | - A. Muraro
- Food Allergy Referral Centre Veneto Region; Department of Women and Child Health; Padua General University Hospital; Padua Italy
| | - G. Roberts
- The David Hide Asthma and Allergy Research Centre; St Mary's Hospital, Newport Isle of Wight; NIHR Southampton Biomedical Research Centre; University Hospital Southampton NHS Foundation Trust; Southampton UK
- University of Southampton; Southampton UK
| | - A. Sheikh
- Asthma UK; Centre for Applied Research; Usher Institute of Population Health Sciences and Informatics; The University of Edinburgh; Edinburgh UK
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30
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Pfaar O, Bonini S, Cardona V, Demoly P, Jakob T, Jutel M, Kleine-Tebbe J, Klimek L, Klysner S, Kopp MV, Kuna P, Larché M, Muraro A, Schmidt-Weber CB, Shamji MH, Simonsen K, Somoza C, Valovirta E, Zieglmayer P, Zuberbier T, Wahn U. Perspectives in allergen immunotherapy: 2017 and beyond. Allergy 2018; 73 Suppl 104:5-23. [PMID: 29171712 DOI: 10.1111/all.13355] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2017] [Indexed: 01/01/2023]
Abstract
The Future of the Allergists and Specific Immunotherapy (FASIT) workshop provides a regular platform for global experts from academia, allergy clinics, regulatory authorities and industry to review developments in the field of allergen immunotherapy (AIT). The most recent meeting, held in February 2017, had two main themes: advances in AIT and hot topics in AIT from the regulatory point of view. The first theme covered opportunities for personalized AIT, advances in adjuvants and delivery systems, and the development of new molecules and future vaccines for AIT. Key topics in the second part of the meeting were the effects of the enactment of European Directive 2001/83 on the availability of allergens for therapy and diagnosis across the EU, the challenges of conducting Phase 3 studies in the field, the future role of allergen exposure chambers in AIT studies and specific considerations in performing AIT studies in the paediatric population. Finally, the group highlighted the forthcoming EAACI guidelines and their particular importance for the standardization of practice in the treatment of allergies. This review presents a comprehensive insight into those panel discussions and highlights unmet needs and also possible solutions to them for the future.
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Affiliation(s)
- O. Pfaar
- Department of Otorhinolaryngology; Head and Neck Surgery; Universitätsmedizin Mannheim; Medical Faculty Mannheim; Heidelberg University; Mannheim Germany
- Center for Rhinology and Allergology; Wiesbaden Germany
| | - S. Bonini
- Italian National Research Council; Institute of Translational Pharmacology; Rome, and University of Campania ‘Luigi Vanvitelli’; Naples Italy
- Expert-on Secondment at the European Medicines Agency; London UK
| | - V. Cardona
- Hospital Vall D'Hebron, S. Allergologia, S. Medicina Interna; Barcelona Spain
| | - P. Demoly
- Departement de Pneumologie et Addictologie; Hopital Arnaud de Villeneuve; University Hospital of Montpellier; Montpellier France
| | - T. Jakob
- Department of Dermatology and Allergology; University Medical Center Giessen (UKGM); Justus-Liebig-University Giessen; Giessen Germany
- Allergy Research Group; Department of Dermatology; Medical Center - University Freiburg; Freiburg Germany
| | - M. Jutel
- Department of Clinical Immunology; Wroclaw Medical University; Wroclaw Poland
- All-Med Medical Research Institute; Wroclaw Poland
| | - J. Kleine-Tebbe
- Allergy & Asthma Center Westend; Outpatient Clinic and Clinical Research Center; Berlin Germany
| | - L. Klimek
- Center for Rhinology and Allergology; Wiesbaden Germany
| | - S. Klysner
- Expres ion Biotechnologies Aps; Hørsholm Denmark
| | - M. V. Kopp
- Department of Pediatric Allergy and Pulmonology; University of Luebeck; Luebeck Germany
- Airway Research Center North (ARCN); Member of the Deutsches Zentrum für Lungenforschung (DZL); Luebeck Germany
| | - P. Kuna
- Department of Internal Medicine, Asthma and Allergy; Barlicki University Hospital; Medical University of Lodz; Lodz Poland
| | - M. Larché
- Divisions of Clinical Immunology & Allergy, and Respirology; Department of Medicine and Firestone Institute for Respiratory Health; McMaster University; Hamilton ON Canada
| | - A. Muraro
- Food Allergy Referral Centre; Padua University Hospital; Padua Italy
| | - C. B. Schmidt-Weber
- Center of Allergy and Environment (ZAUM); Member of the German Center for Lung Research (DZL); Technical University of Munich and Helmholtz Center Munich; Munich Germany
| | - M. H. Shamji
- Immunomodulation and Tolerance Group; Allergy and Clinical Immunology; Inflammation Repair and Development; National Heart and Lung Institute; Imperial College; London UK
- MRC & Asthma UK Centre in Allergic Mechanisms of Asthma; London UK
| | | | - C. Somoza
- Biological Products and Biotechnology Division; Medicines for Human Use Department; Agencia Española de Medicamentos y Productos Sanitarios (AEMPS); Madrid Spain
| | - E. Valovirta
- Department of Lung Disease and Clinical Allergology; University of Turku and Terveystalo Allergy Clinic; Turku Finland
| | - P. Zieglmayer
- Allergy Center Vienna West; Vienna Challenge Chamber; Vienna Austria
| | - T. Zuberbier
- Comprehensive Allergy-Centre-Charité; Department of Dermatology and Allergy; Charité - Universitätsmedizin Berlin; Berlin Germany
- Member of Global Allergy and Asthma European Network (GA LEN); GA LEN coordinating Office; Charité - Universitätsmedizin Berlin; Germany
| | - U. Wahn
- Department for Pediatric Pneumology and Immunology; Charité - Universitätsmedizin Berlin; Berlin Germany
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Scuri M, Vestbo J, Papi A, Corradi M, Spinola M, Montagna I, Francisco C, Cohuet G, Vezzoli S, Muraro A, Petruzzelli S, Vesque D, Singh D. Comparaison de l’incidence des pneumonies et des exacerbations chez des patients BPCO traités par une triple association fixe : analyse post-hoc des études TRILOGY et TRINITY. Rev Mal Respir 2018. [DOI: 10.1016/j.rmr.2017.10.442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Scuri M, Singh D, Papi A, Corradi M, Montagna I, Francisco C, Cohuet G, Vezzoli S, Muraro A, Petruzzelli S, Vesque D, Vestbo J. Tolérance cardiovasculaire de la triple association fixe en particules extra-fines (béclométasone – DPB, formotérol – FF et glycopyrronium – GB – TRIMBOW ® ) dans la BPCO : résultats d’une analyse de tolérance des études TRILOGY et TRINITY. Rev Mal Respir 2018. [DOI: 10.1016/j.rmr.2017.10.441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Bonertz A, Roberts GC, Hoefnagel M, Timon M, Slater JE, Rabin RL, Bridgewater J, Pini C, Pfaar O, Akdis C, Goldstein J, Poulsen LK, van Ree R, Rhyner C, Barber D, Palomares O, Sheikh A, Pawankar R, Hamerlijnk D, Klimek L, Agache I, Angier E, Casale T, Fernandez‐Rivas M, Halken S, Jutel M, Lau S, Pajno G, Sturm G, Varga EM, Gerth van Wijk R, Bonini S, Muraro A, Vieths S. Challenges in the implementation of EAACI guidelines on allergen immunotherapy: A global perspective on the regulation of allergen products. Allergy 2018; 73:64-76. [PMID: 28771830 DOI: 10.1111/all.13266] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2017] [Indexed: 11/30/2022]
Abstract
Regulatory approaches for allergen immunotherapy (AIT) products and the availability of high-quality AIT products are inherently linked to each other. While allergen products are available in many countries across the globe, their regulation is very heterogeneous. First, we describe the regulatory systems applicable for AIT products in the European Union (EU) and in the United States (US). For Europe, a depiction of the different types of relevant procedures, as well as the committees involved, is provided and the fundamental role of national agencies of the EU member states in this complex and unique network is highlighted. Furthermore, the regulatory agencies from Australia, Canada, Japan, Russia, and Switzerland provided information on the system implemented in their countries for the regulation of allergen products. While AIT products are commonly classified as biological medicinal products, they are made available by varying types of procedures, most commonly either by obtaining a marketing authorization or by being distributed as named patient products. Exemptions from marketing authorizations in exceptional cases, as well as import of allergen products from other countries, are additional tools applied by countries to ensure availability of needed AIT products. Several challenges for AIT products are apparent from this analysis and will require further consideration.
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Affiliation(s)
| | - G. C. Roberts
- University of Southampton Southampton UK
- University Hospital Southampton NHS Foundation Trust Southampton UK
- David Hide Asthma and Allergy Research Centre Newport Isle of Wight UK
| | - M. Hoefnagel
- CBG‐MEB (Medicines Evaluation Board) Utrecht The Netherlands
| | - M. Timon
- Division of Biological Products, Advanced Therapies and Biotechnology Agencia Española de Medicamentos y Productos Sanitarios (AEMPS) Madrid Spain
| | - J. E. Slater
- US Food and Drug Administration Silver Spring MD USA
| | - R. L. Rabin
- US Food and Drug Administration Silver Spring MD USA
| | | | - C. Pini
- Istituto Superiore di Sanità Rome Italy
| | - O. Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery Medical Faculty Mannheim Universitätsmedizin Mannheim, Heidelberg University Mannheim Germany
- Center for Rhinology and Allergology Wiesbaden Germany
| | - C. Akdis
- Swiss Institute of Allergy and Asthma Research University Zurich Davos Switzerland
| | - J. Goldstein
- Division of Allergy, Immunology and Transplantation National Institute of Allergy and Infectious Diseases National Institutes of Health Bethesda MD USA
| | - L. K. Poulsen
- Allergy Clinic Copenhagen University Hospital at Gentofte Copenhagen Denmark
| | - R. van Ree
- Departments of Experimental Immunology and of Otorhinolaryngology Academic Medical Center University of Amsterdam Amsterdam The Netherlands
| | | | - D. Barber
- Universidad CEU San Pablo Madrid Spain
| | - O. Palomares
- Department of Biochemistry and Molecular Biology School of Chemistry Complutense University of Madrid (UCM) Madrid Spain
| | - A. Sheikh
- The University of Edinburgh Scotland UK
| | | | - D. Hamerlijnk
- Patient Advocacy Group Dutch Lung Foundation Amersfoort The Netherlands
| | - L. Klimek
- Center for Rhinology and Allergology Wiesbaden Germany
| | - I. Agache
- Department of Allergy and Clinical Immunology Faculty of Medicine Transylvania University Brasov Brasov Romania
| | - E. Angier
- Sheffield Teaching Hospital Sheffield UK
| | - T. Casale
- University of South Florida Tampa FL USA
| | | | - S. Halken
- Hans Christian Andersen Childrens Hospital Odense University Hospital Odense Denmark
| | - M. Jutel
- Poland and ALL‐MED Medical Research Institute Wroclaw Medical University Wrocław Poland
| | - S. Lau
- Department for Pediatric Pneumology and Immunology Charité Universitätsmedizin Berlin Germany
| | - G. Pajno
- Department of Pediatrics and Allergy Unit University of Messina Messina Italy
| | - G. Sturm
- Department of Dermatology and Venerology Medical University of Graz Austria
- Outpatient Allergy Clinic Reumannplatz Vienna Austria
| | | | | | - S. Bonini
- University of Campania Luigi Vanvitelli, IFT‐CNR Naples, Rome Italy
| | - A. Muraro
- Padua University Hospital Padua Italy
| | - S. Vieths
- Paul‐Ehrlich‐Institut Langen Germany
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Dhami S, Kakourou A, Asamoah F, Agache I, Lau S, Jutel M, Muraro A, Roberts G, Akdis CA, Bonini M, Cavkaytar O, Flood B, Gajdanowicz P, Izuhara K, Kalayci Ö, Mosges R, Palomares O, Pfaar O, Smolinska S, Sokolowska M, Asaria M, Netuveli G, Zaman H, Akhlaq A, Sheikh A. Allergen immunotherapy for allergic asthma: A systematic review and meta-analysis. Allergy 2017; 72:1825-1848. [PMID: 28543086 DOI: 10.1111/all.13208] [Citation(s) in RCA: 189] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND To inform the development of the European Academy of Allergy and Clinical Immunology's (EAACI) Guidelines on Allergen Immunotherapy (AIT) for allergic asthma, we assessed the evidence on the effectiveness, cost-effectiveness and safety of AIT. METHODS We performed a systematic review, which involved searching nine databases. Studies were screened against predefined eligibility criteria and critically appraised using established instruments. Data were synthesized using random-effects meta-analyses. RESULTS 98 studies satisfied the inclusion criteria. Short-term symptom scores were reduced with a standardized mean difference (SMD) of -1.11 (95% CI -1.66, -0.56). This was robust to a prespecified sensitivity analyses, but there was evidence suggestive of publication bias. Short-term medication scores were reduced SMD -1.21 (95% CI -1.87, -0.54), again with evidence of potential publication bias. There was no reduction in short-term combined medication and symptom scores SMD 0.17 (95% CI -0.23, 0.58), but one study showed a beneficial long-term effect. For secondary outcomes, subcutaneous immunotherapy (SCIT) improved quality of life and decreased allergen-specific airway hyperreactivity (AHR), but this was not the case for sublingual immunotherapy (SLIT). There were no consistent effects on asthma control, exacerbations, lung function, and nonspecific AHR. AIT resulted in a modest increased risk of adverse events (AEs). Although relatively uncommon, systemic AEs were more frequent with SCIT; however no fatalities were reported. The limited evidence on cost-effectiveness was mainly available for sublingual immunotherapy (SLIT) and this suggested that SLIT is likely to be cost-effective. CONCLUSIONS AIT can achieve substantial reductions in short-term symptom and medication scores in allergic asthma. It was however associated with a modest increased risk of systemic and local AEs. More data are needed in relation to secondary outcomes, longer-term effectiveness and cost-effectiveness.
