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1. ARIA‐EAACI care pathways for allergen immunotherapy in respiratory allergy

Author

Jean Bousquet, Oliver Pfaar, Ioana Agache, Anna Bedbrook, Cezmi A Akdis, G. Walter Canonica, Tomas Chivato, Mona Al‐Ahmad, Amir H Abdul Latiff, Ignacio J Ansotegui, Claus Bachert, Abdullah Baharuddin, Karl‐Christian Bergmann, Carsten Bindslev‐Jensen, Leif Bjermer, Matteo Bonini, Sinthia Bosnic‐Anticevich, Isabelle Bosse, Helen A. Brough, Luisa Brussino, Moises A Calderon, Luis Caraballo, Victoria Cardona, Pedro Carreiro‐Martins, Tomas Casale, Lorenzo Cecchi, Alfonso M Cepeda Sarabia, Ekaterine Chkhartishvili, Derek K Chu, Ieva Cirule, Alvaro A Cruz, Wienczyslawa Czarlewski, Stefano delGiacco, Pascal Demoly, Philippe Devillier, Dejan Dokic, Stephen L Durham, Motohiro Ebisawa, Yehia El‐Gamal✝, Regina Emuzyte, Amiran Gamkrelidze, Jean Luc Fauquert, Alessandro Fiocchi, Wytske J Fokkens, Joao A Fonseca, Jean‐François Fontaine, Radoslaw Gawlik, Asli Gelincik, Bilun Gemicioglu, Jose E Gereda, Roy Gerth van Wijk, R Maximiliano Gomez, Maia Gotua, Ineta Grisle, Maria‐Antonieta Guzmán, Tari Haahtela, Susanne Halken, Enrico Heffler, Karin Hoffmann‐Sommergruber, Elham Hossny, Martin Hrubiško, Carla Irani, Juan Carlos Ivancevich, Zhanat Ispayeva, Kaja Julge, Igor Kaidashev, Omer Kalayci, Musa Khaitov, Ludger Klimek, Edward Knol, Marek L Kowalski, Helga Kraxner, Inger Kull, Piotr Kuna, Violeta Kvedariene, Vicky Kritikos, Antti Lauerma, Susanne Lau, Daniel Laune, Michael Levin, Desiree E Larenas‐Linnemann, Karin C Lodrup Carlsen, Carlo Lombardi, Olga M Lourenço, Bassam Mahboub, Hans‐Jørgen Malling, Patrick Manning, Gailen D Marshall, Erik Melén, Eli O Meltzer, Neven Miculinic, Branislava Milenkovic, Mostafa Moin, Stephen Montefort, Mario Morais‐Almeida, Charlotte G Mortz, Ralph Mösges, Joaquim Mullol, Leyla Namazova Baranova, Hugo Neffen, Kristof Nekam, Marek Niedoszytko, Mikaëla Odemyr, Robyn E O'Hehir, Markus Ollert, Liam O'Mahony, Ken Ohta, Yoshitaka Okamoto, Kimi Okubo, Giovanni B Pajno, Oscar Palomares, Susanna Palkonen, Petr Panzner, Nikolaos GPapadopoulos, Hae‐Sim Park, Giovanni Passalacqua, Vincenzo Patella, Ruby Pawankar, Nhân Pham‐Thi, Davor Plavec, Todor A Popov, Marysia Recto, Frederico S Regateiro, Carmen Riggioni, Graham Roberts, Monica Rodriguez‐Gonzales, Nelson Rosario, Menachem Rottem, Philip W Rouadi, Dermot Ryan, Boleslaw Samolinski, Mario Sanchez‐Borges✝, Faradiba S Serpa, Joaquin Sastre, Glenis K. Scadding, Mohamed H Shamji, Peter Schmid‐Grendelmeier, Holger J Schünemann, Aziz Sheikh, Nicola Scichilone, Juan Carlos Sisul, Mikhail Sofiev, Dirceu Solé, Talant Sooronbaev, Manuel Soto‐Martinez, Manuel Soto‐Quiros, Milan Sova, Jürgen Schwarze, Isabel Skypala, Charlotte Suppli‐Ulrik, Luis Taborda‐Barata, Ana Todo‐Bom, Maria J Torres, Marylin Valentin‐Rostan, Peter‐Valentin Tomazic, Antonio Valero, Sanna Toppila‐Salmi, Ioanna Tsiligianni, Eva Untersmayr, Marilyn Urrutia‐Pereira, Arunas Valiulis, Erkka Valovirta, Olivier Vandenplas, Maria Teresa Ventura, Pakit Vichyanond, Martin Wagenmann, Dana Wallace, Jolanta Walusiak‐Skorupa, De Yun Wang, Susan Waserman, Gary WK Wong, Arzu Yorgancioglu, Osman M Yusuf, Mario Zernotti, Luo Zhang, Mihaela Zidarn, Torsten Zuberbier, and Marek Jutel

