Search

Your search keyword '"Wytske Fokkens"' showing total 312 results
Start Over Author "Wytske Fokkens"
312 results on '"Wytske Fokkens"'

1. A EUFOREA comment on a lost comorbidity of asthma

Author

Diego M. Conti, Peter W. Hellings, Zuzana Diamant, Leif Bjermer, Milos Jesenak, Vibeke Backer, Wytske Fokkens, Susanne Lau, Elizabeth Van Staeyen, and Glenis K. Scadding

Subjects
Asthma, Comorbidities, Allergic rhinitis, Chronic rhinosinusitis with nasal polyps, Chronic rhinosinusitis without nasal polyps, Immunologic diseases. Allergy, RC581-607
Abstract

Abstract “Epidemiology of comorbidities and their association with asthma control” (Tomisa, G., Horváth, A., Sánta, B. et al. Epidemiology of comorbidities and their association with asthma control. Allergy Asthma Clin Immunol 17, 95 (2021). https://doi.org/10.1186/s13223-021-00598-3 ) is an interesting paper reflecting data collection from more than 12,000 asthmatic patients in Hungary regarding their condition and associated comorbidities. We found it valuable that the paper provides an overview of asthma comorbidities not usually considered in similar reports. Nevertheless, we believe that chronic rhinosinusitis (CRS) with or without nasal polyps (CRSwNP or CRSsNP) should have been listed due to its high incidence and prevalence, its association with asthma which is also endorsed in both GINA and EPOS, as well as in several peer-reviewed scientific papers, and to reflect the role of this comorbidity in poor control and a most severe presentation of asthma for the patient. Consequently, several targeted therapies (especially monoclonal antibodies) used for several years in severe forms of asthma are now indicated also for the effective treatment of nasal polyps.

Published
2023
Full Text
View/download PDF

2. Mepolizumab improvements in health-related quality of life and disease symptoms in a patient population with very severe chronic rhinosinusitis with nasal polyps: psychometric and efficacy analyses from the SYNAPSE study

Author

Wytske Fokkens, Andrew Trigg, Stella E. Lee, Robert H. Chan, Zuzana Diamant, Claire Hopkins, Peter Howarth, Valerie Lund, Bhabita Mayer, Ana R. Sousa, Steve Yancey, Maggie Tabberer, and SYNAPSE study group

Subjects
SNOT-22, VAS, Chronic rhinosinusitis with nasal polyps, Psychometric, Efficacy, Quality of life, Public aspects of medicine, RA1-1270
Abstract

Plain English summary Patients with chronic rhinosinusitis (CRS) often have blocked or runny noses, and loss of sense of smell. They can also have sac-like growths in their nose called nasal polyps, which often require surgical removement. The symptoms of CRS with nasal polyps can affect quality of life. In a clinical study named SYNAPSE, a new treatment option called mepolizumab reduced the size and severity of nasal polyps in patients suffering from very severe CRS with nasal polyps, compared with placebo. Mepolizumab also reduced the need for nasal polyp surgery. The SYNAPSE study also measured if 1 year of mepolizumab treatment improved patients’ symptoms and quality of life. This was evaluated by asking patients to complete two separate tasks. These tasks were rating symptoms on a visual analogue scale (VAS) and completing a quality of life questionnaire called SNOT-22. The objective of this analysis was to see if these questionnaires accurately assessed a patient’s quality of life. The analysis also assessed how many patients had major improvements in their symptoms with mepolizumab. Overall, data from 407 patients in the SYNAPSE study was analyzed. Results showed that both the VAS and SNOT-22 questionnaires accurately captured CRS symptoms and quality of life. In addition, patients treated with mepolizumab for 1 year had improvements in quality of life compared with placebo. In conclusion, these findings suggest that the VAS and SNOT-22 questionnaires are appropriate evaluation tools for patients with very severe CRS with nasal polyps. The findings also show that mepolizumab treatment is beneficial for these patients.

Published
2023
Full Text
View/download PDF

3. Corrigendum on: White paper on European patient needs and suggestions on chronic type 2 inflammation of airways and skin by EUFOREA

Author

Louise De Prins, Ulrike Raap, Tara Mueller, Peter Schmid-Grendelmeier, Christiane H. Haase, Vibeke Backer, Wytske Fokkens, Linda B. Benoist, Emmanuel Prokopakis, Maria Doulaptsi, Claire Hopkins, Nele Claeys, Thijs Teeling, Lindsay Cypers, Leen Cools, Leif H. Bjermer, Zuzana Diamant, Ulrich Wahn, Glenis Scadding, Claus Bachert, Peter Walther, Sunni R. Patel, Elizabeth Van Staeyen, and Peter Hellings

Subjects
atopic dermatitis (AD), asthma, chronic rhinosinusitis, nasal polyps, type 2 inflammation, quality of life, Immunologic diseases. Allergy, RC581-607
Published
2022
Full Text
View/download PDF

4. White Paper on European Patient Needs and Suggestions on Chronic Type 2 Inflammation of Airways and Skin by EUFOREA

Author

Louise De Prins, Ulrike Raap, Tara Mueller, Peter Schmid-Grendelmeier, Christiane H. Haase, Vibeke Backer, Wytske Fokkens, Linda B. Benoist, Emmanuel Prokopakis, Maria Doulaptsi, Claire Hopkins, Nele Claeys, Thijs Teeling, Lindsay Cypers, Leen Cools, Leif H. Bjermer, Zuzana Diamant, Ulrich Wahn, Glenis Scadding, Claus Bachert, Peter Walther, Sunni R. Patel, Elizabeth Van Staeyen, and Peter Hellings