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Affiliation(s)
- S. Dhami
- Evidence-Based Health Care Ltd; Edinburgh UK
| | - A. Kakourou
- Department of Hygiene and Epidemiology; University of Ioannina School of Medicine; Ioannina Greece
| | - F. Asamoah
- Centre for Environmental and Preventive Medicine; Wolfson Institute of Preventive Medicine Barts and the London School of Medicine and Dentistry; Queen Mary University of London; London UK
| | - I. Agache
- Faculty of Medicine; Department of Allergy and Clinical Immunology; Transylvania University Brasov; Brasov Romania
| | - S. Lau
- Department of Pediatric Pneumology and Immunology; Charité Universitätsmedizin; Berlin Germany
| | - M. Jutel
- Wroclaw Medical University; Wroclaw Poland
- ALL-MED Medical Research Institute; Wroclaw Poland
| | - A. Muraro
- Food Allergy Referral Centre Veneto Region; University Hospital of Padua; Padua Italy
| | - G. Roberts
- The David Hide Asthma and Allergy Research Centre; St Mary's Hospital; Newport UK
- NIHR Biomedical Research Centre; University Hospital Southampton NHS Foundation Trust; Southampton UK
- Faculty of Medicine; University of Southampton; Southampton UK
| | - C. A. Akdis
- Swiss Institute for Allergy and Asthma Research; Christine Kühne-Center for Allergy Research and Education (CK-CARE); Davos Switzerland
| | - M. Bonini
- National Heart and Lung Institute; Imperial College London; London UK
| | - O. Cavkaytar
- Department of Allergy and Clinical Immunology; Sami Ulus Women's & Children's Diseases Training and Research Hospital; Ankara Turkey
- Department of Pediatric Allergy and Immunology; Ulus Women's & Children's Diseases Training and Research Hospital; Ankara Turkey
| | - B. Flood
- European Federation of Allergy and Airways Diseases Patients Association; Brussels Belgium
| | | | | | | | - R. Mosges
- Institute of Medical Statistics, Informatics and Epidemiology (IMSIE); University of Cologne; Köln Germany
| | - O. Palomares
- Department of Biochemistry and Molecular Biology; Complutense University of Madrid; Madrid Spain
| | - O. Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery; Universitätsmedizin Mannheim; Medical Faculty Mannheim; Heidelberg University; Mannheim Germany
- Center for Rhinology and Allergology; Wiesbaden Germany
| | - S. Smolinska
- Wroclaw Medical University; Wroclaw Poland
- ALL-MED Medical Research Institute; Wroclaw Poland
| | - M. Sokolowska
- Swiss Institute for Allergy and Asthma Research; Christine Kühne-Center for Allergy Research and Education (CK-CARE); Davos Switzerland
| | - M. Asaria
- Centre for Health Economics; University of York; York UK
| | - G. Netuveli
- Institute for Health and Human Development; University of East London; London UK
| | - H. Zaman
- Bradford School of Pharmacy; Bradford UK
| | - A. Akhlaq
- Health and Hospital Management; Institute of Business Management; Karachi Pakistan
| | - A. Sheikh
- Asthma UK Centre for Applied Research; The University of Edinburgh; Edinburgh UK
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Bousquet J, Farrell J, Crooks G, Hellings P, Bel EH, Bewick M, Chavannes NH, de Sousa JC, Cruz AA, Haahtela T, Joos G, Khaltaev N, Malva J, Muraro A, Nogues M, Palkonen S, Pedersen S, Robalo-Cordeiro C, Samolinski B, Strandberg T, Valiulis A, Yorgancioglu A, Zuberbier T, Bedbrook A, Aberer W, Adachi M, Agusti A, Akdis CA, Akdis M, Ankri J, Alonso A, Annesi-Maesano I, Ansotegui IJ, Anto JM, Arnavielhe S, Arshad H, Bai C, Baiardini I, Bachert C, Baigenzhin AK, Barbara C, Bateman ED, Beghé B, Kheder AB, Bennoor KS, Benson M, Bergmann KC, Bieber T, Bindslev-Jensen C, Bjermer L, Blain H, Blasi F, Boner AL, Bonini M, Bonini S, Bosnic-Anticevitch S, Boulet LP, Bourret R, Bousquet PJ, Braido F, Briggs AH, Brightling CE, Brozek J, Buhl R, Burney PG, Bush A, Caballero-Fonseca F, Caimmi D, Calderon MA, Calverley PM, Camargos PAM, Canonica GW, Camuzat T, Carlsen KH, Carr W, Carriazo A, Casale T, Cepeda Sarabia AM, Chatzi L, Chen YZ, Chiron R, Chkhartishvili E, Chuchalin AG, Chung KF, Ciprandi G, Cirule I, Cox L, Costa DJ, Custovic A, Dahl R, Dahlen SE, Darsow U, De Carlo G, De Blay F, Dedeu T, Deleanu D, De Manuel Keenoy E, Demoly P, Denburg JA, Devillier P, Didier A, Dinh-Xuan AT, Djukanovic R, Dokic D, Douagui H, Dray G, Dubakiene R, Durham SR, Dykewicz MS, El-Gamal Y, Emuzyte R, Fabbri LM, Fletcher M, Fiocchi A, Fink Wagner A, Fonseca J, Fokkens WJ, Forastiere F, Frith P, Gaga M, Gamkrelidze A, Garces J, Garcia-Aymerich J, Gemicioğlu B, Gereda JE, González Diaz S, Gotua M, Grisle I, Grouse L, Gutter Z, Guzmán MA, Heaney LG, Hellquist-Dahl B, Henderson D, Hendry A, Heinrich J, Heve D, Horak F, Hourihane JOB, Howarth P, Humbert M, Hyland ME, Illario M, Ivancevich JC, Jardim JR, Jares EJ, Jeandel C, Jenkins C, Johnston SL, Jonquet O, Julge K, Jung KS, Just J, Kaidashev I, Khaitov MR, Kalayci O, Kalyoncu AF, Keil T, Keith PK, Klimek L, Koffi N’Goran B, Kolek V, Koppelman GH, Kowalski ML, Kull I, Kuna P, Kvedariene V, Lambrecht B, Lau S, Larenas-Linnemann D, Laune D, Le LTT, Lieberman P, Lipworth B, Li J, Lodrup Carlsen K, Louis R, MacNee W, Magard Y, Magnan A, Mahboub B, Mair A, Majer I, Makela MJ, Manning P, Mara S, Marshall GD, Masjedi MR, Matignon P, Maurer M, Mavale-Manuel S, Melén E, Melo-Gomes E, Meltzer EO, Menzies-Gow A, Merk H, Michel JP, Miculinic N, Mihaltan F, Milenkovic B, Mohammad GMY, Molimard M, Momas I, Montilla-Santana A, Morais-Almeida M, Morgan M, Mösges R, Mullol J, Nafti S, Namazova-Baranova L, Naclerio R, Neou A, Neffen H, Nekam K, Niggemann B, Ninot G, Nyembue TD, O’Hehir RE, Ohta K, Okamoto Y, Okubo K, Ouedraogo S, Paggiaro P, Pali-Schöll I, Panzner P, Papadopoulos N, Papi A, Park HS, Passalacqua G, Pavord I, Pawankar R, Pengelly R, Pfaar O, Picard R, Pigearias B, Pin I, Plavec D, Poethig D, Pohl W, Popov TA, Portejoie F, Potter P, Postma D, Price D, Rabe KF, Raciborski F, Radier Pontal F, Repka-Ramirez S, Reitamo S, Rennard S, Rodenas F, Roberts J, Roca J, Rodriguez Mañas L, Rolland C, Roman Rodriguez M, Romano A, Rosado-Pinto J, Rosario N, Rosenwasser L, Rottem M, Ryan D, Sanchez-Borges M, Scadding GK, Schunemann HJ, Serrano E, Schmid-Grendelmeier P, Schulz H, Sheikh A, Shields M, Siafakas N, Sibille Y, Similowski T, Simons FER, Sisul JC, Skrindo I, Smit HA, Solé D, Sooronbaev T, Spranger O, Stelmach R, Sterk PJ, Sunyer J, Thijs C, To T, Todo-Bom A, Triggiani M, Valenta R, Valero AL, Valia E, Valovirta E, Van Ganse E, van Hage M, Vandenplas O, Vasankari T, Vellas B, Vestbo J, Vezzani G, Vichyanond P, Viegi G, Vogelmeier C, Vontetsianos T, Wagenmann M, Wallaert B, Walker S, Wang DY, Wahn U, Wickman M, Williams DM, Williams S, Wright J, Yawn BP, Yiallouros PK, Yusuf OM, Zaidi A, Zar HJ, Zernotti ME, Zhang L, Zhong N, Zidarn M, Mercier J. Erratum to: Scaling up strategies of the chronic respiratory disease programme of the European Innovation Partnership on Active and Healthy Ageing (Action Plan B3: Area 5). Clin Transl Allergy 2017; 7:5. [PMID: 28239450 PMCID: PMC5319069 DOI: 10.1186/s13601-016-0135-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 11/29/2016] [Indexed: 11/10/2022] Open
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Dhami S, Nurmatov U, Arasi S, Khan T, Asaria M, Zaman H, Agarwal A, Netuveli G, Roberts G, Pfaar O, Muraro A, Ansotegui IJ, Calderon M, Cingi C, Durham S, Wijk RG, Halken S, Hamelmann E, Hellings P, Jacobsen L, Knol E, Larenas‐Linnemann D, Lin S, Maggina P, Mösges R, Oude Elberink H, Pajno G, Panwankar R, Pastorello E, Penagos M, Pitsios C, Rotiroti G, Timmermans F, Tsilochristou O, Varga E, Schmidt‐Weber C, Wilkinson J, Williams A, Worm M, Zhang L, Sheikh A. Allergen immunotherapy for allergic rhinoconjunctivitis: A systematic review and meta-analysis. Allergy 2017; 72:1597-1631. [PMID: 28493631 DOI: 10.1111/all.13201] [Citation(s) in RCA: 186] [Impact Index Per Article: 26.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND The European Academy of Allergy and Clinical Immunology (EAACI) is in the process of developing Guidelines on Allergen Immunotherapy (AIT) for Allergic Rhinoconjunctivitis. To inform the development of clinical recommendations, we undertook a systematic review to assess the effectiveness, cost-effectiveness, and safety of AIT in the management of allergic rhinoconjunctivitis. METHODS We searched nine international biomedical databases for published, in-progress, and unpublished evidence. Studies were independently screened by two reviewers against predefined eligibility criteria and critically appraised using established instruments. Our primary outcomes of interest were symptom, medication, and combined symptom and medication scores. Secondary outcomes of interest included cost-effectiveness and safety. Data were descriptively summarized and then quantitatively synthesized using random-effects meta-analyses. RESULTS We identified 5960 studies of which 160 studies satisfied our eligibility criteria. There was a substantial body of evidence demonstrating significant reductions in standardized mean differences (SMD) of symptom (SMD -0.53, 95% CI -0.63, -0.42), medication (SMD -0.37, 95% CI -0.49, -0.26), and combined symptom and medication (SMD -0.49, 95% CI -0.69, -0.30) scores while on treatment that were robust to prespecified sensitivity analyses. There was in comparison a more modest body of evidence on effectiveness post-discontinuation of AIT, suggesting a benefit in relation to symptom scores. CONCLUSIONS AIT is effective in improving symptom, medication, and combined symptom and medication scores in patients with allergic rhinoconjunctivitis while on treatment, and there is some evidence suggesting that these benefits are maintained in relation to symptom scores after discontinuation of therapy.