Subjects
allergic rhinitis, asthma, immunotherapy, precision medicine, Immunologic diseases. Allergy, RC581-607
Published
2021
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2. Digitally‐enabled, patient‐centred care in rhinitis and asthma multimorbidity: The ARIA‐MASK‐air® approach

Author

Jean Bousquet, Josep M. Anto, Bernardo Sousa‐Pinto, Wienczyslawa Czarlewski, Anna Bedbrook, Tari Haahtela, Ludger Klimek, Oliver Pfaar, Piotr Kuna, Maciej Kupczyk, Frederico S. Regateiro, Boleslaw Samolinski, Arunas Valiulis, Arzu Yorgancioglu, Sylvie Arnavielhe, Xavier Basagaña, Karl C. Bergmann, Sinthia Bosnic‐Anticevich, Luisa Brussino, G. Walter Canonica, Victoria Cardona, Lorenzo Cecchi, Claudia Chaves‐Loureiro, Elisio Costa, Alvaro A. Cruz, Bilun Gemicioglu, Wytske J. Fokkens, Juan Carlos Ivancevich, Helga Kraxner, Violeta Kvedariene, Désirée E. Larenas‐Linnemann, Daniel Laune, Renaud Louis, Michael Makris, Marcus Maurer, Erik Melén, Yann Micheli, Mario Morais‐Almeida, Joaquim Mullol, Marek Niedoszytko, Yoshitaka Okamoto, Nikolaos G. Papadopoulos, Vincenzo Patella, Nhân Pham‐Thi, Philip W. Rouadi, Joaquin Sastre, Nicola Scichilone, Aziz Sheikh, Mikhail Sofiev, Luis Taborda‐Barata, Sanna Toppila‐Salmi, Ioanna Tsiligianni, Erkka Valovirta, Maria Teresa Ventura, Rafael José Vieira, Mihaela Zidarn, Rita Amaral, Ignacio J. Ansotegui, Annabelle Bédard, Samuel Benveniste, Michael Bewick, Carsten Bindslev‐Jensen, Hubert Blain, Matteo Bonini, Rodolphe Bourret, Fulvio Braido, Pedro Carreiro‐Martins, Denis Charpin, Ivan Cherrez‐Ojeda, Tomas Chivato, Derek K. Chu, Cemal Cingi, Stefano DelGiacco, Frédéric deBlay, Philippe Devillier, Govert DeVries, Maria Doulaptsi, Virginie Doyen, Gérard Dray, Jean‐François Fontaine, R. Maximiliano Gomez, Jan Hagemann, Enrico Heffler, Maja Hofmann, Ewa Jassem, Marek Jutel, Thomas Keil, Vicky Kritikos, Inger Kull, Marek Kulus, Olga Lourenço, Eve Mathieu‐Dupas, Enrica Menditto, Ralph Mösges, Ruth Murray, Rachel Nadif, Hugo Neffen, Stefania Nicola, Robyn O’Hehir, Heidi Olze, Yuliia Palamarchuk, Jean‐Louis Pépin, Benoit Pétré, Robert Picard, Constantinos Pitsios, Francesca Puggioni, Santiago Quirce, Filip Raciborski, Sietze Reitsma, Nicolas Roche, Monica Rodriguez‐Gonzalez, Jan Romantowski, Ana Sá‐Sousa, Faradiba S. Serpa, Marine Savouré, Mohamed H. Shamji, Milan Sova, Annette Sperl, Cristiana Stellato, Ana Todo‐Bom, Peter Valentin Tomazic, Olivier Vandenplas, Michiel VanEerd, Tuula Vasankari, Frédéric Viart, Susan Waserman, Joao A. Fonseca, and Torsten Zuberbier