Subjects
atopic dermatitis, asthma, chronic rhinosinusitis, nasal polyps, Type 2 inflammation, quality of life, Immunologic diseases. Allergy, RC581-607
Abstract

BackgroundType 2 inflammation underlies the chronicity of disease in subgroups of patients with asthma, chronic rhinosinusitis with nasal polyps (CRSwNP) and atopic dermatitis (AD), that often co-exist. Although several studies have investigated the unmet needs of asthma, AD and CRSwNP as such, little is known about the similarities and differences in experiences and perspectives of the current management of patients with comorbid Type 2 inflammatory diseases.AimsTo improve insight into the common and organ-specific needs of patients with Type 2 inflammation and comorbidities, allowing the formulation of recommendations to better address these needs in the future.MethodologyThis qualitative study was conducted between July 2021 and December 2021 using semi-structured face-to-face or telephone interviews with patients suffering from year-long severe chronic Type 2 inflammation and at least one co-morbid inflammatory condition. Seven participating academic centers in Europe interviewed asthma (Copenhagen and Leuven), CRSwNP (London, Amsterdam and Crete) and/or AD (Oldenburg and Zurich) patients on patient characteristics, disease severity, shortcomings of current care pathways and suggestions for improvement of care. Transcripts were analyzed using an inductive thematic analysis approach.ResultsEighty-one patients with severe Type 2 inflammation and comorbidities were interviewed. Similar needs were recognized by patients with Type 2 inflammation, with both a lack of coordination in care and a lack of a real cure reported as being most frustrating. However, several needs are specific to asthma, CRSwNP and AD. Suggestions for improvement of care were generic across diseases, such as the implementation of a multidisciplinary approach, the improved facilitation of access to better treatments, the increase of general awareness on disease burden, and better educational programs for healthcare providers and patients. Of note, patients with CRSwNP also stated the need for alternatives to sinus surgery, whereas patients with asthma requested better medical care to prevent exacerbations and patients with AD would warmly welcome the reimbursement of emollients.ConclusionPatients with asthma, CRSwNP and AD have shared unmet needs that need to be addressed by physicians, the academic community and health policy makers. This survey provides unique recommendations made by patients for the implementation of better care.

Published
2022
Full Text
View/download PDF

5. Benefits and harm of systemic steroids for short- and long-term use in rhinitis and rhinosinusitis: an EAACI position paper

Author

Valerie Hox, Evelijn Lourijsen, Arnout Jordens, Kristian Aasbjerg, Ioana Agache, Isam Alobid, Claus Bachert, Koen Boussery, Paloma Campo, Wytske Fokkens, Peter Hellings, Claire Hopkins, Ludger Klimek, Mika Mäkelä, Ralph Mösges, Joaquim Mullol, Laura Pujols, Carmen Rondon, Michael Rudenko, Sanna Toppila-Salmi, Glenis Scadding, Sophie Scheire, Peter-Valentin Tomazic, Thibaut Van Zele, Martin Wagemann, Job F. M. van Boven, and Philippe Gevaert

Subjects
Glucocorticosteroids, Rhinitis, Rhinosinusitis, Immunologic diseases. Allergy, RC581-607
Abstract

Abstract Because of the inflammatory mechanisms of most chronic upper airway diseases such as rhinitis and chronic rhinosinusitis, systemic steroids have been used for their treatment for decades. However, it has been very well documented that—potentially severe—side-effects can occur with the accumulation of systemic steroid courses over the years. A consensus document summarizing the benefits of systemic steroids for each upper airway disease type, as well as highlighting the potential harms of this treatment is currently lacking. Therefore, a panel of international experts in the field of Rhinology reviewed the available literature with the aim of providing recommendations for the use of systemic steroids in treating upper airway disease.

Published
2020
Full Text
View/download PDF

6. Executive Summary of ARIA 2019: Integrated care pathways for allergic rhinitis in Argentina, Spain and Mexico

Author

Juan Carlos Ivancevich, Victoria Cardona, Désirée Larenas-Linnemann, Joaquim Mullol, Hugo Neffen, Mario Zernotti, Estrella Asayag, Ariel Eduardo Blua, R. Maximiliano Gómez, Edgardo Jares, Jorge Máspero, Josep M. Anto, Toni Dedeu, Mónica Rodríguez-González, Yunuen Rocío Huerta-Villalobos, José Miguel Fuentes-Pérez, Eréndira Rodríguez-Zagal, Antonio Valero, Joan Bartra, Isam Alobid, José Antonio Castillo-Vizuete, Teresa Dordal, Rafael Hijano, César Picado, Joaquín Sastre, Martín Bedolla-Barajas, María Teresa Burguete-Cabañas, María del Carmen Costa-Domínguez, Margarita Domínguez-Silva, Jesús Guillermo Espinoza-Contreras, José Luis Gálvez-Romero, Cecilia Yvonne García-Cobas, María de la Luz Hortensia García-Cruz, Luiana Hernández-Velázquez, Jorge A. Luna-Pech, Juan José Matta, María Dolores Mogica-Martínez, Daniela Rivero-Yeverino, Lucy Tania Ruiz, Blanca E. Del Río-Navarro, Javier Gómez-Vera, Alejandra Macías-Weinmann, Ionna Agache, Ignacio Ansotegui, Claus Bachert, Anna Bedbrook, Giorgio Walter Canonica, Thomas B. Casale, Álvaro Cruz, Wytske Fokkens, Peter Hellings, Bolesław Samolinski, and Jean Bousquet