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Toigo V, Piovan R, Dal Bello S, Gaio E, Luchetta A, Pasqualotto R, Zaccaria P, Bigi M, Chitarin G, Marcuzzi D, Pomaro N, Serianni G, Agostinetti P, Agostini M, Antoni V, Aprile D, Baltador C, Barbisan M, Battistella M, Boldrin M, Brombin M, Dalla Palma M, De Lorenzi A, Delogu R, De Muri M, Fellin F, Ferro A, Finotti C, Fiorentin A, Gambetta G, Gnesotto F, Grando L, Jain P, Maistrello A, Manduchi G, Marconato N, Moresco M, Ocello E, Pavei M, Peruzzo S, Pilan N, Pimazzoni A, Recchia M, Rizzolo A, Rostagni G, Sartori E, Siragusa M, Sonato P, Sottocornola A, Spada E, Spagnolo S, Spolaore M, Taliercio C, Valente M, Veltri P, Zamengo A, Zaniol B, Zanotto L, Zaupa M, Boilson D, Graceffa J, Svensson L, Schunke B, Decamps H, Urbani M, Kushwah M, Chareyre J, Singh M, Bonicelli T, Agarici G, Masiello A, Paolucci F, Simon M, Bailly-Maitre L, Bragulat E, Gomez G, Gutierrez D, Mico G, Moreno JF, Pilard V, Kashiwagi M, Hanada M, Tobari H, Watanabe K, Maeshima T, Kojima A, Umeda N, Yamanaka H, Chakraborty A, Baruah U, Rotti C, Patel H, Nagaraju M, Singh N, Patel A, Dhola H, Raval B, Fantz U, Heinemann B, Kraus W, Hanke S, Hauer V, Ochoa S, Blatchford P, Chuilon B, Xue Y, De Esch H, Hemsworth R, Croci G, Gorini G, Rebai M, Muraro A, Cavenago M, D'Arienzo M, Sandri S. A substantial step forward in the realization of the ITER HNB system: The ITER NBI Test Facility. Fusion Engineering and Design 2017. [DOI: 10.1016/j.fusengdes.2016.11.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Hellings PW, Klimek L, Cingi C, Agache I, Akdis C, Bachert C, Bousquet J, Demoly P, Gevaert P, Hox V, Hupin C, Kalogjera L, Manole F, Mösges R, Mullol J, Muluk NB, Muraro A, Papadopoulos N, Pawankar R, Rondon C, Rudenko M, Seys SF, Toskala E, Van Gerven L, Zhang L, Zhang N, Fokkens WJ. Non-allergic rhinitis: Position paper of the European Academy of Allergy and Clinical Immunology. Allergy 2017; 72:1657-1665. [PMID: 28474799 DOI: 10.1111/all.13200] [Citation(s) in RCA: 139] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2017] [Indexed: 12/11/2022]
Abstract
This EAACI position paper aims at providing a state-of-the-art overview on nonallergic rhinitis (NAR). A significant number of patients suffering from persistent rhinitis are defined as nonallergic noninfectious rhinitis (NANIR) patients, often denominated in short as having NAR. NAR is defined as a symptomatic inflammation of the nasal mucosa with the presence of a minimum of two nasal symptoms such as nasal obstruction, rhinorrhea, sneezing, and/or itchy nose, without clinical evidence of endonasal infection and without systemic signs of sensitization to inhalant allergens. Symptoms of NAR may have a wide range of severity and be either continuously present and/or induced by exposure to unspecific triggers, also called nasal hyperresponsiveness (NHR). NHR represents a clinical feature of both AR and NAR patients. NAR involves different subgroups: drug-induced rhinitis, (nonallergic) occupational rhinitis, hormonal rhinitis (including pregnancy rhinitis), gustatory rhinitis, senile rhinitis, and idiopathic rhinitis (IR). NAR should be distinguished from those rhinitis patients with an allergic reaction confined to the nasal mucosa, also called "entopy" or local allergic rhinitis (LAR). We here provide an overview of the current consensus on phenotypes of NAR, recommendations for diagnosis, a treatment algorithm, and defining the unmet needs in this neglected area of research.
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Affiliation(s)
- P. W. Hellings
- Clinical division of Otorhinolaryngology Head & Neck Surgery University Hospitals Leuven Leuven Belgium
- Laboratory of Clinical Immunology Department of Microbiology and Immunology KU Leuven Leuven Belgium
| | - L. Klimek
- Center for Rhinology and Allergology Wiesbaden Germany
| | - C. Cingi
- Department of Otorhinolaryngology Head and Neck Surgery University of Eskisehir Osmangazi Eskisehir Turkey
| | - I. Agache
- Department of Allergy and Clinical Immunology Transylvania University Brasov Romania
| | - C. Akdis
- Swiss Institute of Allergy and Asthma Research Christine Kuhne-Center for Allergy Research and Education University of Zurich Davos Switzerland
| | - C. Bachert
- Upper Airway Research Laboratory Ghent University Hospital Ghent Belgium
| | - J. Bousquet
- Hôpital Arnaud de Villeneuve University Hospital of Montpellier Montpellier France
| | - P. Demoly
- Hôpital Arnaud de Villeneuve University Hospital of Montpellier Montpellier France
| | - P. Gevaert
- Upper Airway Research Laboratory Ghent University Hospital Ghent Belgium
| | - V. Hox
- Service d'ORL Cliniques Universitaires St-Luc Brussels Belgium
| | - C. Hupin
- Service d'ORL Cliniques Universitaires St-Luc Brussels Belgium
- Institut de Recherche Expérimentale et Clinique (IREC) Pole de Pneumologie, ORL & Dermatologie Université catholique de Louvain (UCL) Brussels Belgium
| | - L. Kalogjera
- Department of Otorhinolaryngology and Head and Neck Surgery University Hospital Sestre milosrdnice Zagreb Croatia
| | - F. Manole
- ENT Department Faculty of Medicine University of Oradea Oradea Romania
| | - R. Mösges
- Institute of Medical Statistics, Informatics, and Epidemiology Medical Faculty University of Köln Cologne Germany
| | - J. Mullol
- Unitat de Rinologia i Clinica de l'Olfacte, Servei d'Otorinolaringologia Hospital Clínic Barcelona Catalonia Spain
| | - N. B. Muluk
- ENT Department Faculty of Medicine Kirikkale University Kirikkale Turkey
| | - A. Muraro
- The Referral Centre for Food Allergy Diagnosis and Treatment Veneto Region Department of Mother and Child Health University of Padua Padua Italy
| | - N. Papadopoulos
- Allergy Department 2nd Pediatric Clinic University of Athens Athens Greece
- University of Manchestter Manchester UK
| | | | - C. Rondon
- Allergy Service Carlos Haya Hospital Malaga Spain
| | - M. Rudenko
- London Allergyology and Immunology Center London UK
| | - S. F. Seys
- Laboratory of Clinical Immunology Department of Microbiology and Immunology KU Leuven Leuven Belgium
| | - E. Toskala
- Department of Otorhinolaryngology-Head and Neck Surgery Temple University Philadelphia USA
| | - L. Van Gerven
- Clinical division of Otorhinolaryngology Head & Neck Surgery University Hospitals Leuven Leuven Belgium
- Laboratory of Clinical Immunology Department of Microbiology and Immunology KU Leuven Leuven Belgium
| | - L. Zhang
- Department of Otolaryngology Head and Neck Surgery Beijing Tongren Hospital Capital Medical University Beijing China
| | - N. Zhang
- Upper Airway Research Laboratory Ghent University Hospital Ghent Belgium
| | - W. J. Fokkens
- Department of Otorhinolaryngology Head & Neck Surgery Academic Medical Centre (AMC) Amsterdam The Netherlands
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Hellings PW, Fokkens WJ, Bachert C, Akdis CA, Bieber T, Agache I, Bernal-Sprekelsen M, Canonica GW, Gevaert P, Joos G, Lund V, Muraro A, Onerci M, Zuberbier T, Pugin B, Seys SF, Bousquet J. Positioning the principles of precision medicine in care pathways for allergic rhinitis and chronic rhinosinusitis - A EUFOREA-ARIA-EPOS-AIRWAYS ICP statement. Allergy 2017; 72:1297-1305. [PMID: 28306159 DOI: 10.1111/all.13162] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2017] [Indexed: 12/20/2022]
Abstract
Precision medicine (PM) is increasingly recognized as the way forward for optimizing patient care. Introduced in the field of oncology, it is now considered of major interest in other medical domains like allergy and chronic airway diseases, which face an urgent need to improve the level of disease control, enhance patient satisfaction and increase effectiveness of preventive interventions. The combination of personalized care, prediction of treatment success, prevention of disease and patient participation in the elaboration of the treatment plan is expected to substantially improve the therapeutic approach for individuals suffering from chronic disabling conditions. Given the emerging data on the impact of patient stratification on treatment outcomes, European and American regulatory bodies support the principles of PM and its potential advantage over current treatment strategies. The aim of the current document was to propose a consensus on the position and gradual implementation of the principles of PM within existing adult treatment algorithms for allergic rhinitis (AR) and chronic rhinosinusitis (CRS). At the time of diagnosis, prediction of success of the initiated treatment and patient participation in the decision of the treatment plan can be implemented. The second-level approach ideally involves strategies to prevent progression of disease, in addition to prediction of success of therapy, and patient participation in the long-term therapeutic strategy. Endotype-driven treatment is part of a personalized approach and should be positioned at the tertiary level of care, given the efforts needed for its implementation and the high cost of molecular diagnosis and biological treatment.
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Affiliation(s)
- P. W. Hellings
- Department of Otorhinolaryngology-Head and Neck Surgery; UZ Leuven; Leuven Belgium
- Department of Otorhinolaryngology; Academic Medical Center; Amsterdam The Netherlands
- Department of Otorhinolaryngology-Head and Neck Surgery; Upper Airways Research Laboratory; Ghent University; Ghent Belgium
| | - W. J. Fokkens
- Department of Otorhinolaryngology; Academic Medical Center; Amsterdam The Netherlands
| | - C. Bachert
- Department of Otorhinolaryngology-Head and Neck Surgery; Upper Airways Research Laboratory; Ghent University; Ghent Belgium
- Department of Otorhinolaryngology; Karolinska Institute; Stockholm Sweden
| | - C. A. Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF); Christine-Kühne Center for Allergy Research and Education; University of Zurich; Davos Switzerland
| | - T. Bieber
- Department of Dermatology and Allergy; Christine Kühne-Center for Allergy Research and Education; Friedrich-Wilhelms-University; Bonn Germany
| | - I. Agache
- Faculty of Medicine; Transylvania University; Brasov Romania
| | - M. Bernal-Sprekelsen
- Department of Otorhinolaryngology; Hospital Clínic Universitari; Barcelona Spain
| | - G. W. Canonica
- Department of Biomedical Science; Personalized Medicine Clinic Asthma & Allergy; Humanitas Clinical and Research Center; Humanitas University - Rozzano (Milano); Rozzano Italy
| | - P. Gevaert
- Department of Otorhinolaryngology-Head and Neck Surgery; Upper Airways Research Laboratory; Ghent University; Ghent Belgium
| | - G. Joos
- Department of Respiratory Medicine; Ghent University; Ghent Belgium
| | - V. Lund
- Royal National Throat, Nose and Ear Hospital; University College London Hospitals; London UK
| | - A. Muraro
- Department of Women and Child Health; Food Allergy Referral Centre Veneto Region; Padua General University Hospital; Padua Italy
| | - M. Onerci
- Department of Otorhinolaryngology Head and Neck Surgery; Hacettepe University Faculty of Medicine; Ankara Turkey
| | - T. Zuberbier
- Department of Dermatology and Allergy; Comprehensive Allergy-Centre-Charité; Charité-Universitätsmedizin Berlin; Berlin Germany
| | - B. Pugin
- European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA); Brussels Belgium
| | - S. F. Seys
- European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA); Brussels Belgium
- Department of Immunology and Microbiology; Laboratory of Clinical Immunology; KU Leuven; Leuven Belgium
| | - J. Bousquet
- Department of Respiratory Disease; University Hospital Arnaud de Villeneuve; Montpellier France
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40
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Bousquet J, Agache I, Aliberti MR, Angles R, Annesi-Maesano I, Anto JM, Arnavielhe S, Asayag E, Bacci E, Bedbrook A, Bachert C, Baroni I, Barreto BA, Bedolla-Barajas M, Bergmann KC, Bertorello L, Bewick M, Bieber T, Birov S, Bindslev-Jensen C, Blua A, Bochenska Marciniak M, Bogus-Buczynska I, Bosnic-Anticevich S, Bosse I, Bourret R, Bucca C, Buonaiuto R, Burguete Cabanas MT, Caillaud D, Caimmi DP, Caiazza D, Camargos P, Canfora G, Cardona V, Carriazo AM, Cartier C, Castellano G, Chavannes NH, Cecci L, Ciaravolo MM, Cingi C, Ciceran A, Colas L, Colgan E, Coll J, Conforti D, Correia de Sousa J, Cortés-Grimaldo RM, Corti F, Costa E, Courbis AL, Cousein E, Cruz AA, Custovic A, Cvetkovski B, Dario C, da Silva J, Dauvilliers Y, De Blay F, Dedeu T, De Feo G, De Martino B, Demoly P, De Vries G, Di Capua Ercolano S, Di Carluccio N, Doulapsi M, Dray G, Dubakiene R, Eller E, Emuzyte R, Espinoza-Contreras JG, Estrada-Cardona A, Farrell J, Farsi A, Ferrero J, Fokkens WJ, Fonseca J, Fontaine JF, Forti S, Gálvez-Romero JL, García-Cobas CI, Garcia Cruz MH, Gemicioğlu B, Gerth van Wijk R, Guidacci M, Gómez-Vera J, Guldemond NA, Gutter Z, Haahtela T, Hajjam J, Hellings PW, Hernández-Velázquez L, Illario M, Ivancevich JC, Jares E, Joos G, Just J, Kalayci O, Kalyoncu AF, Karjalainen J, Keil T, Khaltaev N, Klimek L, Kritikos V, Kull I, Kuna P, Kvedariene V, Kolek V, Krzych-Fałta E, Kupczyk M, Lacwik P, La Grutta S, Larenas-Linnemann D, Laune D, Lauri D, Lavrut J, Lessa M, Levato G, Lewis L, Lieten I, Lipiec A, Louis R, Luna-Pech JA, Magnan A, Malva J, Maspero JF, Matta-Campos JJ, Mayora O, Medina-Ávalos MA, Melén E, Menditto E, Millot-Keurinck J, Moda G, Morais-Almeida M, Mösges R, Mota-Pinto A, Mullol J, Muraro A, Murray R, Noguès M, Nalin M, Napoli L, Neffen H, O'Hehir RE, Onorato GL, Palkonen S, Papadopoulos NG, Passalacqua G, Pépin JL, Pereira AM, Persico M, Pfaar O, Pozzi AC, Prokopakis E, Pugin B, Raciborski F, Rimmer J, Rizzo JA, Robalo-Cordeiro C, Rodríguez-González M, Rolla G, Roller-Wirnsberger RE, Romano A, Romano M, Romano MR, Salimäki J, Samolinski B, Serpa FS, Shamai S, Sierra M, Sova M, Sorlini M, Stellato C, Stelmach R, Strandberg T, Stroetmann V, Stukas R, Szylling A, Tan R, Tibaldi V, Todo-Bom A, Toppila-Salmi S, Tomazic P, Trama U, Triggiani M, Valero A, Valovirta E, Valiulis A, van Eerd M, Vasankari T, Vatrella A, Ventura MT, Verissimo MT, Viart F, Williams S, Wagenmann M, Wanscher C, Westman M, Wickman M, Young I, Yorgancioglu A, Zernotti E, Zuberbier T, Zurkuhlen A, De Oliviera B, Senn A. Transfer of innovation on allergic rhinitis and asthma multimorbidity in the elderly (MACVIA-ARIA) - EIP on AHA Twinning Reference Site (GARD research demonstration project). Allergy 2017; 73:77-92. [PMID: 28600902 DOI: 10.1111/all.13218] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2017] [Indexed: 01/10/2023]
Abstract
The overarching goals of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) are to enable European citizens to lead healthy, active and independent lives whilst ageing. The EIP on AHA includes 74 Reference Sites. The aim of this study was to transfer innovation from an app developed by the MACVIA-France EIP on AHA reference site (Allergy Diary) to other reference sites. The phenotypic characteristics of rhinitis and asthma multimorbidity in adults and the elderly will be compared using validated information and communication technology (ICT) tools (i.e. the Allergy Diary and CARAT: Control of Allergic Rhinitis and Asthma Test) in 22 Reference Sites or regions across Europe. This will improve the understanding, assessment of burden, diagnosis and management of rhinitis in the elderly by comparison with an adult population. Specific objectives will be: (i) to assess the percentage of adults and elderly who are able to use the Allergy Diary, (ii) to study the phenotypic characteristics and treatment over a 1-year period of rhinitis and asthma multimorbidity at baseline (cross-sectional study) and (iii) to follow-up using visual analogue scale (VAS). This part of the study may provide some insight into the differences between the elderly and adults in terms of response to treatment and practice. Finally (iv) work productivity will be examined in adults.