Subjects
asthma, digital, MASK‐air, mHealth, rhinitis, Immunologic diseases. Allergy, RC581-607
Abstract

Abstract MASK‐air®, a validated mHealth app (Medical Device regulation Class IIa) has enabled large observational implementation studies in over 58,000 people with allergic rhinitis and/or asthma. It can help to address unmet patient needs in rhinitis and asthma care. MASK‐air® is a Good Practice of DG Santé on digitally‐enabled, patient‐centred care. It is also a candidate Good Practice of OECD (Organisation for Economic Co‐operation and Development). MASK‐air® data has enabled novel phenotype discovery and characterisation, as well as novel insights into the management of allergic rhinitis. MASK‐air® data show that most rhinitis patients (i) are not adherent and do not follow guidelines, (ii) use as‐needed treatment, (iii) do not take medication when they are well, (iv) increase their treatment based on symptoms and (v) do not use the recommended treatment. The data also show that control (symptoms, work productivity, educational performance) is not always improved by medications. A combined symptom‐medication score (ARIA‐EAACI‐CSMS) has been validated for clinical practice and trials. The implications of the novel MASK‐air® results should lead to change management in rhinitis and asthma.

Published
2023
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3. Real‐world data using mHealth apps in rhinitis, rhinosinusitis and their multimorbidities

Author

Bernardo Sousa‐Pinto, Aram Anto, Markus Berger, Stephanie Dramburg, Oliver Pfaar, Ludger Klimek, Marek Jutel, Wienczyslawa Czarlewski, Anna Bedbrook, Arunas Valiulis, Ioana Agache, Rita Amaral, Ignacio J. Ansotegui, Katharina Bastl, Uwe Berger, Karl C. Bergmann, Sinthia Bosnic‐Anticevich, Fulvio Braido, Luisa Brussino, Victoria Cardona, Thomas Casale, G. Walter Canonica, Lorenzo Cecchi, Denis Charpin, Tomás Chivato, Derek K. Chu, Cemal Cingi, Elisio M. Costa, Alvaro A. Cruz, Philippe Devillier, Stephen R. Durham, Motohiro Ebisawa, Alessandro Fiocchi, Wytske J. Fokkens, Bilun Gemicioğlu, Maia Gotua, Maria‐Antonieta Guzmán, Tari Haahtela, Juan Carlos Ivancevich, Piotr Kuna, Igor Kaidashev, Musa Khaitov, Violeta Kvedariene, Désirée E. Larenas‐Linnemann, Brian Lipworth, Daniel Laune, Paolo M. Matricardi, Mario Morais‐Almeida, Joaquim Mullol, Robert Naclerio, Hugo Neffen, Kristoff Nekam, Marek Niedoszytko, Yoshitaka Okamoto, Nikolaos G. Papadopoulos, Hae‐Sim Park, Giovanni Passalacqua, Vincenzo Patella, Simone Pelosi, Nhân Pham‐Thi, Ted A. Popov, Frederico S. Regateiro, Sietze Reitsma, Monica Rodriguez‐Gonzales, Nelson Rosario, Philip W. Rouadi, Boleslaw Samolinski, Ana Sá‐Sousa, Joaquin Sastre, Aziz Sheikh, Charlotte Suppli Ulrik, Luis Taborda‐Barata, Ana Todo‐Bom, Peter Valentin Tomazic, Sanna Toppila‐Salmi, Salvatore Tripodi, Ioanna Tsiligianni, Erkka Valovirta, Maria Teresa Ventura, Antonio A. Valero, Rafael José Vieira, Dana Wallace, Susan Waserman, Sian Williams, Arzu Yorgancioglu, Luo Zhang, Mihaela Zidarn, Jaron Zuberbier, Heidi Olze, Josep M. Antó, Torsten Zuberbier, João A. Fonseca, and Jean Bousquet