Subjects
aria, rinitis alérgica, vías integradas de atención, estudios en vida real, adherencia, automedicación, Immunologic diseases. Allergy, RC581-607
Abstract

The health and economic impact of allergic diseases are increasing rapidly, and changes in management strategies are required. Its influence reduces the capacity of work and school performance by at least a third. The ICPs of the airways (integrated care pathways for respiratory diseases) are structured multidisciplinary healthcare plans, promoting the recommendations of the guidelines in local protocols and their application to clinical practice. This document presents an executive summary for Argentina, Mexico, and Spain. Next-generation ARIA guidelines are being developed for the pharmacological treatment of allergic rhinitis (AR), using the GRADE-based guidelines for AR, tested with real-life evidence provided by mobile technology with visual analogue scales. It is concluded that in the AR treatment, H1-antihistamines are less effective than intranasal corticosteroids (INCS), in severe AR the INCS represent the first line of treatment, and intranasal combination INCS + anti-H1 is more effective than monotherapy. However, according to the MASK real-life observational study, patients have poor adherence to treatment and often self-medicate, according to their needs.

Published
2019
Full Text
View/download PDF

7. Mometasone furoate and fluticasone furoate are equally effective in restoring nasal epithelial barrier dysfunction in allergic rhinitis

Author

Maria Doulaptsi, Tine Wils, Peter W. Hellings, Katleen Martens, Ricard Farré, Maria Vicario, Wytske Fokkens, Emmanuel Prokopakis, and Brecht Steelant

Subjects
Fluticasone furoate, Mometasone furoate, Tight junctions, Epithelial integrity, Allergic rhinitis, Immunologic diseases. Allergy, RC581-607
Abstract

Tight junction defects (TJ) have been associated with a defective epithelial barrier function in allergic rhinitis (AR). Intranasal corticosteroids are potent drugs frequently used to treat AR and are shown to restore epithelial integrity by acting on TJs and by reducing type 2 cytokine production. However, the effect of different classes of intranasal corticosteroids on the epithelial barrier has not been studied. Therefore, we compared the effect of 2 intranasal corticosteroids, ie, fluticasone furoate (FF) and mometasone furoate (MF) on epithelial barrier function. Both FF and MF similarly increased trans-epithelial electrical resistance of primary nasal epithelial cell cultures from AR patients. In a house dust mite-induced allergic asthma mouse model, FF and MF had similar beneficial effects on fluorescein isothiocyanate–dextran 4 kDa mucosal permeability, eosinophilic infiltration and IL-13 levels. Both molecules increased mRNA expression of the TJ proteins occludin and zonula occludens-1, thereby restoring epithelial barrier function. Lastly, we showed that long-term FF treatment also increased expression of occludin in AR patients compared to controls. In conclusion, both FF and MF effectively restore epithelial barrier function by increasing expression of TJ proteins in AR patients.

Published
2021
Full Text
View/download PDF

8. Sleep in elite swimmers: prevalence of sleepiness, obstructive sleep apnoea and poor sleep quality

Author

Abigail Walker, Matus Putala, Pavol Surda, Pavel Siarnik, Katherine De Rome, Nikul Amin, Miljyot Singh Sangha, and Wytske Fokkens

Subjects
Medicine (General), R5-920
Abstract

ObjectivesLimited data suggest that swimmers might be affected by poor quality of sleep significantly. The aim was to explore the prevalence of sleep disturbances in swimmers and possible link between rhinitis and sleep disturbance.MethodsStudy 1 was an observational case–control, questionnaire-based study involving 157 elite and non-elite swimmers, 36 non-swimming athletes and 50 controls. In study 2, we measured sleep quality and duration using actigraphy in 20 elite swimmers. We also looked for presence of sleep-disordered breathing using overnight pulse oximetry monitor.ResultsIn study 1, we observed a significant difference in prevalence of excessive daytime sleepiness between groups of elite swimmers and controls. Pittsburgh Sleep Quality Index (PSQI) scores do not suggest that quality of sleep in group of swimmers is impaired. In study 2, we found that prevalence of obstructive sleep apnoea (OSA) in elite swimmers defined as oxygen desaturation index ≥5 was 30%. Analysis of actigraphy data revealed that on nights prior to training days, ‘going to’ bed time was significantly earlier and total sleep time was significantly reduced.ConclusionSwimmers and non-swimming athletes suffer significantly more with excessive daytime sleepiness than healthy controls. In elite swimmers, this is likely linked to high prevalence of OSA. PSQI scores do not suggest that quality of sleep in group of swimmers is impaired, but actigraphy shows great variations between sleep pattern preceding training and rest day. This seems to be associated with early-morning sessions which can be a disruptive element of weekly sleep patterns.