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Affiliation(s)
- J 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.,VIMA, INSERM U 1168, VIMA: Ageing and Chronic Diseases, Epidemiological and Public Health Approaches, Villejuif, France.,Université Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny le Bretonneux, France
| | - I Agache
- Faculty of Medicine, Transylvania University, Brasov, Romania
| | | | - R Angles
- Innovación y nuevas tecnologías, Salud Sector sanitario de Barbastro, Barbastro, Spain
| | - I Annesi-Maesano
- EPAR U707 INSERM, Paris, France.,EPAR UMR-S UPMC, Paris VI, Paris, France
| | - J M Anto
- ISGLoBAL, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,IMIM (Hospital del Mar Research Institute), Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | | | - E Asayag
- Argentine Society of Allergy and Immunopathology, Buenos Aires, Argentina
| | - E Bacci
- Regione Liguria, Genoa, Italy
| | - A Bedbrook
- MACVIA-France, Contre les MAladies Chroniques pour un VIeillissement Actif en France European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France
| | - C Bachert
- Upper Airways Research Laboratory, ENT Department, Ghent University Hospital, Ghent, Belgium
| | | | | | - M Bedolla-Barajas
- Hospital Civil de Guadalajara Dr. Juan I. Menchaca, Guadalarara, Mexico
| | - K C Bergmann
- Comprehensive Allergy-Centre-Charité, Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany.,Global Allergy and Asthma European Network (GA2LEN), Berlin, Germany
| | | | - M Bewick
- iQ4U Consultants Ltd, London, UK
| | - T Bieber
- Department of Dermatology and Allergy, Rheinische Friedrich-Wilhelms-University, Bonn, Germany
| | - S Birov
- Empirica Communication and Technology Research, Bonn, Germany
| | - C Bindslev-Jensen
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark
| | - A Blua
- Argentine Association of Respiratory Medicine, Buenos Aires, Argentina
| | - M Bochenska Marciniak
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - I Bogus-Buczynska
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - S Bosnic-Anticevich
- Woolcock Institute of Medical Research, University of Sydney and Sydney Local Health District, Glebe, NSW, Australia
| | - I Bosse
- Allergist, La Rochelle, France
| | - R Bourret
- Centre Hospitalier Valenciennes, Valenciennes, France
| | - C Bucca
- Chief of the University Pneumology Unit- AOU Molinette, Hospital City of Health and Science of Torino, Torino, Italy
| | - R Buonaiuto
- Pharmacist of COFASER - Consorzio Farmacie Servizi-Salerno, Salerno, Italy
| | | | - D Caillaud
- Service de pneumologie, CHU et université d'Auvergne, Clermont-Ferrand, France
| | - D P Caimmi
- Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France
| | - D Caiazza
- Pharmacist of COFASER - Consorzio Farmacie Servizi-Salerno, Salerno, Italy
| | - P Camargos
- Department of Pediatrics, Medical School, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - G Canfora
- Mayor of Sarno and President of Salerno Province, Anesthesiology Service, Sarno "Martiri del Villa Malta" Hospital, Sarno, Italy
| | - V Cardona
- S. Allergologia, S. Medicina Interna, Hospital Vall d'Hebron, Barcelona, Spain
| | - A M Carriazo
- Regional Ministry of Health of Andalusia, Seville, Spain
| | - C Cartier
- ASA - Advanced Solutions Accelerator, Clapiers, France
| | | | - N H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - L Cecci
- S.O.S Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy
| | | | - C Cingi
- ENT Department, Medical Faculty, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - A Ciceran
- Argentine Federation of Otorhinolaryngology Societies, Buenos Aires, Argentina
| | - L Colas
- Service de Pneumologie, UMR INSERM, UMR1087and CNR 6291, l'institut du thorax, University of Nantes, Nantes, France
| | - E Colgan
- Department of Health, Social Services and Public Safety, Belfast, UK
| | - J Coll
- Innovación y nuevas tecnologías, Salud Sector sanitario de Barbastro, Barbastro, Spain
| | - D Conforti
- Fondazione Bruno Kessler (FBK), Trento, Italy
| | - J Correia de Sousa
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
| | | | - F Corti
- FIMMG (Federazione Italiana Medici di Medicina Generale), Milan, Italy
| | - E Costa
- UCIBIO, REQYULTE, Faculty of Pharmacy and Competence Center on Active and Healthy Ageing of University of Porto (AgeUPNetWork), Porto, Portugal
| | | | - E Cousein
- Vice Président de la CME - Centre Hospitalier, Valenciennes, France
| | - A A Cruz
- ProAR - Nucleo de Excelencia em Asma, Federal University of Bahia, Bahia, Brazil.,GARD/WHO Executive Committee and Federal University of Bahia, Bahia, Brazil
| | - A Custovic
- Department of Pediatric, Imperial College London, London, UK
| | - B Cvetkovski
- Woolcock Institute of Medical Research, University of Sydney and Sydney Local Health District, Glebe, NSW, Australia
| | - C Dario
- Azienda Provinciale per i Servizi Sanitari di Trento (APSS-Trento), Trento, Italy
| | - J da Silva
- Allergy Service, University Hospital of Federal University of Santa Catarina (HU-UFSC), Florianópolis, Brazil
| | - Y Dauvilliers
- Sleep Unit, Department of Neurology, Hôpital Gui-de-Chauliac Montpellier, Inserm U1061, Montpellier, France
| | - F De Blay
- Allergy Division, Chest Disease Department, University Hospital of Strasbourg, Strasbourg, France
| | - T Dedeu
- AQuAS, Barcelona, Spain & EUREGHA, European Regional and Local Health Association, Brussels, Belgium
| | - G De Feo
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | | | - P Demoly
- Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France
| | - G De Vries
- Peercode DV, Gerdermalsen, The Netherlands
| | | | - N Di Carluccio
- Pharmacist of COFASER - Consorzio Farmacie Servizi-Salerno, Salerno, Italy
| | - M Doulapsi
- Department of Otolaryngology, University of Crete School of Medicine, Heraklion, Greece
| | - G Dray
- Ecole des Mines, Alès, France
| | - R Dubakiene
- Medical Faculty, Vilnius University, Vilnius, Lithuania
| | - E Eller
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark
| | - R Emuzyte
- Clinic of Children's Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | | | | | - J Farrell
- Department of Health, Social Services and Public Safety, Belfast, UK
| | - A Farsi
- S.O.S Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy
| | - J Ferrero
- Andalusian Agency for Healthcare Quality, Seville, Spain
| | - W J Fokkens
- Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, The Netherlands
| | - J Fonseca
- Center for Health Technology and Services Research- CINTESIS, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.,Allergy Unit, CUF Porto Instituto & Hospital, Porto, Portugal
| | | | - S Forti
- Fondazione Bruno Kessler (FBK), Trento, Italy
| | | | | | - M H Garcia Cruz
- Allergy Clinic, National Institute of Respiratory Diseases, Mexico City, Mexico
| | - B Gemicioğlu
- Department of Pulmonary Diseases, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - R Gerth van Wijk
- Department of Internal Medicine, Section of Allergology, Erasmus MC, Rotterdam, The Netherlands
| | - M Guidacci
- Member of the Brazilian Society of Pediatrics and Society of Immunization, Representative of GINA (Global Initiative Against Asthma), Brasilia, Brazil
| | - J Gómez-Vera
- Allergy Clinic, Hospital Regional del ISSSTE 'Lic. López Mateos', Mexico City, Mexico
| | - N A Guldemond
- Institute of Health Policy and Management iBMG, Erasmus University, Rotterdam, The Netherlands
| | - Z Gutter
- University Hospital Olomouc - National eHealth Centre, Olomouk, Czech Republic
| | - T Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - J Hajjam
- Centich: centre d'expertise national des technologies de l'information et de la communication pour l'autonomie, Gérontopôle autonomie longévité des Pays de la Loire, Conseil régional des Pays de la Loire, Centre d'expertise Partenariat Européen d'Innovation pour un vieillissement actif et en bonne santé, Nantes, France
| | - P W Hellings
- Laboratory of Clinical Immunology, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | | | - M Illario
- Division for Health Innovation, Campania Region and Federico II University Hospital Naples (R&D and DISMET), Naples, Italy
| | - J C Ivancevich
- Servicio de Alergia e Immunologia, Clinica Santa Isabel, Buenos Aires, Argentina
| | - E Jares
- Libra Foundation, Buenos Aires, Argentina
| | - G Joos
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - J Just
- Allergology Department, Centre de l'Asthme et des Allergies, Hôpital d'Enfants Armand-Trousseau (APHP, Paris), Paris, France.,Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Equipe EPAR, Paris, France
| | - O Kalayci
- Pediatric Allergy and Asthma Unit, Hacettepe University School of Medicine, Ankara, Turkey
| | - A F Kalyoncu
- Immunology and Allergy Division, Department of Chest Diseases, School of Medicine, Hacettepe University, Ankara, Turkey
| | - J Karjalainen
- Allergy Centre, Tampere University Hospital, Tampere, Finland
| | - T Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, and Institute for Clinical Epidemiology and Biometry, University of Wuerzburg, Wuerzburg, Germany
| | | | - L Klimek
- Center for Rhinology and Allergology, Wiesbaden, Germany
| | - V Kritikos
- Woolcock Institute of Medical Research, University of Sydney and Sydney Local Health District, Glebe, NSW, Australia
| | - I Kull
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - P Kuna
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - V Kvedariene
- Clinic of Infectious, Chest Diseases, Dermatology and Allergology, Vilnius University, Vilnius, Lithuania
| | - V Kolek
- Department of Respiratory Medicine, Faculty of Medicine and Dentistry, University Hospital, Olomouc, Czech Republic
| | - E Krzych-Fałta
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - M Kupczyk
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - P Lacwik
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - S La Grutta
- Institute of Biomedicine and Molecular Immunology (IBIM), National Research Council (CNR), Palermo, Italy
| | - D Larenas-Linnemann
- Clínica de Alergia, Asma y Pediatría, Hospital Médica Sur, México City, Mexico
| | | | - D Lauri
- Presidente CMMC, Milano, Italy
| | - J Lavrut
- Head of the Allergy Department of Pedro de Elizalde Children's Hospital, Buenos Aires, Argentina
| | - M Lessa
- Faculdade de Medicina da Universidade Federal da Bahia, Salvador de Bahia, Brazil
| | | | - L Lewis
- Promotor B3 Action GRoup EIP on AHA and Senior Fellow, International Foundation for Integreted Care, Aberystwyth, UK
| | - I Lieten
- Tech Life Valley, Diepenbeek, Belgium
| | - A Lipiec
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - R Louis
- Department of Pulmonary Medicine, CHU Sart-Tilman, Liege, Belgium
| | | | - A Magnan
- Service de Pneumologie, UMR INSERM, UMR1087and CNR 6291, l'institut du thorax, University of Nantes, Nantes, France
| | - J Malva
- Faculty of Medicine, Institute of Biomedical Imaging and Life Sciences (IBILI), University of Coimbra, Coimbra, Portugal.,Ageing@Coimbra EIP-AHA Reference Site, Coimbra, Portugal