Subjects
allergic rhinitis, app, chronic rhinosinusitis, mHealth, Immunologic diseases. Allergy, RC581-607
Abstract

Abstract Digital health is an umbrella term which encompasses eHealth and benefits from areas such as advanced computer sciences. eHealth includes mHealth apps, which offer the potential to redesign aspects of healthcare delivery. The capacity of apps to collect large amounts of longitudinal, real‐time, real‐world data enables the progression of biomedical knowledge. Apps for rhinitis and rhinosinusitis were searched for in the Google Play and Apple App stores, via an automatic market research tool recently developed using JavaScript. Over 1500 apps for allergic rhinitis and rhinosinusitis were identified, some dealing with multimorbidity. However, only six apps for rhinitis (AirRater, AllergyMonitor, AllerSearch, Husteblume, MASK‐air and Pollen App) and one for rhinosinusitis (Galenus Health) have so far published results in the scientific literature. These apps were reviewed for their validation, discovery of novel allergy phenotypes, optimisation of identifying the pollen season, novel approaches in diagnosis and management (pharmacotherapy and allergen immunotherapy) as well as adherence to treatment. Published evidence demonstrates the potential of mobile health apps to advance in the characterisation, diagnosis and management of rhinitis and rhinosinusitis patients.

Published
2022
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4. Allergen immunotherapy in MASK‐air users in real‐life: Results of a Bayesian mixed‐effects model

Author

Bernardo Sousa‐Pinto, Luís Filipe Azevedo, Ana Sá‐Sousa, Rafael José Vieira, Rita Amaral, Ludger Klimek, Wienczyslawa Czarlewski, Josep M. Anto, Anna Bedbrook, Violeta Kvedariene, Maria Teresa Ventura, Ignacio J. Ansotegui, Karl‐Christian Bergmann, Luisa Brussino, G. Walter Canonica, Victoria Cardona, Pedro Carreiro‐Martins, Thomas Casale, Lorenzo Cecchi, Tomás Chivato, Derek K. Chu, Cemal Cingi, Elisio M. Costa, Alvaro A. Cruz, Giulia De Feo, Philippe Devillier, Wytske J. Fokkens, Mina Gaga, Bilun Gemicioğlu, Tari Haahtela, Juan Carlos Ivancevich, Zhanat Ispayeva, Marek Jutel, Piotr Kuna, Igor Kaidashev, Helga Kraxner, Désirée E. Larenas‐Linnemann, Daniel Laune, Brian Lipworth, Renaud Louis, Michaël Makris, Riccardo Monti, Mario Morais‐Almeida, Ralph Mösges, Joaquim Mullol, Mikaëla Odemyr, Yoshitaka Okamoto, Nikolaos G. Papadopoulos, Vincenzo Patella, Nhân Pham‐Thi, Frederico S. Regateiro, Sietze Reitsma, Philip W. Rouadi, Boleslaw Samolinski, Milan Sova, Ana Todo‐Bom, Luis Taborda‐Barata, Peter Valentin Tomazic, Sanna Toppila‐Salmi, Joaquin Sastre, Ioanna Tsiligianni, Arunas Valiulis, Dana Wallace, Susan Waserman, Arzu Yorgancioglu, Mihaela Zidarn, Torsten Zuberbier, João Almeida Fonseca, Jean Bousquet, and Oliver Pfaar

Subjects
allergic rhinitis, immunotherapy, mobile health, patient‐reported outcomes, real‐life data analysis, Immunologic diseases. Allergy, RC581-607
Abstract