Published
2019
Full Text
View/download PDF

9. European Summit on the Prevention and Self-Management of Chronic Respiratory Diseases: report of the European Union Parliament Summit (29 March 2017)

Author

Peter W. Hellings, David Borrelli, Sirpa Pietikainen, Ioana Agache, Cezmi Akdis, Claus Bachert, Michael Bewick, Erna Botjes, Jannis Constantinidis, Wytske Fokkens, Tari Haahtela, Claire Hopkins, Maddalena Illario, Guy Joos, Valerie Lund, Antonella Muraro, Benoit Pugin, Sven Seys, David Somekh, Pär Stjärne, Arunas Valiulis, Erkka Valovirta, and Jean Bousquet

Subjects
Advocacy, EUFOREA, Asthma, Mobile health technology, Allergy, Immunologic diseases. Allergy, RC581-607
Abstract

Abstract On March 29, 2017, a European Summit on the Prevention and Self-Management of Chronic Respiratory Diseases (CRD) was organized by the European Forum for Research and Education in Allergy and Airway Diseases. The event took place in the European Parliament of Brussels and was hosted by MEP David Borrelli and MEP Sirpa Pietikainen. The aim of the Summit was to correspond to the needs of the European Commission and of patients suffering from CRD to join forces in Europe for the prevention and self-management. Delegates of the European Rhinologic Society, European Respiratory Society, European Academy of Allergy and Clinical Immunology, European Academy of Paediatrics, and European Patients Organization EFA all lectured on their vision and action plan to join forces in achieving adequate prevention and self-management of CRD in the context of Precision Medicine. Recent data highlight the preventive capacity of education on optimal care pathways for CRD. Self-management and patient empowerment can be achieved by novel educational on-line materials and by novel mobile health tools enabling patients and doctors to monitor and optimally treat CRDs based on the level of control. This report summarizes the contributions of the representatives of different European academic stakeholders in the field of CRD.

Published
2017
Full Text
View/download PDF

10. Rush immunotherapy with multiple aeroallergens is safe in an adult population

Author

Wytske Fokkens, Maurits van Maaren, Marije Wolvers, and Roy Gerth van Wijk

Subjects
immunotherapy, rush immunotherapy, allergic rhinitis, allergic rhinoxonjunctivitis, treatment, adverse reactions, systemic, local reaction, Otorhinolaryngology, RF1-547
Abstract

Background: The safety of rush subcutaneous immunotherapy (SCIT) to multiple aeroallergens has not been widely studied. The objectives of this retrospective study were to evaluate the incidence of adverse reactions of a rush immunotherapy scheme with five injections at the first day with different allergens in adult patients with allergic rhinitis with or without asthma. All patients took an antihistamine before the start of the first injection of the rush scheme. Methods: adverse reactions were analysed in a prospectively recorded database of 232 rush SCIT treatments with tree pollen, given to 138 patients with allergic rhinoconjunctivitis (61 (44%) male), mean age 31 years old ( 9-57), 45 (33%) with concomitant asthma, and 28 (20%) with eczema. Results: Systemic adverse reactions (gr 1-2) were reported 7 times (3%), one patient on house dust mite (HDM) complained of shortness of breath and had a reduction in peak expiratory flow (PEF) of 10% (gr 2). The other 6 patients (4 on HDM and 2 on GP) complained of mild upper respiratory symptoms mostly itchy throat. Four of the 7 participants who had systemic adverse reactions, had also received at least one rush SCIT with another allergen in the week before. A local reaction (with redness and swelling) was reported in 13 patients. Two HDM SCIT rushes were aborted, and patients proceeded on a conventional schedule. Conclusion: Rush SCIT with 5 injections on the first day of the treatment does not give more adverse reactions than what is usually reported with conventional immunotherapy.

Published
2018
Full Text
View/download PDF

11. Correction to: Benefits and harm of systemic steroids for short- and long-term use in rhinitis and rhinosinusitis: an EAACI position paper

Author

Valerie Hox, Evelijn Lourijsen, Arnout Jordens, Kristian Aasbjerg, Ioana Agache, Isam Alobid, Claus Bachert, Koen Boussery, Paloma Campo, Wytske Fokkens, Peter Hellings, Claire Hopkins, Ludger Klimek, Mika Mäkelä, Ralph Mösges, Joaquim Mullol, Laura Pujols, Carmen Rondon, Michael Rudenko, Sanna Toppila-Salmi, Glenis Scadding, Sophie Scheire, Peter-Valentin Tomazic, Thibaut Van Zele, Martin Wagenmann, Job F. M. van Boven, and Philippe Gevaert

Subjects
Immunologic diseases. Allergy, RC581-607
Abstract

An amendment to this paper has been published and can be accessed via the original article.

Published
2020
Full Text
View/download PDF

12. Acute and chronic rhinosinusitis and allergic rhinitis in relation to comorbidity, ethnicity and environment.

Author

Ruth Hoffmans, Alex Wagemakers, Cornelis van Drunen, Peter Hellings, and Wytske Fokkens

Subjects
Medicine, Science
Abstract

This study was conducted to assess the effect of comorbidity, ethnicity, occupation, smoking and place of residence on allergic rhinitis (AR), acute rhinosinusitis (ARS) and chronic rhinosinusitis (CRS).A GA2LEN (The Global Allergy and Asthma European Network) screening questionnaire was sent to a random sample of the Dutch population (n = 16700) in three different areas of the Netherlands.Fifty percent (8347) of the questionnaires sent were returned. A total of 29% respondents (27-31% in different areas) met the criteria for AR, 18% (17-21%) for ARS and 16% (13-18%) for CRS. Risk factors for AR were itchy rash, eczema, adverse response after taking a painkiller, asthma, CRS and ARS. Moreover, the risk of AR was twice as low for full-time housewives/househusbands than for people with jobs. The risk of ARS or CRS was significantly higher in respondents with a doctor's diagnosis of CRS, AR, itchy rash or smoking. The risk of CRS was also significantly higher in respondents with an adverse response after taking painkillers, active smoking or asthma. Caucasians are generally less likely to have AR or CRS than Latin-Americans, Hindustani and African-Creoles, and more likely to have ARS than Asian, Hindustani, Mediterranean and African-Creoles.This study found shared and distinct risk factors for AR, ARS and CRS and therefore provides support for the belief that they have shared symptoms but are different diseases with different aetiologies.