| | - J F Maspero
- Argentine Association of Allergy and Clinical Immunology, Buenos Aires, Argentina
| | | | - O Mayora
- Fondazione Bruno Kessler (FBK), Trento, Italy
| | | | - E Melén
- Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm and Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - E Menditto
- CIRFF, Federico II University, Naples, Italy
| | - J Millot-Keurinck
- Caisse d'assurance retraite et de la santé au travail du Languedoc-Roussillon (CARSAT-LR), Montpellier, France
| | - G Moda
- Regione Piemonte, Torino, Italy
| | - M Morais-Almeida
- Allergy and Clinical Immunology Department, Hospital CUF-Descobertas, Lisboa, Portugal
| | - R Mösges
- Institute of Medical Statistics, Informatics and Epidemiology, Medical Faculty, University of Cologne, Cologne, Germany
| | - A Mota-Pinto
- Ageing@Coimbra EIP-AHA Reference Site, Coimbra, Portugal.,Laboratory of General Pathology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Institute of Biomedical Imaging and Life Sciences (IBILI), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - J Mullol
- Clinical & Experimental Respiratory Immunoallergy, ENT Department, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - A Muraro
- Department of Women and Child Health, Food Allergy Referral Centre Veneto Region, Padua General University Hospital, Padua, Italy
| | - R Murray
- MedScript Ltd, Dundalk, Co. Louth, Ireland
| | - M Noguès
- Caisse d'assurance retraite et de la santé au travail du Languedoc-Roussillon (CARSAT-LR), Montpellier, France
| | | | - L Napoli
- Consortium of Pharmacies and Services COSAFER, Salerno, Italy
| | - H Neffen
- Head of Respiratory Medicine, Alassia Children's Hospital, Center for Allergy and Immunology, Santa Fe, Argentina
| | - R E O'Hehir
- Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Central Clinical School, Monash University, Melbourne, Vic., Australia
| | - G L Onorato
- MACVIA-France, Contre les MAladies Chroniques pour un VIeillissement Actif en France European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France
| | - S Palkonen
- EFA European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium
| | - N G Papadopoulos
- Center for Pediatrics and Child Health, Institute of Human Development, Royal Manchester Children's Hospital, University of Manchester, Manchester, UK.,Allergy Department, 2nd Pediatric Clinic, Athens General Children's Hospital "P&A Kyriakou", University of Athens, Athens, Greece
| | - G Passalacqua
- Allergy and Respiratory Diseases, IRCCS San Martino Hospital-IST-University of Genoa, Genoa, Italy
| | - J L Pépin
- Department of Pneumology, CHU Grenoble, Grenoble, France
| | - A M Pereira
- Allergy Unit, CUF-Porto Hospital and Institute, Center for Research in Health Technologies and Information Systems, CINTESIS, Universidade do Porto, Porto, Portugal
| | - M Persico
- Sociologist, Municipality, Sorrento, Italy
| | - O Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Center for Rhinology and Allergology, Wiesbaden, Germany
| | - A C Pozzi
- Vice-Presidente of IML, Milano, Italy
| | - E Prokopakis
- Department of Otolaryngology, University of Crete School of Medicine, Heraklion, Greece
| | - B Pugin
- Laboratory of Clinical Immunology, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - F Raciborski
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - J Rimmer
- Woolcock Institute of Medical Research, University of Sydney and Sydney Local Health District, Glebe, NSW, Australia
| | | | - C Robalo-Cordeiro
- Centre of Pneumology, Coimbra University Hospital, Coimbra, Portugal
| | | | - G Rolla
- Regione Piemonte, Torino, Italy
| | | | - A Romano
- Allergy Unit, Presidio Columbus, Rome, Catholic University of Sacred Heart, Rome, Italy.,IRCCS Oasi Maria S.S., Troina, Italy
| | | | | | - J Salimäki
- Association of Finnish Pharmacists, Helsinki, Finland
| | - B Samolinski
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | | | - S Shamai
- Institute of Medical Statistics, Informatics and Epidemiology, Medical Faculty, University of Cologne, Cologne, Germany
| | - M Sierra
- Innovación y nuevas tecnologías, Salud Sector sanitario de Barbastro, Barbastro, Spain
| | - M Sova
- Departement of Internal Medicine, University Hospital, Olomouc, Czech Republic
| | - M Sorlini
- IML (Lombardy Medical Initiative), Bergamo, Italy
| | - C Stellato
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | - R Stelmach
- Pulmonary Division, Heart Institute (InCor), Hospital da Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - T Strandberg
- Center for Life Course Health Research, Helsinki University Hospital, Helsinki University, University of Oulu, Oulu, Finland
| | - V Stroetmann
- Empirica Communication and Technology Research, Bonn, Germany
| | - R Stukas
- Public Health Institute of Vilnius University, Vilnius, Lithuania
| | - A Szylling
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - R Tan
- Woolcock Institute of Medical Research, University of Sydney and Sydney Local Health District, Glebe, NSW, Australia
| | | | - A Todo-Bom
- Imunoalergologia, Centro Hospitalar Universitário de Coimbra and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - S Toppila-Salmi
- Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - P Tomazic
- Department of ENT, Medical University of Graz, Graz, Austria
| | - U Trama
- Division on Pharmacy and Devices Policy, Campania Region, Naples, Italy
| | - M Triggiani
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | - A Valero
- Pneumology and Allergy Department, Hospital Clínic, Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, University of Barcelona, Barcelona, Spain
| | - E Valovirta
- Department of Lung Diseases and Clinical Allergology, University of Turku, Turku, Finland.,Allergy Clinic, Terveystalo, Turku, Finland
| | - A Valiulis
- Vilnius University Clinic of Children's Diseases and Public Health Institute, Vilnius, Lithuania.,European Academy of Paediatrics (EAP/UEMS-SP), Brussels, Belgium
| | - M van Eerd
- Peercode DV, Gerdermalsen, The Netherlands
| | - T Vasankari
- FILHA, Finnish Lung Association, Helsinki, Finland
| | - A Vatrella
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | - M T Ventura
- Unit of Geriatric Immunoallergology, University of Bari Medical School, Bari, Italy
| | - M T Verissimo
- Faculty of Medicine, Institute of Biomedical Imaging and Life Sciences (IBILI), University of Coimbra, Coimbra, Portugal.,Ageing@Coimbra EIP-AHA Reference Site, Coimbra, Portugal
| | - F Viart
- ASA - Advanced Solutions Accelerator, Clapiers, France
| | - S Williams
- International Primary Care Respiratory Group IPCRG, Aberdeen, UK
| | - M Wagenmann
- Department of Otorhinolaryngology, HNO-Klinik, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - C Wanscher
- EIP on AHA Coordinator, Region of Southern Denmark, Odense, Denmark
| | - M Westman
- Department of Medicine Solna, Immunology and Allergy Unit, Karolinska Institutet and Department of ENT Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - M Wickman
- Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm and Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - I Young
- Queen's University, Belfast, UK
| | - A Yorgancioglu
- Celal Bayar University Department of Pulmonology, GARD Executive Committee, Manisa, Turkey
| | - E Zernotti
- Universidad Católica de Córdoba, Córdoba, Argentina
| | - T Zuberbier
- Comprehensive Allergy-Centre-Charité, Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany.,Global Allergy and Asthma European Network (GA2LEN), Berlin, Germany
| | - A Zurkuhlen
- Gesundheitsregion KölnBonn - HRCB Projekt GmbH, Kohln, Germany
| | | | - A Senn
- EC-CNECT-H2, European Commission, Brussels, Belgium
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Nurmatov U, Dhami S, Arasi S, Pajno GB, Fernandez-Rivas M, Muraro A, Roberts G, Akdis C, Alvaro-Lozano M, Beyer K, Bindslev-Jensen C, Burks W, du Toit G, Ebisawa M, Eigenmann P, Knol E, Makela M, Nadeau KC, O'Mahony L, Papadopoulos N, Poulsen LK, Sackesen C, Sampson H, Santos AF, van Ree R, Timmermans F, Sheikh A. Allergen immunotherapy for IgE-mediated food allergy: a systematic review and meta-analysis. Allergy 2017; 72:1133-1147. [PMID: 28058751 DOI: 10.1111/all.13124] [Citation(s) in RCA: 276] [Impact Index Per Article: 39.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND The European Academy of Allergy and Clinical Immunology (EAACI) is developing Guidelines for Allergen Immunotherapy (AIT) for IgE-mediated Food Allergy. To inform the development of clinical recommendations, we sought to critically assess evidence on the effectiveness, safety and cost-effectiveness of AIT in the management of food allergy. METHODS We undertook a systematic review and meta-analysis that involved searching nine international electronic databases for randomized controlled trials (RCTs) and nonrandomized studies (NRS). Eligible studies were independently assessed by two reviewers against predefined eligibility criteria. The quality of studies was assessed using the Cochrane Risk of Bias tool for RCTs and the Cochrane ACROBAT-NRS tool for quasi-RCTs. Random-effects meta-analyses were undertaken, with planned subgroup and sensitivity analyses. RESULTS We identified 1814 potentially relevant papers from which we selected 31 eligible studies, comprising of 25 RCTs and six NRS, studying a total of 1259 patients. Twenty-five trials evaluated oral immunotherapy (OIT), five studies investigated sublingual immunotherapy, and one study evaluated epicutaneous immunotherapy. The majority of these studies were in children. Twenty-seven studies assessed desensitization, and eight studies investigated sustained unresponsiveness postdiscontinuation of AIT. Meta-analyses demonstrated a substantial benefit in terms of desensitization (risk ratio (RR) = 0.16, 95% CI 0.10, 0.26) and suggested, but did not confirm sustained unresponsiveness (RR = 0.29, 95% CI 0.08, 1.13). Only one study reported on disease-specific quality of life (QoL), which reported no comparative results between OIT and control group. Meta-analyses revealed that the risk of experiencing a systemic adverse reaction was higher in those receiving AIT, with a more marked increase in the risk of local adverse reactions. Sensitivity analysis excluding those studies judged to be at high risk of bias demonstrated the robustness of summary estimates of effectiveness and safety of AIT for food allergy. None of the studies reported data on health economic analyses. CONCLUSIONS AIT may be effective in raising the threshold of reactivity to a range of foods in children with IgE-mediated food allergy whilst receiving (i.e. desensitization) and post-discontinuation of AIT. It is, however, associated with a modest increased risk in serious systemic adverse reactions and a substantial increase in minor local adverse reactions. More data are needed in relation to adults, long term effects, the impact on QoL and the cost-effectiveness of AIT.
