11 results on '"Hudes G"'
Search Results
2. No difference in omalizumab efficacy in patients with asthma by number of asthma-related and allergic comorbidities.
- Author
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Chen M, Choo E, Yoo B, Raut P, Haselkorn T, Pazwash H, Holweg CTJ, and Hudes G
- Subjects
- Adolescent, Adult, Aged, Child, Comorbidity, Double-Blind Method, Female, Forced Expiratory Volume, Gastroesophageal Reflux drug therapy, Gastroesophageal Reflux epidemiology, Gastroesophageal Reflux physiopathology, Humans, Hypersensitivity epidemiology, Hypersensitivity physiopathology, Male, Middle Aged, Nasal Polyps drug therapy, Nasal Polyps epidemiology, Nasal Polyps physiopathology, Sinusitis drug therapy, Sinusitis epidemiology, Sinusitis physiopathology, Treatment Outcome, Young Adult, Anti-Allergic Agents therapeutic use, Anti-Asthmatic Agents therapeutic use, Hypersensitivity drug therapy, Omalizumab therapeutic use
- Abstract
Background: Comorbidities are common in asthma and may complicate treatment response., Objective: To examine response to omalizumab in patients with moderate-to-severe allergic asthma by asthma-related and allergic comorbidities., Methods: Patients aged 12 years or more from placebo-controlled 008/009 (n = 1071), EXTRA (n = 848), and INNOVATE (n = 419), and single-armed PROSPERO (n = 801) omalizumab studies were included. Poisson regression/analysis of covariance models were used to estimate adjusted exacerbation rates and forced expiratory volume in 1 second (FEV1) change from baseline after omalizumab initiation for subgroups by number of comorbidities (0, 1 [008/009]; 0, 1, ≥2 [EXTRA and INNOVATE]; 0, 1, 2, ≥3 [PROSPERO]). Self-reported comorbidities included allergic rhinoconjunctivitis, chronic rhinosinusitis, recurrent acute sinusitis, nasal polyps, atopic and contact dermatitis, urticaria, food allergy, anaphylaxis, other allergies, gastroesophageal reflux disease, eosinophilic esophagitis, and eosinophilic granulomatosis with polyangiitis., Results: In the EXTRA and INNOVATE studies, no consistent pattern was observed for placebo-corrected relative rate reduction in normalized asthma exacerbations among omalizumab-treated comorbidity subgroups. In PROSPERO, on-study exacerbation rates in the comorbidity subgroups were similar (0, 0.68; 1, 0.70; 2, 0.77; ≥3, 0.80). FEV1 improvements were observed throughout the study for omalizumab vs placebo for all comorbidity subgroups. There were no consistent differences in FEV1 improvements among comorbidity subgroups in 008/009, EXTRA, or INNOVATE. Similarly, no among-group differences were observed for FEV1 change from baseline at month 12 in PROSPERO (0, 0.05 L; 1, 0.08 L; 2, 0.00 L; ≥3, 0.04 L). The 95% confidence intervals overlapped substantially in all instances., Conclusion: In these analyses of placebo-controlled/single-armed studies, on-study exacerbation rates and FEV1 improvements with omalizumab treatment were similar irrespective of comorbidity burden., Trial Registration: ClinicalTrials.gov identifiers are as follows: EXTRA, NCT00314574 (https://clinicaltrials.gov/ct2/show/NCT00314574); INNOVATE, NCT00046748 (https://clinicaltrials.gov/ct2/show/NCT00046748); and PROSPERO, NCT01922037 (https://clinicaltrials.gov/ct2/show/NCT01922037)., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)
- Published
- 2021
- Full Text
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3. Eosinophilic esophagitis as possible complication of aspirin treatment in patient with aspirin-exacerbated respiratory disease.
- Author
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Pelletier T, Tamayev R, Iammatteo M, Nautsch D, Hudes G, Lukin D, and Jerschow E
- Subjects
- Adult, Aspirin therapeutic use, Female, Humans, Nasal Polyps chemistry, Nasal Polyps immunology, Aspirin adverse effects, Aspirin immunology, Asthma, Aspirin-Induced immunology, Eosinophilic Esophagitis chemically induced, Eosinophilic Esophagitis immunology
- Published
- 2017
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4. Effect of ivermectin on allergy-type manifestations in occult strongyloidiasis.