Published
2018
Full Text
View/download PDF

13. Diagnostic strategies in nasal congestion

Author

John Krouse, Valerie Lund, Wytske Fokkens, and et al

Subjects
Medicine (General), R5-920
Abstract

John Krouse1, Valerie Lund2, Wytske Fokkens3, Eli O Meltzer41Temple University School of Medicine, Philadelphia, PA, USA; 2Ear Institute, University College London, UK; 3Department of Otorhinolaryngology, Amsterdam Medical Centre, Netherlands; 4Allergy and Asthma Medical Group and Research Center, San Diego, CA and Department of Pediatrics, University of California, San Diego, USAAbstract: Nasal congestion is a major symptom of upper respiratory tract disorders, and its characterization an important part of the diagnosis of these illnesses. Patient history and assessment of nasal symptoms are essential components of diagnosis, providing an initial evaluation that may be adequate to rule out serious conditions. However, current congestion medications are not always fully effective. Thus, if symptoms do not respond adequately to therapy, or symptoms suggestive of more serious conditions are present, specialized assessments may be needed. Various techniques are available for diagnosing patients, including those used chiefly by primary care clinicians and those requiring the expertise of otolaryngologists, allergists, and other specialists. Endoscopy remains a mainstay for evaluating nasal blockage and its causes, while modalities such as peak nasal inspiratory flow and acoustic rhinometry are evolving to provide easy-to-use, noninvasive procedures that are sensitive enough to measure small but clinically important abnormalities and therapeutic changes. Several imaging modalities are available to the specialist for severe or unusual cases, as are specialized diagnostic procedures that measure adjunctive features of congestion, such as impaired mucociliary function.Keywords: allergic rhinitis, congestion, diagnosis, obstruction, rhinosinusitis

Published
2010

15. Unified Airway Disease

Author

Wytske Fokkens and Sietze Reitsma

Subjects
Otorhinolaryngology, General Medicine
Published
2023

16. Evaluating enrollment and outcome criteria in trials of biologics for chronic rhinosinusitis with nasal polyps

Author

Larry Borish, Noam A. Cohen, Geoffrey Chupp, Claire Hopkins, Martin Wagenmann, Ana R. Sousa, Steven G. Smith, Jared Silver, Shibing Yang, Bhabita Mayer, Steven W. Yancey, Robert H. Chan, and Wytske Fokkens

Subjects
Pulmonary and Respiratory Medicine, Biological Products, Nasal Polyps, Adrenal Cortex Hormones, Immunology, Chronic Disease, Immunology and Allergy, Humans, Omalizumab, Sinusitis, Rhinitis
Abstract

Objective: Treatment for chronic rhinosinusitis with nasal polyps (CRSwNP) generally involves intranasal corticosteroids (INCS) and saline irrigation, followed by short courses of systemic corticosteroids (SCS) or surgery with postoperative medical therapy for patients who do not respond to INCS. However, both SCS use and surgery are associated with a range of adverse effects or complications, have a high recurrence rate, and are unsuitable for some patients. Biologics targeting the underlying pathophysiology are promising treatment alternatives for these patients. Dupilumab, omalizumab, and mepolizumab are approved for use in patients with severe, uncontrolled CRSwNP. However, the lack of a consistent definition of severe CRSwNP makes the decision to initiate biologic treatment particularly complex. Furthermore, the position of each biologic in the overall management of CRSwNP remains to be clarified. Data Sources: Publications reporting results of phase III trials of dupilumab, omalizumab, mepolizumab, and benralizumab in the treatment of CRSwNP. Study Selections: Randomized, controlled phase III trials of biologics approved for CRSwNP. Results: These trials all used different enrollment criteria. We discuss the complexities of assessing CRSwNP disease severity and highlight how these impact comparisons of the populations and outcomes of the phase III biologic trials. Conclusion: To position biologic agents appropriately within the existing CRSwNP treatment paradigm, future trials will need to include comparable patient populations and standardized outcome measures. Such trials will help to ensure that biologic treatment is targeted appropriately to support optimal clinical outcomes.