Abstract Background Evidence regarding the effectiveness of allergen immunotherapy (AIT) on allergic rhinitis has been provided mostly by randomised controlled trials, with little data from real‐life studies. Objective To compare the reported control of allergic rhinitis symptoms in three groups of users of the MASK‐air® app: those receiving sublingual AIT (SLIT), those receiving subcutaneous AIT (SCIT), and those receiving no AIT. Methods We assessed the MASK‐air® data of European users with self‐reported grass pollen allergy, comparing the data reported by patients receiving SLIT, SCIT and no AIT. Outcome variables included the daily impact of allergy symptoms globally and on work (measured by visual analogue scales—VASs), and a combined symptom‐medication score (CSMS). We applied Bayesian mixed‐effects models, with clustering by patient, country and pollen season. Results We analysed a total of 42,756 days from 1,093 grass allergy patients, including 18,479 days of users under AIT. Compared to no AIT, SCIT was associated with similar VAS levels and CSMS. Compared to no AIT, SLIT‐tablet was associated with lower values of VAS global allergy symptoms (average difference = 7.5 units out of 100; 95% credible interval [95%CrI] = −12.1;−2.8), lower VAS Work (average difference = 5.0; 95%CrI = −8.5;−1.5), and a lower CSMS (average difference = 3.7; 95%CrI = −9.3;2.2). When compared to SCIT, SLIT‐tablet was associated with lower VAS global allergy symptoms (average difference = 10.2; 95%CrI = −17.2;−2.8), lower VAS Work (average difference = 7.8; 95%CrI = −15.1;0.2), and a lower CSMS (average difference = 9.3; 95%CrI = −18.5;0.2). Conclusion In patients with grass pollen allergy, SLIT‐tablet, when compared to no AIT and to SCIT, is associated with lower reported symptom severity. Future longitudinal studies following internationally‐harmonised standards for performing and reporting real‐world data in AIT are needed to better understand its ‘real‐world’ effectiveness.

Published
2022
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5. Validity, reliability, and responsiveness of daily monitoring visual analog scales in MASK‐air®

Author

Bernardo Sousa‐Pinto, Patrik Eklund, Oliver Pfaar, Ludger Klimek, Torsten Zuberbier, Wienczyslawa Czarlewski, Annabelle Bédard, Carsten Bindslev‐Jensen, Anna Bedbrook, Sinthia Bosnic‐Anticevich, Luisa Brussino, Victoria Cardona, Alvaro A. Cruz, Govert deVries, Philippe Devillier, Wytske J. Fokkens, José Miguel Fuentes‐Pérez, Bilun Gemicioğlu, Tari Haahtela, Yunen Rocío Huerta‐Villalobos, Juan Carlos Ivancevich, Inger Kull, Piotr Kuna, Violeta Kvedariene, Désirée E. Larenas Linnemann, Daniel Laune, Michael Makris, Erik Melén, Mário Morais‐Almeida, Ralph Mösges, Joaquim Mullol, Robyn E. O'Hehir, Nikolaos G. Papadopoulos, Ana Margarida Pereira, Emmanuel P. Prokopakis, Fotis Psarros, Frederico S. Regateiro, Sietze Reitsma, Boleslaw Samolinski, Nicola Scichilone, Jane daSilva, Cristiana Stellato, Ana Todo‐Bom, Peter Valentin Tomazic, Sanna Toppila Salmi, Antonio Valero, Arunas Valiulis, Erkka Valovirta, Michiel vanEerd, Maria Teresa Ventura, Arzu Yorgancioglu, Xavier Basagaña, Josep M. Antó, Jean Bousquet, and João Almeida Fonseca

Subjects
allergic rhinitis, mobile health, reliability, responsiveness, visual analog scales, Immunologic diseases. Allergy, RC581-607
Abstract