- Author
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Rampur L, Jariwala SP, Hudes G, Rosenstreich DL, and de Vos G
- Subjects
- Adult, Aged, Animals, Eosinophils immunology, Female, Humans, Hypersensitivity blood, Immunoglobulin E blood, Immunoglobulin G blood, Leukocyte Count, Male, Middle Aged, Strongyloidiasis blood, Antiparasitic Agents therapeutic use, Hypersensitivity drug therapy, Ivermectin therapeutic use, Strongyloides stercoralis, Strongyloidiasis drug therapy
- Abstract
Background: The immunomodulatory effects of helminths have been well described. However, there is a relative lack of literature regarding the link between parasites and allergic diseases. A number of patients with allergic symptoms have positive serologic test results for Strongyloides stercoralis., Objective: To identify patients with allergy-type symptoms and coexisting Strongyloides infection and to analyze the effect of Strongyloides eradication therapy with ivermectin on these symptoms., Methods: The medical records of our allergy clinic sites were reviewed for Strongyloides test results between January 2011 and October 2014. Each allergy-type symptom was assessed separately with regard to improvement after ivermectin therapy., Results: Among the 1,446 patients who had Strongyloides serologic tests ordered, 127 (8.8%) had positive test results. Eighty-four patients had follow-up data regarding allergy-type symptoms after ivermectin treatment. Among these, 52 patients (61.9%) reported skin-related problems (pruritus, urticaria, angioedema, and/or rash). Forty-nine patients (58.3%) had asthma, and 73.8% had allergic rhinoconjunctivitis. Although respiratory symptoms typically did not respond to ivermectin treatment, 24 of 48 patients (50%) with skin symptoms reported a significant subjective improvement of symptoms after ivermectin treatment. Peripheral eosinophil counts significantly decreased after ivermectin treatment from 450 to 200/μL (P < .001)., Conclusion: Serologic testing for strongyloides may be indicated for patients with allergy-type symptoms and a suggestive exposure history. Patients with strongyloidiasis and primarily cutaneous symptoms experienced significant symptomatic improvement after ivermectin therapy., (Copyright © 2016 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.)
- Published
- 2016
- Full Text
- View/download PDF
5. Utility of low-dose oral aspirin challenges for diagnosis of aspirin-exacerbated respiratory disease.
- Author
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Jerschow E, Ren Z, Hudes G, Sanak M, Morales E, Schuster V, Spivack SD, and Rosenstreich D
- Subjects
- Administration, Oral, Adult, Allergens adverse effects, Aspirin adverse effects, Female, Humans, Immunization methods, Leukotriene E4 urine, Male, Middle Aged, Nitric Oxide metabolism, Sensitivity and Specificity, Allergens administration & dosage, Aspirin administration & dosage, Asthma, Aspirin-Induced diagnosis, Drug Hypersensitivity diagnosis
- Abstract
Background: Aspirin-exacerbated respiratory disease (AERD) is diagnosed through graded aspirin challenges that induce hypersensitivity reactions and eicosanoid level changes. It is not known whether diagnostically useful changes also occur after low-dose aspirin challenges that do not induce hypersensitivity reactions., Objective: To investigate the utility of low-dose oral aspirin challenges for diagnosing AERD by measuring different clinical parameters and eicosanoid changes., Methods: Sixteen patients with AERD and 13 patients with aspirin-tolerant asthma underwent oral challenges with low-dose (20 or 40 mg) aspirin and diagnostic oral graded aspirin challenges (up to 325 mg of aspirin). Forced expiratory volume in 1 second, nasal peak flow, the fraction of exhaled nitric oxide (FeNO), and eicosanoid levels in plasma and urine were analyzed., Results: In patients with AERD but not in those with aspirin-tolerant asthma, 40-mg aspirin challenges induced a significant mean (SEM) decrease from baseline in FeNO (19% [5.1%]; P = .001) without causing any hypersensitivity reaction. The FeNO decrease also occurred after higher-dose aspirin challenges (27.8% [4.9%]; P < .001). The sensitivity and specificity of 40-mg aspirin-induced FeNO changes for identifying AERD were 90% and 100% with an area under the curve of 0.98 (95% CI, 0.92-1.00). The low-dose challenge also induced a significant leukotriene E4 urine increase in patients with AERD (from 6.32 [0.08] to 6.91 [0.15] log-pg/mg creatinine; P < .001), but the sensitivity and specificity of these changes were less than for the FeNO changes., Conclusion: The low-dose aspirin-induced decrease in FeNO in patients with AERD may be useful for the diagnosis of aspirin allergy without inducing a hypersensitivity reaction., Trial Registration: clinicaltrials.gov Identifier: NCT01320072., (Copyright © 2016 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.)
