Search

Acute respiratory infections are a major cause of morbidity and mortality in children worldwide. Dietary and nutritional interventions, including minerals and vitamin supplementation, have been explored as potential treatments for these infections. However, the evidence on their efficacy is limited and inconclusive. This systematic review and meta‐analysis aim to provide a comprehensive summary of the available evidence on the effectiveness of dietary and nutritional interventions for treating acute respiratory tract infections in children. A systematic review was conducted according to the PRISMA 2020 guidelines in April 2022 and updated in April 2023. Clinical trials focusing on dietary or nutritional interventions, including supplementations, in children with acute respiratory tract infections were included. The selection of interventions and outcomes was based on biological plausibility. Data were extracted using a standardized form, and the risk of bias was assessed using the Cochrane Risk of Bias Tool. Meta‐analysis was performed using random‐effect models. A total of 50 studies were included in the review. Four trials were conducted in low, 32 in lower‐middle, 12 in upper‐middle, and only two in high‐income countries. The studies evaluated various dietary interventions, including zinc, vitamin A, vitamin E, vitamin D, and probiotics. The results of individual studies on the efficacy of these interventions were mixed, with some showing positive effects on clinical outcomes such as duration of symptoms, while others showed no significant impact. Meta‐analysis was conducted for zinc supplementation in children with pneumonia, and the pooled results suggested a potential limited benefit in terms of reduced hospital length of stay but not time to recovery. Meta‐analyses on vitamin D did not show any effect in children with pneumonia. This systematic review fills a critical gap in the literature by synthesizing the available evidence on the efficacy and safety of nutritional or dietary interventions for acute respiratory tract infections in children. The findings indicate no dietary or nutritional intervention can currently be recommended for the routine treatment of respiratory tract infections in children based on single supplement studies. The metanalysis suggests that zinc supplementation might have a beneficial effect on length of hospitalization in children with pneumonia. New studies are needed to establish more conclusive evidence for pediatric acute respiratory diseases especially for children living in a context of high‐income countries. [ABSTRACT FROM AUTHOR]

Background: Abrocitinib efficacy by comorbidity status in patients with moderate‐to‐severe atopic dermatitis (AD) has not been previously assessed. This post hoc analysis evaluated the efficacy and safety of abrocitinib in patients with AD and allergic comorbidities. Methods: Data were pooled from patients who received abrocitinib 200 mg, 100 mg, or placebo in phase 2b (NCT02780167) and phase 3 (NCT03349060, NCT03575871) monotherapy trials. Patients with and without allergic comorbidities (allergic asthma, rhinitis, conjunctivitis, or food allergy) were evaluated for Investigator's Global Assessment (IGA) response (clear [0] or almost clear [1]), ≥75% improvement in the Eczema Area and Severity Index (EASI‐75), ≥4‐point improvement in Peak Pruritus Numerical Rating Scale (PP‐NRS4), and Dermatology Life Quality Index (DLQI) response (<2 with baseline score ≥2). Other outcomes were Patient‐Oriented Eczema Measure (POEM), SCORing Atopic Dermatitis (SCORAD), Pruritus and Symptoms Assessment for Atopic Dermatitis (PSAAD), and treatment‐emergent adverse events (TEAEs). Results: Of 942 patients, 498 (53%) reported at least one allergic comorbidity (asthma only, 33%; conjunctivitis only or rhinitis only or both, 17%; food allergies only, 15%; >1 allergic comorbidity, 34%). Regardless of comorbidity status, from Week 2 to Week 12, higher percentages of patients treated with either abrocitinib dose achieved IGA 0/1, EASI‐75, PP‐NRS4, or DLQI 0/1 versus placebo‐treated patients. Changes from baseline in POEM, SCORAD, and PSAAD were greater with abrocitinib than with placebo in patients with and without allergic comorbidities. Most TEAEs were mild or moderate. Conclusions: Efficacy and safety data support abrocitinib use to manage AD in patients with or without allergic comorbidities. [ABSTRACT FROM AUTHOR]