Abstract Background MASK‐air® is an app that supports allergic rhinitis patients in disease control. Users register daily allergy symptoms and their impact on activities using visual analog scales (VASs). We aimed to assess the concurrent validity, reliability, and responsiveness of these daily VASs. Methods Daily monitoring VAS data were assessed in MASK‐air® users with allergic rhinitis. Concurrent validity was assessed by correlating daily VAS values with those of the EuroQol‐5 Dimensions (EQ‐5D) VAS, the Control of Allergic Rhinitis and Asthma Test (CARAT) score, and the Work Productivity and Activity Impairment Allergic Specific (WPAI‐AS) Questionnaire (work and activity impairment scores). Intra‐rater reliability was assessed in users providing multiple daily VASs within the same day. Test–retest reliability was tested in clinically stable users, as defined by the EQ‐5D VAS, CARAT, or “VAS Work” (i.e., VAS assessing the impact of allergy on work). Responsiveness was determined in users with two consecutive measurements of EQ‐5D‐VAS or “VAS Work” indicating clinical change. Results A total of 17,780 MASK‐air® users, with 317,176 VAS days, were assessed. Concurrent validity was moderate–high (Spearman correlation coefficient range: 0.437–0.716). Intra‐rater reliability intraclass correlation coefficients (ICCs) ranged between 0.870 (VAS assessing global allergy symptoms) and 0.937 (VAS assessing allergy symptoms on sleep). Test–retest reliability ICCs ranged between 0.604 and 0.878—“VAS Work” and “VAS asthma” presented the highest ICCs. Moderate/large responsiveness effect sizes were observed—the sleep VAS was associated with lower responsiveness, while the global allergy symptoms VAS demonstrated higher responsiveness. Conclusion In MASK‐air®, daily monitoring VASs have high intra‐rater reliability and moderate–high validity, reliability, and responsiveness, pointing to a reliable measure of symptom loads.

Published
2021
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6. Next-generation ARIA care pathways for rhinitis and asthma: a model for multimorbid chronic diseases