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Affiliation(s)
- U. Nurmatov
- Division of Population Medicine Neuadd Meirionnydd; School of Medicine; Cardiff University; Cardiff UK
| | - S. Dhami
- Evidence-Based Health Care Ltd; Edinburgh UK
| | - S. Arasi
- Department of Pediatrics; Allergy Unit; University of Messina; Messina Italy
- Molecular Allergology and Immunomodulation-Department of Pediatric Pneumology and Immunology; Charité Medical University; Berlin Germany
| | - G. B. Pajno
- Department of Pediatrics; Allergy Unit; University of Messina; Messina Italy
| | | | - A. Muraro
- Department of Women and Child Health; Food Allergy Referral Centre Veneto Region; Padua General University Hospital; Padua Italy
| | - G. Roberts
- The David Hide Asthma and Allergy Research Centre; St Mary's Hospital, Newport; Isle of WIght UK
- NIHR Respiratory Biomedial Research Unit and Faculty of Medicine; University of Southampton; Southampton UK
| | - C. Akdis
- Swiss Institute for Allergy and Asthma Research; Davos Platz Switzerland
| | - M. Alvaro-Lozano
- Paediatric Allergy and Clinical Immunology Section; Hospital Sant Joan de Déu; Universitat de Barcelona; Barcelona Spain
| | - K. Beyer
- Pediatric Pneumology and Immunology; Charité Universitätsmedizin; Berlin Germany
- Icahn School of Medicine at Mount Sinai; New York NY USA
| | - C. Bindslev-Jensen
- Department of Dermatology and Allergy Centre; Odense University Hospital; Odense Denmark
| | - W. Burks
- Department of Pediatrics; School of Medicine; University of North Carolina at Chapel Hill; Chapel Hill NC USA
| | - G. du Toit
- Department of Paediatric Allergy; Division of Asthma, Allergy and Lung Biology; MRC & Asthma Centre in Allergic Mechanisms of Asthma; King's College London; St Thomas NHS Foundation Trust; London UK
| | - M. Ebisawa
- Department of Allergy; Clinical Research Center for Allergy & Rheumatology; Sagamihara National Hospital; Sagamihara Kanagawa Japan
| | - P. Eigenmann
- University Hospitals of Geneva and Medical School of the University of Geneva; Geneva Switzerland
| | - E. Knol
- Department of Immunology and Department of Dermatology & Allergology; University Medical Center; Utrecht The Netherlands
| | - M. Makela
- Skin and Allergy Hospital; Helsinki University Hospital; Helsinki Finland
| | - K. C. Nadeau
- Department of Pediatrics; Division of Immunology, Allergy and Rheumatology; Stanford University; Stanford CA USA
| | - L. O'Mahony
- Swiss Institute of Allergy and Asthma Research (SIAF); University of Zurich; Davos Switzerland
| | - N. Papadopoulos
- Department of Allergy; 2nd Pediatric Clinic; University of Athens; Athens Greece
| | - L. K. Poulsen
- Department of Allergy Clinic; Copenhagen University Hospital; Gentofte Denmark
| | - C. Sackesen
- Department of Pediatric Allergist; Koç University Hospital; İstanbul Turkey
| | - H. Sampson
- World Allergy Organization (WAO); Mount Sinai Hospital NY, USA
| | - A. F. Santos
- Department of Paediatric Allergy; Division of Asthma, Allergy and Lung Biology; King's College London; Guy's and St Thomas’ Hospital NHS Foundation Trust; London UK
| | - R. van Ree
- Department of Otorhinolaryngology; Academic Medical Center; Amsterdam The Netherlands
| | - F. Timmermans
- Nederlands Anafylaxis Netwerk - European Anaphylaxis Taskforce; Dordrecht The Netherlands
| | - A. Sheikh
- Allergy and Respiratory Research Group; Centre of Medical Informatics; Usher Institute of Population Health Sciences and Informatics; The University of Edinburgh; Edinburgh UK
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Muraro A, Lemanske RF, Castells M, Torres MJ, Khan D, Simon HU, Bindslev-Jensen C, Burks W, Poulsen LK, Sampson HA, Worm M, Nadeau KC. Precision medicine in allergic disease-food allergy, drug allergy, and anaphylaxis-PRACTALL document of the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma and Immunology. Allergy 2017; 72:1006-1021. [PMID: 28122115 DOI: 10.1111/all.13132] [Citation(s) in RCA: 113] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2017] [Indexed: 12/30/2022]
Abstract
This consensus document summarizes the current knowledge on the potential for precision medicine in food allergy, drug allergy, and anaphylaxis under the auspices of the PRACTALL collaboration platform. PRACTALL is a joint effort of the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma and Immunology, which aims to synchronize the European and American approaches to allergy care. Precision medicine is an emerging approach for disease treatment based on disease endotypes, which are phenotypic subclasses associated with specific mechanisms underlying the disease. Although significant progress has been made in defining endotypes for asthma, definitions of endotypes for food and drug allergy or for anaphylaxis lag behind. Progress has been made in discovery of biomarkers to guide a precision medicine approach to treatment of food and drug allergy, but further validation and quantification of these biomarkers are needed to allow their translation into practice in the clinical management of allergic disease.
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Affiliation(s)
- A. Muraro
- Food Allergy Referral Centre Veneto Region; Department of Women and Child Health; Padua General University Hospital; Padua Italy
| | - R. F. Lemanske
- Department of Pediatrics; University of Wisconsin School of Medicine and Public Health; Madison WI USA
| | - M. Castells
- Drug Hypersensitivity and Desensitization Center; Brigham & Women's Hospital; Harvard Medical School; Boston MA USA
| | - M. J. Torres
- Allergy Unit; Regional University Hospital of Malaga-IBIMA; UMA; Malaga Spain
| | - D. Khan
- Division of Allergy & Immunology; Department of Internal Medicine; University of Texas Southwestern Medical Center; Dallas TX USA
| | - H.-U. Simon
- Institute of Pharmacology; University of Bern; Bern Switzerland
| | - C. Bindslev-Jensen
- Department of Dermatology and Allergy Centre; Odense Research Center for Anaphylaxis (ORCA); Odense University Hospital; Odense Denmark
| | - W. Burks
- Department of Pediatrics; University of North Carolina; Chapel Hill NC USA
| | - L. K. Poulsen
- Allergy Clinic; Copenhagen University Hospital at Gentofte Hospital; Copenhagen Denmark
| | - H. A. Sampson
- Icahn School of Medicine at Mount Sinai; New York NY USA
| | - M. Worm
- Klinik für Dermatologie; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - K. C. Nadeau
- Department of Medicine; Stanford University School of Medicine; Stanford CA USA
- Sean N. Parker Center for Allergy and Asthma Research; Stanford University School of Medicine; Stanford CA USA
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43
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Polloni L, DunnGalvin A, Ferruzza E, Bonaguro R, Lazzarotto F, Toniolo A, Celegato N, Muraro A. Coping strategies, alexithymia and anxiety in young patients with food allergy. Allergy 2017; 72:1054-1060. [PMID: 27886387 DOI: 10.1111/all.13097] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2016] [Indexed: 12/16/2022]
Abstract
BACKGROUND Food allergy is major public health concern affecting nearly 15 million Americans and 80 million Europeans. Risk of anaphylaxis and implications for social activities affect patients' quality of life and psychological well-being. We previously found that young patients reported higher levels of alexithymia (difficulty in recognizing and expressing emotions) compared with healthy peers and may influence affect, management style and clinical outcomes. This study aimed to explore links between coping strategies, alexithymia and anxiety among food-allergic adolescents and young adults. METHODS Ninety-two patients with IgE-mediated food allergy (mean age 18.6 years) completed Coping Orientation to Problems Experienced Inventory, Toronto Alexithymia Scale and Trait Anxiety subscale of State-Trait Anxiety Inventory. Multivariate analyses of variance assessed differences and associations between subgroups on the scales. RESULTS Significant differences found between alexithymia levels in coping style were explained by Avoidance strategies. 'Avoidance' had the highest contribution in explaining alexithymia, followed by trait anxiety, age, anaphylaxis and social support. Respondents with higher alexithymia use avoidance as coping strategy over and above other coping strategies such as problem-solving and positive thinking, are younger, will have experienced anaphylaxis and will have lower social support. CONCLUSIONS Recognizing the specific role of affect regulation in health behaviours may constitute an important step in supporting patients to explore more adaptive strategies.
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Affiliation(s)
- L. Polloni
- Food Allergy Referral Centre for Diagnosis and Treatment; Veneto Region; Department of Woman and Child Health; Padua University Hospital; Padua Italy
| | - A. DunnGalvin
- School of Applied Psychology; University College Cork; Cork City Ireland
- Department of Paediatrics and Child Health; Cork University Hospital; Cork City Ireland
| | - E. Ferruzza
- Department of Developmental Psychology and Socialization; University of Padua; Padua Italy
| | - R. Bonaguro
- Food Allergy Referral Centre for Diagnosis and Treatment; Veneto Region; Department of Woman and Child Health; Padua University Hospital; Padua Italy
| | - F. Lazzarotto
- Food Allergy Referral Centre for Diagnosis and Treatment; Veneto Region; Department of Woman and Child Health; Padua University Hospital; Padua Italy
| | - A. Toniolo
- Food Allergy Referral Centre for Diagnosis and Treatment; Veneto Region; Department of Woman and Child Health; Padua University Hospital; Padua Italy
| | - N. Celegato
- Food Allergy Referral Centre for Diagnosis and Treatment; Veneto Region; Department of Woman and Child Health; Padua University Hospital; Padua Italy
| | - A. Muraro
- Food Allergy Referral Centre for Diagnosis and Treatment; Veneto Region; Department of Woman and Child Health; Padua University Hospital; Padua Italy
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Cingi C, Gevaert P, Mösges R, Rondon C, Hox V, Rudenko M, Muluk NB, Scadding G, Manole F, Hupin C, Fokkens WJ, Akdis C, Bachert C, Demoly P, Mullol J, Muraro A, Papadopoulos N, Pawankar R, Rombaux P, Toskala E, Kalogjera L, Prokopakis E, Hellings PW, Bousquet J. Multi-morbidities of allergic rhinitis in adults: European Academy of Allergy and Clinical Immunology Task Force Report. Clin Transl Allergy 2017; 7:17. [PMID: 28572918 PMCID: PMC5452333 DOI: 10.1186/s13601-017-0153-z] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 05/12/2017] [Indexed: 12/14/2022] Open
Abstract
This report has been prepared by the European Academy of Allergy and Clinical Immunology Task Force on Allergic Rhinitis (AR) comorbidities. The aim of this multidisciplinary European consensus document is to highlight the role of multimorbidities in the definition, classification, mechanisms, recommendations for diagnosis and treatment of AR, and to define the needs in this neglected area by a literature review. AR is a systemic allergic disease and is generally associated with numerous multi-morbid disorders, including asthma, eczema, food allergies, eosinophilic oesophagitis (EoE), conjunctivitis, chronic middle ear effusions, rhinosinusitis, adenoid hypertrophy, olfaction disorders, obstructive sleep apnea, disordered sleep and consequent behavioural and educational effects. This report provides up-to-date usable information to: (1) improve the knowledge and skills of allergists, so as to ultimately improve the overall quality of patient care; (2) to increase interest in this area; and (3) to present a unique contribution to the field of upper inflammatory disease.
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Affiliation(s)
- C Cingi
- Department of Otorhinolaryngology, Eskisehir Osmangazi University School of Medicine, Eskisehir, Turkey
| | - P Gevaert
- Upper Airway Research Laboratory, Ghent University Hospital, Ghent, Belgium
| | - R Mösges
- Institute of Medical Statistics, Informatics, and Epidemiology, Medical Faculty, University of Köln, Cologne, Germany
| | - C Rondon
- Allergy Unit, IBIMA, Regional University Hospital of Malaga, UMA, Malaga, Spain
| | - V Hox
- Clinical division of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Louvain, Belgium
| | - M Rudenko
- London Allergy and Immunology Centre, London, UK
| | - N B Muluk
- ENT Department, Faculty of Medicine, Kirikkale University, Kirikkale, Turkey
| | - G Scadding
- Royal National Throat, Nose and Ear Hospital, London, UK
| | - F Manole
- Faculty of Medicine, ENT Department, University of Oradea, Oradea, Romania
| | - C Hupin
- Institut de Recherche Expérimentale et Clinique (IREC), Pole de Pneumologie, ORL & Dermatologie, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - W J Fokkens
- Department of Otorhinolaryngology, Head and Neck Surgery, Academic Medical Centre (AMC), Amsterdam, The Netherlands
| | - C Akdis
- Christine Kuhne-Center for Allergy Research and Education, Swiss Institute of Allergy and Asthma Research, University of Zurich, Davos, Switzerland
| | - C Bachert
- Upper Airway Research Laboratory, Ghent University Hospital, Ghent, Belgium
| | - P Demoly
- Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, Montpellier, France
| | - J Mullol
- Unitat de Rinologia i Clinica de l'Olfacte, Servei d'Otorinolaringologia, Hospital Clínic, Barcelona, Catalonia Spain
| | - A Muraro
- The Referral Centre for Food Allergy Diagnosis and Treatment Veneto Region, Department of Mother and Child Health, University of Padua, Padua, Italy
| | - N Papadopoulos
- Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece
| | | | - P Rombaux
- Service d'ORL, Cliniques Universitaires St-Luc, Brussels, Belgium
| | - E Toskala
- Department of Otorhinolaryngology-Head and Neck Surgery, Temple University, Philadelphia, PA USA
| | - L Kalogjera
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Sestre milosrdnice, Zagreb, Croatia
| | - E Prokopakis
- Department of Otorhinolaryngology, University Hospital of Crete, Crete, Greece
| | - P W Hellings
- Clinical division of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Louvain, Belgium
| | - J Bousquet
- Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, Montpellier, France
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45
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Bousquet J, Caimmi DP, Bedbrook A, Bewick M, Hellings PW, Devillier P, Arnavielhe S, Bachert C, Bergmann KC, Canonica GW, Chavannes N, Cruz AA, Dahl R, Demoly P, De Vries G, Mathieu-Dupas E, Finkwagner A, Fonseca J, Guldemond N, Haahtela T, Hellqvist-Dahl B, Just J, Keil T, Klimek L, Kowalski ML, Kuitunen M, Kuna P, Kvedariene V, Laune D, Pereira AM, Carreiro-Martins P, Melén E, Morais-Almeida M, Mullol J, Muraro A, Murray R, Nogueira-Silva L, Papadopoulos NG, Passalacqua G, Portejoie F, Price D, Ryan D, Samolinski B, Sheikh A, Siroux V, Spranger O, Todo Bom A, Tomazic PV, Valero A, Valovirta E, Valiulis A, VandenPlas O, van der Meulen S, van Eerd M, Wickman M, Zuberbier T. Pilot study of mobile phone technology in allergic rhinitis in European countries: the MASK-rhinitis study. Allergy 2017; 72:857-865. [PMID: 28072463 DOI: 10.1111/all.13125] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2017] [Indexed: 01/08/2023]
Abstract
BACKGROUND The use of Apps running on smartphones and tablets profoundly affects medicine. The MASK-rhinitis (MACVIA-ARIA Sentinel NetworK for allergic rhinitis) App (Allergy Diary) assesses allergic rhinitis symptoms, disease control and impact on patients' lives. It is freely available in 20 countries (iOS and Android platforms). AIMS To assess in a pilot study whether (i) Allergy Diary users were able to properly provide baseline characteristics (ii) simple phenotypic characteristics based upon data captured by the Allergy Diary could be identified and (iii) information gathered by this study could suggest novel research questions. METHODS The Allergy Diary users were classified into six groups according to the baseline data that they entered into the App: (i) asymptomatic; (ii) nasal symptoms excluding rhinorrhea; (iii) rhinorrhea; (iv) rhinorrhea plus 1-2 nasal/ocular symptoms; (v) rhinorrhea plus ≥3 nasal/ocular symptoms; and (vi) rhinorrhea plus all nasal/ocular symptoms. RESULTS By 1 June 2016, 3260 users had registered with the Allergy Diary and 2710 had completed the baseline questionnaire. Troublesome symptoms were found mainly in the users with the most symptoms. Around 50% of users with troublesome rhinitis and/or ocular symptoms suffered work impairment. Sleep was impaired by troublesome symptoms and nasal obstruction. CONCLUSIONS This is the first App (iOS and Android) to have tested for allergic rhinitis and conjunctivitis. A simple questionnaire administered by cell phones enables the identification of phenotypic differences between a priori defined rhinitis groups. The results suggest novel concepts and research questions in allergic rhinitis that may not be identified using classical methods.