- Published
- 2016
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- View/download PDF
6. Relationship between urine dichlorophenol levels and asthma morbidity.
- Author
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Jerschow E, Parikh P, McGinn AP, de Vos G, Jariwala S, Hudes G, and Rosenstreich D
- Subjects
- Adult, Asthma drug therapy, Female, Humans, Male, Respiratory Sounds drug effects, Surveys and Questionnaires, Asthma urine, Chlorophenols urine, Immunoglobulin E blood
- Abstract
Background: Chlorinated phenols are associated with atopic conditions, but it is not known whether they are associated with wheeze or asthma and whether atopy is involved in these associations., Objectives: To test the association between urine levels of 2 dichlorophenols (2,4- and 2,5-dichlorophenols) and asthma morbidity in atopic and nonatopic wheezers and between total serum immunoglobulin E (IgE) levels., Methods: Data from a sample of 2,125 participants at least 6 years old from the US National Health and Nutrition Examination Survey 2005 to 2006 were analyzed. Asthma morbidity data were available for those participants who reported wheezing in the past year ("wheezers"; n = 250). This subsample was categorized as atopic or nonatopic., Results: Atopic wheezers with higher 2,5-dichlorophenol levels were more frequently diagnosed with asthma by a physician (odds ratio [OR] 4.7 for highest vs lowest tertile, P < .001), required more prescriptions for asthma medications (OR 2.2, P = .046), and reported more exercise-induced wheezing (OR 5.8, P = .045) than atopic wheezers with low dichlorophenol levels. Atopic wheezers with higher 2,5- or 2,4-dichloropheonol levels also were more likely to miss work or school because of wheezing (OR 10.0, P < .001; OR 11.4, P < .01, respectively). In contrast, in nonatopic wheezers, there were no significant associations between dichlorophenol levels and asthma morbidity measurements. The 2 dichlorophenol metabolites were positively associated with increased serum IgE levels in the larger study sample., Conclusion: These findings indicate that in patients with atopy and a history of wheezing, asthma morbidity is associated with high urinary dichlorophenol levels. Increased urine dichlorophenol levels are associated with higher total serum IgE., (Copyright © 2014 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.)
- Published
- 2014
- Full Text
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7. Dichlorophenol-containing pesticides and allergies: results from the US National Health and Nutrition Examination Survey 2005-2006.
- Author
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Jerschow E, McGinn AP, de Vos G, Vernon N, Jariwala S, Hudes G, and Rosenstreich D
- Subjects
- Adult, Allergens adverse effects, Allergens immunology, Environmental Exposure adverse effects, Female, Food adverse effects, Humans, Hypersensitivity blood, Hypersensitivity etiology, Immunoglobulin E blood, Immunoglobulin E immunology, Male, Nutrition Surveys methods, United States epidemiology, Hypersensitivity epidemiology, Hypersensitivity immunology, Pesticides immunology, Pesticides poisoning, Phenols immunology, Phenols poisoning
- Abstract
Background: Epidemiologic studies support the hypothesis that reduced microbial exposure in westernized societies promotes atopy. Dichlorophenols are widely used as pesticides and for chlorination of water. They have a strong bactericidal effect that could affect microflora in the environment. However, it is unknown whether their use is associated with a higher prevalence of allergies., Objective: To test the association between exposure to environmental pesticides represented by dichlorophenols and allergic sensitization measured by allergen-specific serum IgE levels in a US nationally representative sample of 2,211 persons 6 years and older in the National Health and Nutrition Examination Survey 2005-2006., Methods: Exposure to dichlorophenols was defined as high if their levels in urine were present at the 75th percentile and above. Association of the high exposure to dichlorophenols with sensitization to food and environmental allergens was assessed in logistic regression models after adjustment for sample weights and potential confounders., Results: Sensitizations to 1 or more food allergens were more common in those with exposure to 2 dichlorophenol metabolites. After multivariable adjustment, urine dichlorophenol levels at the 75th percentile and above were associated with the presence of sensitization to foods (odds ratio, 1.8; 95% confidence interval, 1.2-2.5; P = .003). No significant association was found between dichlorophenol exposure and sensitization to aeroallergens alone., Conclusion: High urine levels of dichlorophenols are associated with the presence of sensitization to foods in a US population. Excessive use of dichlorophenols may contribute to the increasing incidence of food allergies in westernized societies., (Copyright © 2012 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.)
- Published
- 2012
- Full Text
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8. Chronic urticaria with monoclonal IgG gammopathy: a clinical variant of Schnitzler syndrome?
- Author
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Patel S, Sindher S, Jariwala S, and Hudes G
- Subjects
- Adult, Arthralgia drug therapy, Arthralgia etiology, Chronic Disease, Diagnosis, Differential, Doxepin administration & dosage, Female, Fever drug therapy, Fever etiology, Histamine Antagonists administration & dosage, Humans, Immunoglobulin G blood, Immunoglobulin M blood, Middle Aged, Practice Guidelines as Topic, Schnitzler Syndrome complications, Schnitzler Syndrome drug therapy, Urticaria drug therapy, Urticaria etiology, Arthralgia diagnosis, Fever diagnosis, Schnitzler Syndrome diagnosis, Urticaria diagnosis
- Published
- 2012
- Full Text
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9. Subcutaneous allergen immunotherapy in 3 patients with HIV.