Published
2022

17. Evaluation of switching or simultaneous use of biologic treatment in patients with severe chronic rhinosinusitis with nasal polyps and severe asthma. Considerations in clinical decision making

Author

Josje Otten, Rik van der Lans, Eugenio de Corso, kanstantsin Dziadziulia, Bart Hilvering, Els Weersink, Matteo Bonini, Jan Hagemann, Wanrawee Thaitrakool, Claudio Montuori, Ludger Klimek, Sietze Reitsma, Wytske Fokkens, and Pulmonary medicine

Subjects
Immunology, Immunology and Allergy
Abstract

Introduction: Type 2 targeting biologics have reached the market first for asthma and since 2019 also for CRSwNP. As clear guidelines and predictors for optimal biological choice are missing, patients are sometimes required to switch biologic therapy in order to find the optimal treatment result. In this paper, we evaluate reasons for switching biologics and the treatment effects after each sequential switch. Materials and methods: Ninety-four patients who switched from one biologic to another for their treatment of CRSwNP and asthma were evaluated. Results: Twenty patients experienced satisfactory control of CRSwNP, but insufficient control of severe asthma. Fifty-one patients experienced satisfactory control of severe asthma, but insufficient control of CRSwNP/EOM. Twenty-eight patients experienced insufficient control of both upper and lower airways. Thirteen patients had to switch because of side effects. Furthermore, two cases are described to clarify clinical decision-making. Discussion: For abovementioned patients, a multidisciplinary approach is mandatory to find the best suitable biologic. It seems ineffective to switch to a second anti-IL5 treatment if the first one is not successful. Most patients that failed omalizumab and/or an anti-IL-5 treatment are well controlled on dupilumab. Therefore, we suggest to use dupilumab as first choice when switching biologic agents.