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Affiliation(s)
- J. Bousquet
- MACVIA-LR; Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon; 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, and UVSQ, UMR-S 1168; Université Versailles St-Quentin-en-Yvelines; Yvelines France
| | - D. P. Caimmi
- CHRU de Montpellier; UPMC Paris 06, UMR-S 1136; IPLESP, Equipe EPAR; Sorbonne Universités; Paris France
- Department of Respiratory Diseases; Montpellier University Hospital; Montpellier France
| | - A. Bedbrook
- MACVIA-LR; Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon; European Innovation Partnership on Active and Healthy Ageing Reference Site; Montpellier France
| | | | - P. W. Hellings
- Department of Microbiology and Immunology; Laboratory of Clinical Immunology; KU Leuven; Leuven Belgium
| | - P. Devillier
- Laboratoire de Pharmacologie Respiratoire UPRES EA220; Pôle des Maladies Respiratoires; Hôpital Foch; Suresnes Université Versailles Saint-Quentin; Versailles France
| | | | - C. Bachert
- ENT Department; Upper Airways Research Laboratory; Ghent University Hospital; Ghent Belgium
| | - K. C. Bergmann
- Department of Dermatology and Allergy; Comprehensive Allergy-Centre-Charité; Charité - Universitätsmedizin Berlin; Berlin Germany
- Global Allergy and Asthma European Network (GA LEN); Berlin Germany
| | - G. W. Canonica
- Allergy and Respiratory Diseases Clinic; DIMI; University of Genoa; IRCCS AOU San Martino-IST; Genoa Italy
| | - N.H. Chavannes
- Department of Public Health and Primary Care; Leiden University Medical Center; Leiden The Netherlands
| | - A. A. Cruz
- ProAR - Nucleo de Excelencia em Asma; Federal University of Bahia; Salvador Brasil
- GARD Executive Committee; Geneva Switzerland
| | - R. Dahl
- ProAR - Nucleo de Excelencia em Asma; Federal University of Bahia; Salvador Brasil
- GARD Executive Committee; Geneva Switzerland
| | - P. Demoly
- CHRU de Montpellier; UPMC Paris 06, UMR-S 1136; IPLESP, Equipe EPAR; Sorbonne Universités; Paris France
- Department of Respiratory Diseases; Montpellier University Hospital; Montpellier France
| | | | | | - A. Finkwagner
- Global Allergy and Asthma Platform GAAPP; Vienna Austria
| | - J. Fonseca
- Center for Health Technology and Services Research - CINTESIS; Faculdade de Medicina; Universidade do Porto; Porto Portugal
- Allergy Unit; CUF Porto Instituto & Hospital; Porto Portugal
| | - N. Guldemond
- Institute of Health Policy and Management iBMG - Erasmus Universit; Rotterdam The Netherlands
| | - T. Haahtela
- Skin and Allergy Hospital; Helsinki University Hospital; Helsinki Finland
| | - B. Hellqvist-Dahl
- Department of Respiratory Diseases; Odense University Hospital; Odense Denmark
| | - J. Just
- Allergology Department; Centre de l'Asthme et des Allergies Hôpital d'Enfants Armand-Trousseau (APHP); UPMC Univ Paris 06; UMR_S 1136; Institut Pierre Louis d'Epidémiologie et de Santé Publique; Equipe EPAR; Sorbonne Universités; Paris France
| | - T. Keil
- Institute of Social Medicine, Epidemiology and Health Economics; Charité -Universitätsmedizin Berlin; Berlin Germany
- Institute for Clinical Epidemiology and Biometry; University of Wuerzburg; Wuerzburg Germany
| | - L. Klimek
- Center for Rhinology and Allergology; Wiesbaden Germany
| | - M. L. Kowalski
- Department of Immunology, Rheumatology and Allergy; Healthy Ageing Reseach Centre (HARC); Medical University of Lodz; Lodz Poland
| | - M. Kuitunen
- Children's Hospital; University of Helsinki and University Hospital of Helsinki; Helsinki Finland
| | - P. Kuna
- Division of Internal Medicine, Asthma and Allergy; Barlicki University Hospital; Medical University of Lodz; Lodz Poland
| | - V. Kvedariene
- Clinic of Infectious, Chest Diseases, Dermatology and Allergology; Vilnius University; Vilnius Lithuania
| | | | - A. M. Pereira
- Center for Health Technology and Services Research - CINTESIS; Faculdade de Medicina; Universidade do Porto; Porto Portugal
- Allergy Unit; CUF Porto Instituto & Hospital; Porto Portugal
| | - P. Carreiro-Martins
- CEDOC; Respiratory Research Group; Nova Medical School; Campo dos Martires da Patria; Lisbon Portugal
- Serviço de Imunoalergologia; Hospital de Dona Estefânia; Centro Hospitalar de Lisboa Central, EPE; Lisbon Portugal
| | - E. Melén
- Sachs’ Children and Youth Hospital; Södersjukhuset; Stockholm Sweden
- Institute of Environmental Medicine; Karolinska Institutet; Stockholm Sweden
| | - M. Morais-Almeida
- Allergy and Clinical Immunology Department; Hospital CUF-Descobertas; Lisboa Portugal
| | - J. Mullol
- ENT Department; Hospital Clinic; Clinical & Experimental Respiratory Immunoallergy; IDIBAPS; CIBERES; Universitat de Barcelona; Barcelona Catalonia Spain
| | - A. Muraro
- Department of Women and Child Health; Food Allergy Referral Centre Veneto Region; Padua General University Hospital; Padua Italy
| | - R. Murray
- Medical Communications Consultant; MedScript Ltd; Dundalk Co Louth Ireland
| | - L. Nogueira-Silva
- Center for Health Technology and Services Research - CINTESIS; Porto Portugal
- Department of Internal Medicine; Centro Hospitalar Sao Joao; Porto Portugal
| | - N. G. Papadopoulos
- Center for Pediatrics and Child Health; Institute of Human Development; Royal Manchester Children's Hospital; University of Manchester; Manchester UK
- Allergy Department; 2nd Pediatric Clinic; Athens General Children's Hospital “P&A Kyriakou”; University of Athens; Athens Greece
| | - G. Passalacqua
- Allergy and Respiratory Diseases Clinic; DIMI; University of Genoa; IRCCS AOU San Martino-IST; Genoa Italy
| | - F. Portejoie
- MACVIA-LR; Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon; European Innovation Partnership on Active and Healthy Ageing Reference Site; Montpellier France
| | - D. Price
- Observational and Pragmatic Research Institute; Singapore and Academic Centre of Primary Care; University of Aberdeen; Aberdeen UK
| | - D. Ryan
- Honorary Clinical Research Fellow; Allergy and Respiratory Research Group; The University of Edinburgh; Edinburgh UK
| | - B. Samolinski
- Department of Prevention of Environmental Hazards and Allergology; Medical University of Warsaw; Warsaw Poland
| | - A. Sheikh
- Centre of Medical Informatics; Usher Institute of Population Health Sciences and Informatics; The University of Edinburgh; Edinburgh UK
| | - V. Siroux
- INSERM; Université Grenoble Alpes; IAB, U 1209; Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health; Université Joseph Fourier; Grenoble France
| | - O. Spranger
- Global Allergy and Asthma Platform GAAPP; Vienna Austria
| | - A. Todo Bom
- Imunoalergologia; Centro Hospitalar Universitario de Coimbra and Faculty of Medicine; University of Coimbra; Coimbra Portugal
| | - P. V. Tomazic
- Medical University of Graz; ENT University Hospital Graz; Graz Austria
| | - A. Valero
- Pneumology and Allergy Department; CIBERES and Clinical & Experimental Respiratory Immunoallergy; IDIBAPS; Universitat de Barcelona; Barcelona Spain
| | - E. Valovirta
- Department of Lung Diseases and Clinical Allergology; University of Turku; Turku Finland
- Department of Allergy Clinic; Terveystalo; Turku Finland
| | - A. Valiulis
- Vilnius University Clinic of Children's Diseases and Public Health Institute; Vilnius Lithuania
- European Academy of Paediatrics (EAP/UEMS-SP); Brussels Belgium
| | - O. VandenPlas
- Department of Chest Medicine; Centre Hospitalier Universitaire UCL Namur; Université Catholique de Louvain; Yvoir Belgium
| | - S. van der Meulen
- Attorney at law; Axon Lawyers; the Netherlands. Role: provision of legal services
| | | | - M. Wickman
- Sachs’ Children and Youth Hospital; Södersjukhuset; Stockholm Sweden
- Institute of Environmental Medicine; Karolinska Institutet; Stockholm Sweden
| | - T. Zuberbier
- Department of Dermatology and Allergy; Comprehensive Allergy-Centre-Charité; Charité - Universitätsmedizin Berlin; Berlin Germany
- Global Allergy and Asthma European Network (GA LEN); Berlin Germany
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46
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Polloni L, Ferruzza E, Ronconi L, Toniolo A, Lazzarotto F, Bonaguro R, Celegato N, Muraro A. Assessment of children's nutritional attitudes before oral food challenges to identify patients at risk of food reintroduction failure: a prospective study. Allergy 2017; 72:731-736. [PMID: 27659406 DOI: 10.1111/all.13055] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2016] [Indexed: 01/23/2023]
Abstract
BACKGROUND Inappropriate dietary eliminations may impair quality of life, affect children's growth and unnecessarily impact on healthcare costs. Previous retrospective studies reported that around 25% of children continue a food-avoidance diet despite a negative oral food challenge (OFC). A definite pattern has not been found yet for patients not reintroducing the food. This study aimed to examine the role of child's nutritional attitudes and maternal anxiety in reintroducing food after a negative OFC. METHODS A prospective study was conducted involving 81 mothers of children with IgE-mediated food allergy. They completed a survey on nutritional behaviour and attitudes and the State-Trait Anxiety Inventory on the day of OFC and 6 months later. RESULTS In total, 11.1% of children never or rarely ate the food after a negative OFC. Consumption of the reintroduced food is positively correlated to child's interest in tasting new foods before and after OFC and to changes in child's nutritional habits after OFC. It is negatively correlated to monotony of the diet after OFC. No correlations were found with other participants' characteristics or maternal anxiety. State anxiety significantly decreased after the OFC. A correlation was found between trait and state anxiety and the degree of change in nutritional habits after OFC. CONCLUSIONS Evaluating child's approach towards food before the OFC is a promising approach to identify patients at risk of food reintroduction failure. Furthermore, it underlined the importance of reassessing food consumption in all patients after a negative OFC and supporting patients in the reintroduction of food.