- Author
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Fodeman J, Jariwala S, Hudes G, Jerschow E, and Rosenstreich D
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- Adult, Allergens therapeutic use, CD4 Lymphocyte Count, Chronic Disease, Female, HIV pathogenicity, HIV Infections drug therapy, HIV Infections pathology, HIV Infections physiopathology, Humans, Injections, Subcutaneous, Male, Middle Aged, Rhinitis, Allergic, Perennial drug therapy, Rhinitis, Allergic, Perennial pathology, Rhinitis, Allergic, Perennial physiopathology, Rhinitis, Allergic, Seasonal drug therapy, Rhinitis, Allergic, Seasonal pathology, Rhinitis, Allergic, Seasonal physiopathology, Risk Assessment, Sinusitis, Sneezing, Viral Load drug effects, Allergens immunology, Desensitization, Immunologic, HIV physiology, HIV Infections immunology, Rhinitis, Allergic, Perennial immunology, Rhinitis, Allergic, Seasonal immunology
- Published
- 2010
- Full Text
- View/download PDF
10. The Urticaria Severity Score: a sensitive questionnaire/index for monitoring response to therapy in patients with chronic urticaria.
- Author
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Jariwala SP, Moday H, de Asis ML, Fodeman J, Hudes G, de Vos G, and Rosenstreich D
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- Adolescent, Adult, Aged, Chronic Disease, Female, Humans, Male, Middle Aged, Monitoring, Physiologic, Predictive Value of Tests, Treatment Outcome, Severity of Illness Index, Surveys and Questionnaires, Urticaria physiopathology, Urticaria therapy
- Abstract
Background: Despite the existence of numerous dermatology-specific quality-of-life questionnaires, there exists a need for a well-validated instrument to evaluate and monitor patients with chronic urticaria., Objective: To develop and validate a novel chronic urticaria-specific questionnaire, the Urticaria Severity Score (USS)., Methods: The USS was developed with 12 questions and 7 response options per question included in the final questionnaire. The USS was pilot tested on 28 patients with symptomatic chronic urticaria, and a modified version was tested in 80 patients. In this latter group, the USS was compared with the previously validated Dermatology Life Quality Index (DLQI). Patients completed both questionnaires at baseline and at follow-up (median, 2 weeks). Spearman rank correlation tests were used to compare the USS with the DLQI. At a subsequent visit, 9 additional patients completed the USS to evaluate test-retest reliability., Results: There was a positive correlation between the USS and DLQI at baseline (r = 0.64) and follow-up (r = 0.69). The test-retest reliability correlation for the USS was adequate (r = 0.96) (P = .001). The USS was more sensitive in detecting symptom improvement than the DLQI. The mean (SD) "raw score" change from baseline to follow-up for the USS was 9.95 (12.80), whereas the mean (SD) change from baseline to follow-up for the DLQI was 2.25 (4.87)., Conclusions: The USS is a valid and reliable instrument for monitoring urticaria severity. The USS is more sensitive than the DLQI for quantifying urticaria severity and may be moreapplicable in the evaluation of urticaria-specific treatment efficacy.
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- 2009
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11. A case of common variable immunodeficiency syndrome associated with Takayasu arteritis.
- Author
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Jerschow E, De Vos GS, Hudes G, Rubinstein A, Lipsitz EC, and Rosenstreich D
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- Common Variable Immunodeficiency complications, Female, Humans, Middle Aged, Takayasu Arteritis complications, Common Variable Immunodeficiency therapy, Immunoglobulins, Intravenous therapeutic use, Takayasu Arteritis therapy
- Abstract
Background: Association of common variable immunodeficiency (CVID) with Takayasu arteritis has rarely been reported., Objective: To describe a case of Takayasu arteritis in a 53-year-old Hispanic woman with CVID undergoing long-term (3-year) intravenous immunoglobulin (IVIG) treatment., Methods: The patient's serum immunoglobulin levels and antibody titers to measles, mumps, and rubella were measured. She also underwent angiography of the large vessels., Results: Low to undetectable serum IgA, IgM, and IgG levels and low antibody titers to mumps, measles, and rubella were consistent with the diagnosis of CVID. The angiogram showed narrowing of the proximal left subclavian artery (2-3 mm in diameter)., Conclusions: This patient developed Takayasu arteritis while receiving IVIG for CVID. She clinically improved after her IVIG dose was increased. To our knowledge, this is the second reported case of Takayasu arteritis associated with CVID.
- Published
- 2007
- Full Text
- View/download PDF
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