Published
2023

19. Management of anaphylaxis due to COVID-19 vaccines in the elderly

Author

Paulo Augusto Moreira Camargos, Radolslaw Gawlik, Mirko Petrovic, Gunter J. Sturm, Kristof Nekam, Sergio Bonini, Zhanat Ispayeva, Marilyn Urrutia Pereira, Jean Bousquet, Antti Lauerma, Menachem Rottem, Arzu Yorgancioglu, Hubert Blain, Antonio Cherubini, Mário Morais-Almeida, Nathalie Salles, Charlotte G. Mortz, Sylwia Smolinska, Davor Plavec, A. Bedbrook, Torsten Zuberbier, Helga Kraxner, M. Beatrice Bilò, Sinthia Bosnic-Anticevich, Gaëtan Gavazzi, Finbarr C. Martin, Alvaro A. Cruz, K. S. Bennoor, Isabella Annesi-Maesano, Mohamed H. Shamji, Karin Hoffmann-Sommergruber, Marina Atanaskovic-Markovic, Carsten Bindslev-Jensen, Lan Tt Le, Isabel Skypala, Ana Todo-Bom, Vincenzo Patella, Lorenzo Cecchi, Charlotte Suppli Ulrik, Oscar Palomares, Joaquin Sastre, Hans Jürgen Hoffmann, Knut Brockow, Eva Untersmayr, Martin Hrubisko, Bernadette Eberlein, Aziz Sheikh, Milan Sova, Osman M. Yusuf, Violeta Kvedariene, G. Walter Canonica, Dana Wallace, Ioana Agache, Milena Sokolowska, Jos M. G. A. Schols, Susan Waserman, Stéphanie Miot, Carla Irani, Regina E Roller-Winsberger, Michael Levin, Yves Rolland, Emma Montella, Bilun Gemicioglu, Bolesław Samoliński, Stefano Del Giacco, Madda lenaIllario, Yehia El-Gamal, Olga Lourenço, Jean-Christoph Roger J-P Caubet, Luisa Brussino, Marysia Recto, De Yun Wang, Igor Kaidashev, Renaud Louis, Antonino Romano, Mario E. Zernotti, Jacques Reynes, Pedro Carreiro-Martins, Alexandra F. Santos, Marek Niedoszytko, M. Gotua, Musa Khaitov, Thomas B. Casale, Andrea Matucci, Bernardo Sousa-Pinto, Rafael Stelmach, Dejan Dokic, Joana Vitte, Motohiro Ebisawa, Maria Teresa Ventura, Joaquim Mullol, Tomas Chivato, Petr Panzner, Oliver Pfaar, Sanna Toppila-Salmi, Ioanna Tsiligianni, Wytske Fokkens, Alessandra Vultaggio, H. Neffen, Juan Carlos Ivancevich, Ya-dong Gao, Anna Sediva, Maja Hofmann, Ana Maria Carriazo, João Fonseca, Marek Jutel, A. Benetos, Nhân Pham-Thi, Mona Al-Ahmad, Arunas Valiulis, Mihaela Zidarn, Elizabeth Angier, Yoshitaka Okamoto, Montserrat Fernandez-Rivas, Cezmi A. Akdis, Philip W. Rouadi, Olivier Guérin, John Farrell, Mikaela Odemyr, George Christoff, Vera Mahler, Claus Bachert, Edward F. Knol, Wienczyslawa Czarlewski, Robyn E O'Hehir, Victoria Cardona, Ludger Klimek, Tari Haahtela, Vincent Le Moing, Branislava Milenkovic, Carmen Rondon, Kaja Julge, Jolanta Walusiak-Skorupa, Nikolaos G. Papadopoulos, Aslı Gelincik, Markus Ollert, Piotr Kuna, Leyla Namazova-Baranova, Margitta Worm, Annick Barbaud, Elena Camelia Berghea, Todor A. Popov, Derek K. Chu, María José Torres, Faradiba Sarquis Serpa, Nicola Scichilone, Amir Hamzah Abdul Latiff, Frederico S. Regateiro, Gianni Passalacqua, Humboldt-Universität zu Berlin, Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Institut Hospitalier Universitaire Méditerranée Infection (IHU Marseille), Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Center for Rhinology and Allergology Wiesbaden, University Hospital Mannheim, Humboldt University Of Berlin, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Transylvania University, Wrocław Medical University, Università degli studi di Bari Aldo Moro = University of Bari Aldo Moro (UNIBA), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], University of Cagliari, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Università Politecnica delle Marche [Ancona] (UNIVPM), Medical Consulting Czarlewski, Universiti Putra Malaysia, University of Southampton, Institut Desbrest de santé publique (IDESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), University of Belgrade [Belgrade], Ghent University Hospital, CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Dhaka Shishu Hospital [Bangladesh], University of Medicine and Pharmacy 'Carol Davila' Bucharest (UMPCD), Odense University Hospital (OUH), Italian National Research Council, National Research Council [Italy] (CNR), The University of Sydney, Technische Universität München = Technical University of Munich (TUM), Università degli studi di Torino = University of Turin (UNITO), Universidade Federal de Minas Gerais = Federal University of Minas Gerais [Belo Horizonte, Brazil] (UFMG), IRCCS Research Hospital, Milan, Vall d'Hebron University Hospital [Barcelona], Centro Hospitalar de Lisboa Central E.P.E, University of South Florida [Tampa] (USF), Geneva University Hospital (HUG), Azienda Usl Toscana centro [Firenze], Софийски университет = Sofia University, McMaster University [Hamilton, Ontario], State University of Bahia, Institute of Public Health of Republic of North Macedonia [Skopje], Ain Shams University (ASU), Sagamihara National Hospital [Kanagawa, Japan], Instituto de Investigación Sanitaria del Hospital Clínico San Carlos [Madrid, Spain] (IdISSC), Amsterdam UMC - Amsterdam University Medical Center, Universidade do Porto = University of Porto, Wuhan University [China], CHU Grenoble, Silesian University of Medicine, Istanbul Faculty of Medicine, Cerrahpasa Faculty of Medicine, Istanbul University, Centre Hospitalier Universitaire de Nice (CHU Nice), Helsinki University Hospital [Helsinki, Finlande], Helsingin yliopisto = Helsingfors universitet = University of Helsinki, Medizinische Universität Wien = Medical University of Vienna, Aarhus University [Aarhus], Oncology Institute of St Elisabeth, University of Naples Federico II = Università degli studi di Napoli Federico II, St Joseph University, Hôtel-Dieu de France (HDF), Université Saint-Joseph de Beyrouth (USJ), Kazakh National Medical University, Servicio de Alergia e ImmunologiaBuenos Aires (Clinica Santa Isabel), Tartu University Institute of Clinical Medicine, Ukrainina Medical Stomatological Academy [Poltava, Ukraine], Federal Medicobiological Agency [Moscow, Russian Federation], University Medical Center [Utrecht], Semmelweis University [Budapest], Medical University of Łódź (MUL), Vilnius University [Vilnius], University of Medicine and Pharmacy (VIETNAM), University of Cape Town, CHU Sart Tilman, Université de Liège, University of Beira Interior [Portugal] (UBI), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), uBibliorum, Ear, Nose and Throat, AII - Inflammatory diseases, CHU Montpellier, Wroclaw Medical University [Wrocław, Pologne], University of Bari Aldo Moro (UNIBA), Service de Médecine Interne = Hôpital de jour de médecine [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sagamihara National Hospital, Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), CHU Toulouse [Toulouse], RS: CAPHRI - R1 - Ageing and Long-Term Care, Health Services Research, Bousquet J., Agache I., Blain H., Jutel M., Ventura M.T., Worm M., Del Giacco S., Benetos A., Bilo B.M., Czarlewski W., Abdul Latiff A.H., Al-Ahmad M., Angier E., Annesi-Maesano I., Atanaskovic-Markovic M., Bachert C., Barbaud A., Bedbrook A., Bennoor K.S., Berghea E.C., Bindslev-Jensen C., Bonini S., Bosnic-Anticevich S., Brockow K., Brussino L., Camargos P., Canonica G.W., Cardona V., Carreiro-Martins P., Carriazo A., Casale T., Caubet J.-C., Cecchi L., Cherubini A., Christoff G., Chu D.K., Cruz A.A., Dokic D., El-Gamal Y., Ebisawa M., Eberlein B., Farrell J., Fernandez-Rivas M., Fokkens W.J., Fonseca J.A., Gao Y., Gavazzi G., Gawlik R., Gelincik A., Gemicioglu B., Gotua M., Guerin O., Haahtela T., Hoffmann-Sommergruber K., Hoffmann H.J., Hofmann M., Hrubisko M., Illario M., Irani C., Ispayeva Z., Ivancevich J.C., Julge K., Kaidashev I., Khaitov M., Knol E., Kraxner H., Kuna P., Kvedariene V., Lauerma A., Le L.T.T., Le Moing V., Levin M., Louis R., Lourenco O., Mahler V., Martin F.C., Matucci A., Milenkovic B., Miot S., Montella E., Morais-Almeida M., Mortz C.G., Mullol J., Namazova-Baranova L., Neffen H., Nekam K., Niedoszytko M., Odemyr M., O'Hehir R.E., Okamoto Y., Ollert M., Palomares O., Papadopoulos N.G., Panzner P., Passalacqua G., Patella V., Petrovic M., Pfaar O., Pham-Thi N., Plavec D., Popov T.A., Recto M.T., Regateiro F.S., Reynes J., Roller-Winsberger R.E., Rolland Y., Romano A., Rondon C., Rottem M., Rouadi P.W., Salles N., Samolinski B., Santos A.F., S Sarquis F., Sastre J., M. G. A. Schols J., Scichilone N., Sediva A., Shamji M.H., Sheikh A., Skypala I., Smolinska S., Sokolowska M., Sousa-Pinto B., Sova M., Stelmach R., Sturm G., Suppli Ulrik C., Todo-Bom A.M., Toppila-Salmi S., Tsiligianni I., Torres M., Untersmayr E., Urrutia Pereira M., Valiulis A., Vitte J., Vultaggio A., Wallace D., Walusiak-Skorupa J., Wang D.-Y., Waserman S., Yorgancioglu A., Yusuf O.M., Zernotti M., Zidarn M., Chivato T., Akdis C.A., Zuberbier T., Klimek L., HUS Inflammation Center, University of Helsinki, and Department of Dermatology, Allergology and Venereology