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Affiliation(s)
- L. Polloni
- Food Allergy Referral Centre for Diagnosis and Treatment; Veneto Region; Department of Women and Child Health; Padua University Hospital; Padua Italy
| | - E. Ferruzza
- Department of Developmental Psychology and Socialization; University of Padua; Padua Italy
| | - L. Ronconi
- Department of Philosophy, Sociology, Education and Applied Psychology; University of Padua; Padua Italy
| | - A. Toniolo
- Food Allergy Referral Centre for Diagnosis and Treatment; Veneto Region; Department of Women and Child Health; Padua University Hospital; Padua Italy
| | - F. Lazzarotto
- Food Allergy Referral Centre for Diagnosis and Treatment; Veneto Region; Department of Women and Child Health; Padua University Hospital; Padua Italy
| | - R. Bonaguro
- Food Allergy Referral Centre for Diagnosis and Treatment; Veneto Region; Department of Women and Child Health; Padua University Hospital; Padua Italy
| | - N. Celegato
- Food Allergy Referral Centre for Diagnosis and Treatment; Veneto Region; Department of Women and Child Health; Padua University Hospital; Padua Italy
| | - A. Muraro
- Food Allergy Referral Centre for Diagnosis and Treatment; Veneto Region; Department of Women and Child Health; Padua University Hospital; Padua Italy
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47
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Dhami S, Zaman H, Varga EM, Sturm GJ, Muraro A, Akdis CA, Antolín-Amérigo D, Bilò MB, Bokanovic D, Calderon MA, Cichocka-Jarosz E, Oude Elberink JNG, Gawlik R, Jakob T, Kosnik M, Lange J, Mingomataj E, Mitsias DI, Mosbech H, Ollert M, Pfaar O, Pitsios C, Pravettoni V, Roberts G, Ruëff F, Sin BA, Asaria M, Netuveli G, Sheikh A. Allergen immunotherapy for insect venom allergy: a systematic review and meta-analysis. Allergy 2017; 72:342-365. [PMID: 28120424 DOI: 10.1111/all.13077] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2016] [Indexed: 12/01/2022]
Abstract
BACKGROUND The European Academy of Allergy and Clinical Immunology (EAACI) is in the process of developing the EAACI Guidelines on Allergen Immunotherapy (AIT) for the management of insect venom allergy. To inform this process, we sought to assess the effectiveness, cost-effectiveness and safety of AIT in the management of insect venom allergy. METHODS We undertook a systematic review, which involved searching 15 international biomedical databases for published and unpublished evidence. Studies were independently screened and critically appraised using established instruments. Data were descriptively summarized and, where possible, meta-analysed. RESULTS Our searches identified a total of 16 950 potentially eligible studies; of which, 17 satisfied our inclusion criteria. The available evidence was limited both in volume and in quality, but suggested that venom immunotherapy (VIT) could substantially reduce the risk of subsequent severe systemic sting reactions (OR = 0.08, 95% CI 0.03-0.26); meta-analysis showed that it also improved disease-specific quality of life (risk difference = 1.41, 95% CI 1.04-1.79). Adverse effects were experienced in both the build-up and maintenance phases, but most were mild with no fatalities being reported. The very limited evidence found on modelling cost-effectiveness suggested that VIT was likely to be cost-effective in those at high risk of repeated systemic sting reactions and/or impaired quality of life. CONCLUSIONS The limited available evidence suggested that VIT is effective in reducing severe subsequent systemic sting reactions and in improving disease-specific quality of life. VIT proved to be safe and no fatalities were recorded in the studies included in this review. The cost-effectiveness of VIT needs to be established.
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Affiliation(s)
- S. Dhami
- Evidence-Based Health Care Ltd; Edinburgh UK
| | - H. Zaman
- School of Pharmacy; University of Bradford; Bradford UK
| | - E.-M. Varga
- Department of Pediatric and Adolescent Medicine; Respiratory and Allergic Disease Division; Medical University of Graz; Graz Austria
| | - G. J. Sturm
- Department of Dermatology and Venerology; Medical University of Graz; Graz Austria
- Outpatient Allergy Clinic Reumannplatz; Vienna Austria
| | - A. Muraro
- Department of Women and Child Health; Food Allergy Referral Centre Veneto Region; Padua General University Hospital; Padua Italy
| | - C. A. Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF); Switzerland Servicio de Enfermedades del Sistema Inmune-Alergia; University of Zurich; Zurich Switzerland
- Departamento de Medicina y Especialidades Médicas; Hospital Universitario Príncipe de Asturias; Madrid Spain
| | | | - M. B. Bilò
- Allergy Unit; Department of Internal Medicine; University Hospital of Ancona; Ancona Italy
| | - D. Bokanovic
- Department of Dermatology and Venerology; Medical University of Graz; Graz Austria
| | - M. A. Calderon
- Section of Allergy and Clinical Immunology; Imperial College London; National Heart and Lung Institute; Royal Brompton Hospital; London UK
| | - E. Cichocka-Jarosz
- Department of Pediatrics; Jagiellonian University Medical College; Krakow Poland
| | - J. N. G. Oude Elberink
- Department of Allergology and Internal Medicine; University of Groningen; University Medical Hospital Groningen; Groningen The Netherlands
- Groningen Research Center for Asthma and COPD (GRIAC); Groningen The Netherlands
| | - R. Gawlik
- Department of Internal Medicine, Allergy and Clinical Immunology; Medical University of Silesia; Katowice Poland
| | - T. Jakob
- Department of Dermatology and Allergology; University Medical Center Gießen and Marburg (UKGM); Justus Liebig University Gießen; Gießen Germany
| | - M. Kosnik
- Medical Faculty Ljubljana; University Clinic of Respiratory and Allergic Diseases Golnik; Golnik Slovenia
| | - J. Lange
- Department of Pediatric Pneumonology and Allergy; Medical University of Warsaw; Warsaw Poland
| | - E. Mingomataj
- Department of Allergology and Clinical Immunology; Mother Theresa School of Medicine; Tirana Albania
- Department of Paraclinical Disciplines; Faculty of Technical Medical Sciences; Medicine University of Tirana; Tirana Albania
| | - D. I. Mitsias
- Department of Allergy and Clinical Immunology; 2nd Pediatric Clinic; University of Athens; Athens Greece
| | - H. Mosbech
- Allergy Clinic; Copenhagen University Hospital Gentofte; Gentofte Denmark
| | - M. Ollert
- Department of Infection and Immunity; Luxembourg Institute of Health (LIH); Strassen Luxembourg
| | - O. Pfaar
- Department of Otorhinolaryngology; Head and Neck Surgery; Universitätsmedizin Mannheim; Mannheim Germany
- Medical Faculty Mannheim; Heidelberg University; Heidelberg Germany
- Center for Rhinology Allergology; Wiesbaden Germany
| | - C. Pitsios
- Medical School; University of Cyprus; Nicosia Cyprus
| | - V. Pravettoni
- UOC Clinical Allergy and Immunology; IRCCS Foundation Ca’ Granda Ospedale Maggiore Policlinico; Milan Italy
| | - G. Roberts
- The David Hide Asthma and Allergy Research Centre; St Mary's Hospital; Newport Isle of Wight UK
- NIHR Respiratory Biomedical Research Unit; University Hospital Southampton NHS Foundation Trust; Southampton UK
- Faculty of Medicine; University of Southampton; Southampton UK
| | - F. Ruëff
- Klinik und Poliklinik für Dermatologie und Allergologie; Klinikum der Universität München; Munich Germany
| | - B. A. Sin
- Department of Pulmonary Diseases; Division of Immunology and Allergy; Faculty of Medicine; Ankara University; Ankara Turkey
| | - M. Asaria
- Research Fellow Centre for Health Economics; University of York; UK
| | - G. Netuveli
- Institute for Health and Human Development; University of East London; London UK
| | - A. Sheikh
- Allergy and Respiratory Research Group; The University of Edinburgh; Edinburgh UK
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48
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Singh D, Papi A, Corradi M, Montagna I, Francisco C, Cohuet G, Vezzoli S, Muraro A, Petruzzelli S, Scuri M, Vestbo J, Rellin L. TRILOGY: eine klinische Studie der Phase III zur Beurteilung der Wirksamkeit und Sicherheit einer extrafeinen Dreifach-Fixkombination aus Formoterolfumarat (FF), Glycopyrroniumbromid (GB) und Beclometasondipropionat (BDP) im pMDI (CHF5993) bei Patienten mit COPD. Pneumologie 2017. [DOI: 10.1055/s-0037-1598552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- D Singh
- Centre for Respiratory Medicine and Allergy, University of Manchester
| | - A Papi
- Research Centre on Asthma and Copd, University of Ferrara
| | - M Corradi
- Department of Clinical and Experimental Medicine, University of Parma
| | - I Montagna
- Global Clinical Development, Chiesi Farmaceutici Spa
| | | | - G Cohuet
- Global Clinical Development, Chiesi Sas
| | - S Vezzoli
- Global Clinical Development, Chiesi Farmaceutici Spa
| | - A Muraro
- Global Clinical Development, Chiesi Farmaceutici Spa
| | - S Petruzzelli
- Global Clinical Development, Chiesi Farmaceutici Spa
| | - M Scuri
- Global Clinical Development, Chiesi Farmaceutici Spa
| | - J Vestbo
- Centre for Respiratory Medicine and Allergy, University of Manchester
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49
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Singh D, Corradi M, Montagna I, Cohuet G, Francisco C, Vezzoli S, Muraro A, Petruzzelli S, Scuri M, Vestbo J, Rellin L. TRINITY: eine klinische Vergleichsstudie der Phase III zur Beurteilung der Wirksamkeit und Sicherheit einer extrafeinen Dreifach-Fixkombination aus Formoterolfumarat (FF), Glycopyrroniumbromid (GB) und Beclometasondipropionat (BDP) im pMDI (CHF5993) versus Tiotropiumbromid (Tio) und versus einer freien Dreifach-Wirkstoffkombination aus BDP/FF plus Tio bei Patienten mit COPD. Pneumologie 2017. [DOI: 10.1055/s-0037-1598553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- D Singh
- Centre for Respiratory Medicine and Allergy, University of Manchester
| | - M Corradi
- Department of Clinical and Experimental Medicine, University of Parma
| | - I Montagna
- Global Clinical Development, Chiesi Farmaceutici Spa
| | - G Cohuet
- Global Clinical Development, Chiesi Sas
| | | | - S Vezzoli
- Global Clinical Development, Chiesi Farmaceutici Spa
| | - A Muraro
- Global Clinical Development, Chiesi Farmaceutici Spa
| | - S Petruzzelli
- Global Clinical Development, Chiesi Farmaceutici Spa
| | - M Scuri
- Global Clinical Development, Chiesi Farmaceutici Spa
| | - J Vestbo
- Centre for Respiratory Medicine and Allergy, University of Manchester
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50
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Muraro A, Steelant B, Pietikainen S, Borrelli D, Childers N, Callebaut I, Kortekaas Krohn I, Martens K, Pugin B, Popescu FD, Vieru M, Jutel M, Agache I, Hellings PW. European symposium on the awareness of allergy: report of the promotional campaign in the European Parliament (26-28 April 2016). Allergy 2017; 72:173-176. [PMID: 27696452 DOI: 10.1111/all.13058] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
From 26 to 28 of April 2016, an allergy awareness campaign was organized by the European Academy of Allergy and Clinical Immunology and the European Federation of Allergy and Airway Diseases Patients Associations in the European Parliament in Brussels, with support of the European Parliament's Interest group on Allergy and Asthma and was co-hosted by the Members of the European Parliament David Borrelli, Sirpa Pietikainen and Nessa Childers. Skin prick tests (SPTs) were performed to gain attention for the increasing prevalence of allergic airway diseases in Europe. Since more than 30% of the total European population suffers from airway allergies and asthma, reaching a higher level of awareness and elaboration of an active prevention plan is mandatory. Of the 406 individuals undergoing SPT in the European Parliament, 211 participants (52%) reported to have suffered from an allergy in the past, with allergic symptoms being present in the nose and eyes (40% and 36%, respectively), the skin (27%), lower airways (14%) and the gut (8%). Of the 381 SPT with reliable results, cutaneous hypersensitivity was found in 201 (53%) participants. Of those with positive SPT (n = 201), 70 participants (35%) were monosensitized while 131 participants (65%) were polysensitized. The positive skin reactions were found mostly for grass pollen (n = 108), followed by Dermatophagoides pteronyssinus (n = 105), Dermatophagoides farina (n = 96) and birch pollen (n = 85). Of note, 54 individuals (14% of the total tested population) without reported allergy or allergic symptoms showed a positive SPT without clinical relevance. This report summarizes the main idea and goals of the symposium: chronic airway diseases are a major and growing health problem in Europe. Therefore, a joint preventive action plan needs to be developed for a better health status of European citizens.
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Affiliation(s)
- A. Muraro
- Department of Women and Child Health; Food Allergy Referral Centre Veneto Region; Padua General University Hospital; Padua Italy
| | - B. Steelant
- Clinical Immunology; Department of Microbiology and Immunology; KU Leuven; Leuven Belgium
| | - S. Pietikainen
- Interest Group on Allergy and Asthma of the European Parliament; Leuven Belgium
| | - D. Borrelli
- Interest Group on Allergy and Asthma of the European Parliament; Leuven Belgium
| | - N. Childers
- Interest Group on Allergy and Asthma of the European Parliament; Leuven Belgium
| | - I. Callebaut
- Clinical Department of Otorhinolaryngology, Head and Neck Surgery; University Hospitals Leuven; Leuven Belgium
| | - I. Kortekaas Krohn
- Clinical Immunology; Department of Microbiology and Immunology; KU Leuven; Leuven Belgium
| | - K. Martens
- Clinical Immunology; Department of Microbiology and Immunology; KU Leuven; Leuven Belgium
| | - B. Pugin
- Clinical Immunology; Department of Microbiology and Immunology; KU Leuven; Leuven Belgium
| | - F.-D. Popescu
- Carol Davila University of Medicine and Pharmacy; Bucharest Romania
| | - M. Vieru
- Carol Davila University of Medicine and Pharmacy; Bucharest Romania
| | - M. Jutel
- The Department of Clinical Immunology; Wroclaw Medical University; Wroclaw Poland
- ALL-MED Medical Research Institute; Wroclaw Poland
| | - I. Agache
- The Department of Allergy and Clinical Immunology; Transylvania University; Brasov Romania
| | - P. W. Hellings
- Clinical Immunology; Department of Microbiology and Immunology; KU Leuven; Leuven Belgium
- Clinical Department of Otorhinolaryngology, Head and Neck Surgery; University Hospitals Leuven; Leuven Belgium
- The Department of Otorhinolaryngology; Academic Medical Center; University of Amsterdam; Amsterdam The Netherlands
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