Author

J. Jean Bousquet, Holger J. Schünemann, Alkis Togias, Marina Erhola, Peter W. Hellings, Torsten Zuberbier, Ioana Agache, Ignacio J. Ansotegui, Josep M. Anto, Claus Bachert, Sven Becker, Martin Bedolla-Barajas, Michael Bewick, Sinthia Bosnic-Anticevich, Isabelle Bosse, Louis P. Boulet, Jean Marc Bourrez, Guy Brusselle, Niels Chavannes, Elisio Costa, Alvaro A. Cruz, Wienczyslawa Czarlewski, Wytske J. Fokkens, Joao A. Fonseca, Mina Gaga, Tari Haahtela, Maddalena Illario, Ludger Klimek, Piotr Kuna, Violeta Kvedariene, L. T. T. Le, Desiree Larenas-Linnemann, Daniel Laune, Olga M. Lourenço, Enrica Menditto, Joaquin Mullol, Yashitaka Okamoto, Nikos Papadopoulos, Nhân Pham-Thi, Robert Picard, Hilary Pinnock, Nicolas Roche, Regina E. Roller-Wirnsberger, Christine Rolland, Boleslaw Samolinski, Aziz Sheikh, Sanna Toppila-Salmi, Ioanna Tsiligianni, Arunas Valiulis, Erkka Valovirta, Tuula Vasankari, Maria-Teresa Ventura, Samantha Walker, Sian Williams, Cezmi A. Akdis, Isabella Annesi-Maesano, Sylvie Arnavielhe, Xavier Basagana, Eric Bateman, Anna Bedbrook, K. S. Bennoor, Samuel Benveniste, Karl C. Bergmann, Slawomir Bialek, Nils Billo, Carsten Bindslev-Jensen, Leif Bjermer, Hubert Blain, Mateo Bonini, Philippe Bonniaud, Jacques Bouchard, Vitalis Briedis, Christofer E. Brightling, Jan Brozek, Roland Buhl, Roland Buonaiuto, Giorgo W. Canonica, Victoria Cardona, Ana M. Carriazo, Warner Carr, Christine Cartier, Thomas Casale, Lorenzo Cecchi, Alfonso M. Cepeda Sarabia, Eka Chkhartishvili, Derek K. Chu, Cemal Cingi, Elaine Colgan, Jaime Correia de Sousa, Anne Lise Courbis, Adnan Custovic, Biljana Cvetkosvki, Gennaro D’Amato, Jane da Silva, Carina Dantas, Dejand Dokic, Yves Dauvilliers, Antoni Dedeu, Giulia De Feo, Philippe Devillier, Stefania Di Capua, Marc Dykewickz, Ruta Dubakiene, Motohiro Ebisawa, Yaya El-Gamal, Esben Eller, Regina Emuzyte, John Farrell, Antjie Fink-Wagner, Alessandro Fiocchi, Jean F. Fontaine, Bilun Gemicioğlu, Peter Schmid-Grendelmeir, Amiran Gamkrelidze, Judith Garcia-Aymerich, Maximiliano Gomez, Sandra González Diaz, Maia Gotua, Nick A. Guldemond, Maria-Antonieta Guzmán, Jawad Hajjam, John O’B Hourihane, Marc Humbert, Guido Iaccarino, Despo Ierodiakonou, Juan C. Ivancevich, Guy Joos, Ki-Suck Jung, Marek Jutel, Igor Kaidashev, Omer Kalayci, Przemyslaw Kardas, Thomas Keil, Mussa Khaitov, Nikolai Khaltaev, Jorg Kleine-Tebbe, Marek L. Kowalski, Vicky Kritikos, Inger Kull, Lisa Leonardini, Philip Lieberman, Brian Lipworth, Karin C. Lodrup Carlsen, Claudia C. Loureiro, Renaud Louis, Alpana Mair, Gert Marien, Bassam Mahboub, Joao Malva, Patrick Manning, Esteban De Manuel Keenoy, Gailen D. Marshall, Mohamed R. Masjedi, Jorge F. Maspero, Eve Mathieu-Dupas, Poalo M. Matricardi, Eric Melén, Elisabete Melo-Gomes, Eli O. Meltzer, Jacques Mercier, Neven Miculinic, Florin Mihaltan, Branislava Milenkovic, Giuliana Moda, Maria-Dolores Mogica-Martinez, Yousser Mohammad, Steve Montefort, Ricardo Monti, Mario Morais-Almeida, Ralf Mösges, Lars Münter, Antonella Muraro, Ruth Murray, Robert Naclerio, Luigi Napoli, Leila Namazova-Baranova, Hugo Neffen, Kristoff Nekam, Angelo Neou, Enrico Novellino, Dieudonné Nyembue, Robin O’Hehir, Ken Ohta, Kimi Okubo, Gabrielle Onorato, Solange Ouedraogo, Isabella Pali-Schöll, Susanna Palkonen, Peter Panzner, Hae-Sim Park, Jean-Louis Pépin, Ana-Maria Pereira, Oliver Pfaar, Ema Paulino, Jim Phillips, Davor Plavec, Ted A. Popov, Fabienne Portejoie, David Price, Emmanuel P. Prokopakis, Benoit Pugin, Filip Raciborski, Rojin Rajabian-Söderlund, Sietze Reitsma, Xavier Rodo, Antonino Romano, Nelson Rosario, Menahenm Rottem, Dermot Ryan, Johanna Salimäki, Mario M. Sanchez-Borges, Juan-Carlos Sisul, Dirceu Solé, David Somekh, Talant Sooronbaev, Milan Sova, Otto Spranger, Cristina Stellato, Rafael Stelmach, Charlotte Suppli Ulrik, Michel Thibaudon, Teresa To, Ana Todo-Bom, Peter V. Tomazic, Antonio A. Valero, Rudolph Valenta, Marylin Valentin-Rostan, Rianne van der Kleij, Olivier Vandenplas, Giorgio Vezzani, Frédéric Viart, Giovanni Viegi, Dana Wallace, Martin Wagenmann, De Y. Wang, Susan Waserman, Magnus Wickman, Dennis M. Williams, Gary Wong, Piotr Wroczynski, Panayiotis K. Yiallouros, Arzu Yorgancioglu, Osman M. Yusuf, Heahter J. Zar, Stéphane Zeng, Mario Zernotti, Luo Zhang, Nan S. Zhong, Mihaela Zidarn, the ARIA Study Group, and the MASK Study Group

Subjects
Health care transformation, Care pathways, Rhinitis, ARIA, MASK, POLLAR, Immunologic diseases. Allergy, RC581-607
Abstract

Abstract Background In all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system into integrated care with organizational health literacy. Main body As an example for chronic disease care, MASK (Mobile Airways Sentinel NetworK), a new project of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, and POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EIT Health), in collaboration with professional and patient organizations in the field of allergy and airway diseases, are proposing real-life ICPs centred around the patient with rhinitis, and using mHealth to monitor environmental exposure. Three aspects of care pathways are being developed: (i) Patient participation, health literacy and self-care through technology-assisted “patient activation”, (ii) Implementation of care pathways by pharmacists and (iii) Next-generation guidelines assessing the recommendations of GRADE guidelines in rhinitis and asthma using real-world evidence (RWE) obtained through mobile technology. The EU and global political agendas are of great importance in supporting the digital transformation of health and care, and MASK has been recognized by DG Santé as a Good Practice in the field of digitally-enabled, integrated, person-centred care. Conclusion In 20 years, ARIA has considerably evolved from the first multimorbidity guideline in respiratory diseases to the digital transformation of health and care with a strong political involvement.