Background: Omalizumab is the recommended treatment for antihistamine‐refractory chronic spontaneous urticaria (CSU) and severe allergic asthma. In addition, it has been shown to reduce the frequency of viral respiratory infections in allergic asthma. Respiratory illness is a known trigger for asthma and CSU. Objectives: To explore whether the antiviral effect of omalizumab may be extended to CSU patients independent of their atopic status. Methods: We conducted a prospective parallel‐group pilot pragmatic trial including 30 non‐allergic and non‐atopic CSU patients (cases) under omalizumab 300 mg Q4‐weeks (due to refractory to H1‐antihistamines) and 30 age‐matched healthy controls. All CSU patients had to have a weekly urticaria activity score UAS7 <15 at least 4 weeks before recruitment. Using the self‐filled validated Jackson scale, we evaluated all study participants for common cold symptoms. All cases and controls rated weekly their respiratory symptoms. An increase in the symptom score of at least 4 points compared to baseline (defined as the minimum weekly report of symptoms) was considered an episode suggestive of a viral infection of the upper respiratory tract (URT). The patients were follow‐up every 4 weeks throughout the study period (10 months). Results: CSU patients under omalizumab reported fewer episodes suggestive of an URT viral infection than the healthy controls (median of reported episodes: 0 vs. 1, inter‐quartile range 0–1 vs. 1–1, min–max: 0–3 vs. 0–4, respectively; p = 0.0095). The duration of each episode was the same in both cases and controls. Conclusions: Omalizumab can reduce the number of common cold episodes in CSU patients and consequently may minimize viral‐related CSU exacerbations. This beneficial effect is exerted independently of the atopic status, even in non‐asthmatic individuals or non‐allergic patients without any evidence of respiratory susceptibility. Further large‐scale studies are needed to validate the current findings and elucidate the underlying relevant pathophysiology. [ABSTRACT FROM AUTHOR]

Severe eosinophilic asthma (SEA) is associated with poor disease control and compromised health-related quality of life (HRQoL), leading to a substantial psychosocial and economic disease burden. Benralizumab, an interleukin-5-alpha receptor monoclonal antibody, is approved as an add-on maintenance treatment for SEA, yet real-world evidence of its effectiveness is limited. EMPOWAIR is a non-interventional, multicenter, 48-week prospective cohort study aiming to evaluate the clinical effectiveness and the patient-perceived impact of benralizumab on HRQoL, sleep quality, depression, anxiety, work productivity and activity impairment among SEA patients treated in routine care settings in Greece. The study will also engage advanced remote patient monitoring technologies using portable spirometers and wearable activity trackers to collect data on lung function parameters and physical activity. The study plans to consecutively enroll 150 adult patients treated by lung specialists practicing in various healthcare settings across the country over an 18-month recruitment period. Eligible patients must be newly prescribed benralizumab per the approved label. Primary data will be collected at enrollment and 4, 8, 16, 32, and 48 weeks after treatment initiation through routine clinic visits or telephone contacts as per the standard clinical practice. The primary objective is to assess the change from baseline in HRQoL, as measured by the St. George's Respiratory Questionnaire (SGRQ), and to estimate the proportion of patients achieving a minimum clinically important improvement in respiratory health status, defined as ≥ 4-point reduction from baseline in SGRQ total score, after 16 weeks of benralizumab treatment. The study rationale, design and protocol, are described herein. [ABSTRACT FROM AUTHOR]

Keywords: anaphylaxis; eliciting dose; food allergy; precautionary allergen labelling; reference dose; thresholds EN anaphylaxis eliciting dose food allergy precautionary allergen labelling reference dose thresholds 1661 1666 6 05/31/22 20220601 NES 220601 The disclosure of "priority" allergens when present as an (intended) ingredient in foods is, in most countries, enshrined in legislation. Are current analytical methods suitable to verify VITAL ® 2.0/3.0 allergen reference doses for EU allergens in foods? Summary report of the Ad hoc Joint FAO/WHO expert consultation on risk assessment of food allergens. part 2: review and establish threshold levels in foods of the priority allergens. "Too high, too low": The complexities of using thresholds in isolation to inform precautionary allergen ("may contain") labels. [Extracted from the article]