Published
2019
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7. The prevalence of asthma in adult population of southwestern Iran and its association with chronic rhinosinusitis: a GA2LEN study

Author

Afshin Ostovar, Wytske J. Fokkens, Safoora Pordel, Ali Movahed, Khadijeh Ghasemi, Maryam Marzban, and Shokrollah Farrokhi

Subjects
Asthma, Chronic rhino sinusitis, GA2LEN, Prevalence, Immunologic diseases. Allergy, RC581-607
Abstract

Abstract Background Asthma is recognized as a major public health concern in the world. The aim of this investigation was to evaluate the prevalence of asthma by using the Global Allergy and Asthma Network of Excellence (GA2LEN) questionnaire and examine its association with chronic rhinosinusitis, in the province of Bushehr, Southwestern of Iran. Methods In a cross-sectional, population-based study, a total of 5420 invited individuals, aged 15–65, were selected through a multi-stage, stratified, cluster random sampling and from which 5201 completed the GA2LEN questionnaire (response rate = 95.9%). The prevalence of asthma, current, and physician-diagnosed asthma were analyzed by using sex and age groups and the association of asthma and chronic rhinosinusitis (CRS) was investigated using a multiple logistic regression model. Results Based on the information from the GA2LEN questionnaire, the overall prevalence of asthma in the population under study was 10.0% (95% CI 9.2–10.8). Moreover, the prevalence of current asthma was 8.9% (95% CI 8.1–9.7). Further, the prevalence of current early, late-onset and physician-diagnosed asthma within the asthma group was 51.1% (95% CI 46.5–55.7), 48.9% (95% CI 44.3–53.5) and 3.9% (95% CI 2.1–2.5), respectively. Additionally, CRS was more frequent among the participants with asthma [(57.3%, OR = 2.3; 95% CI 2.1–2.5)], and there was a significant association between CRS and current, early and late-onset of asthma (P

Published
2019
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8. Endotype-driven treatment in chronic upper airway diseases

Author

Glynnis De Greve, Peter W. Hellings, Wytske J. Fokkens, Benoit Pugin, Brecht Steelant, and Sven F. Seys

Subjects
Rhinitis, Chronic rhinosinusitis, Phenotype, Biomarker, Biologicals, Precision medicine, Immunologic diseases. Allergy, RC581-607
Abstract

Abstract Rhinitis and rhinosinusitis are the two major clinical entities of chronic upper airway disease. Chronic rhinosinusitis (CRS) and allergic rhinitis (AR) affect respectively up to 10 and 30% of the total population, hence being associated with an important socio-economic burden. Different phenotypes of rhinitis and CRS have been described based on symptom severity and duration, atopy status, level of control, comorbidities and presence or absence of nasal polyps in CRS. The underlying pathophysiological mechanisms are diverse, with different, and sometimes overlapping, endotypes being recognized. Type 2 inflammation is well characterized in both AR and CRS with nasal polyps (CRSwNP), whereas type 1 inflammation is found in infectious rhinitis and CRS without nasal polyps (CRSsNP). The neurogenic endotype has been demonstrated in some forms of non-allergic rhinitis. Epithelial barrier dysfunction is shown in AR and CRSwNP. Emerging therapies are targeting one specific pathophysiological pathway or endotype. This endotype-driven treatment approach requires careful selection of the patient population who might benefit from a specific treatment. Personalized medicine is addressing the issue of providing targeted treatment for the right patient and should be seen as one aspect of the promising trend towards precision medicine. This review provides a comprehensive overview of the current state of endotypes, biomarkers and targeted treatments in chronic inflammatory conditions of the nose and paranasal sinuses.

Published
2017
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