Subjects
Male, Allergy, Pediatrics, Eaaci Position Paper, COVID-19 vaccines, older (adults, GUIDELINES, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Medicine and Health Sciences, Immunology and Allergy, Medicine, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, Geriatrics, MESH: Aged, RISK, Vaccines, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, people), EPINEPHRINE, Epinephrine, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, COVID -19 vaccines, Anaphylaxis, medicine.drug, older (adults/people), medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), MESH: Covid-19, MESH: Epinephrine, Immunology, adrenaline, anaphylaxis, Aged, COVID-19 Vaccines, Humans, SARS-CoV-2, COVID-19, Settore MED/10 - Malattie Dell'Apparato Respiratorio, 03 medical and health sciences, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Diabetes mellitus, Anaphylaxis/etiology, MESH: SARS-CoV-2, [SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, COVID‐19 vaccines, Older - Adults/people, Asthma, MESH: Humans, business.industry, adrenaline, anaphylaxis, COVID-19 vaccines, older (adults/people), medicine.disease, Obesity, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, MESH: Male, MESH: Anaphylaxis, Older, 3121 General medicine, internal medicine and other clinical medicine, business, MESH: Covid-19 vaccines, 030215 immunology
Abstract

Submitted by (omml@ubi.pt) on 2021-07-05T10:47:24Z No. of bitstreams: 1 2021_Bousquet J_A_COVID anaphylaxis.pdf: 12561118 bytes, checksum: 2f801ee76ad2cb3cbdaa02ffabea8e09 (MD5) Approved for entry into archive by Pessoa (pfep@ubi.pt) on 2021-07-05T10:49:11Z (GMT) No. of bitstreams: 1 2021_Bousquet J_A_COVID anaphylaxis.pdf: 12561118 bytes, checksum: 2f801ee76ad2cb3cbdaa02ffabea8e09 (MD5) Rejected by Pessoa (pfep@ubi.pt), reason: Rever os nomes dos autores. Depois da correção é só voltar a submeter. on 2021-07-05T10:54:19Z (GMT) Submitted by (omml@ubi.pt) on 2021-07-05T11:52:24Z No. of bitstreams: 1 2021_Bousquet J_A_COVID anaphylaxis.pdf: 12561118 bytes, checksum: 2f801ee76ad2cb3cbdaa02ffabea8e09 (MD5) Approved for entry into archive by Pessoa (pfep@ubi.pt) on 2021-07-05T13:34:51Z (GMT) No. of bitstreams: 1 2021_Bousquet J_A_COVID anaphylaxis.pdf: 12561118 bytes, checksum: 2f801ee76ad2cb3cbdaa02ffabea8e09 (MD5) Approved for entry into archive by Pessoa (pfep@ubi.pt) on 2021-07-05T13:35:49Z (GMT) No. of bitstreams: 1 2021_Bousquet J_A_COVID anaphylaxis.pdf: 12561118 bytes, checksum: 2f801ee76ad2cb3cbdaa02ffabea8e09 (MD5) Made available in DSpace on 2021-07-05T13:35:49Z (GMT). No. of bitstreams: 1 2021_Bousquet J_A_COVID anaphylaxis.pdf: 12561118 bytes, checksum: 2f801ee76ad2cb3cbdaa02ffabea8e09 (MD5) Previous issue date: 2021-04-02 info:eu-repo/semantics/publishedVersion

Published
2021

20. Mepolizumab for chronic rhinosinusitis with nasal polyps (SYNAPSE): a randomised, double-blind, placebo-controlled, phase 3 trial

Author

Joseph K Han, Claus Bachert, Wytske Fokkens, Martin Desrosiers, Martin Wagenmann, Stella E Lee, Steven G Smith, Neil Martin, Bhabita Mayer, Steven W Yancey, Ana R Sousa, Robert Chan, Claire Hopkins, Cecilia Ahlström Emanuelsson, Ledit Ardusso, Michael Armstrong, Philip Bardin, Sara Barnes, Miguel Bergna, Christian Betz, Achim Beule, James Blotter, Valeriu Bronescu, Matthew Brown, Sean Carrie, Adam Chaker, Hyung-Ju Cho, Marie-Noëlle Corriveau, Timothy Courville, Mandy Cuevas, Cecelia Damask, Adam DeConde, Jaime Del Carpio, María De Salvo, Hun-Jong Dhong, Stephen Durham, Anton Edin, Dale Ehmer Jr, Pedro Elías, Adil Fatakia, Christine Franzese, Simon Gane, Gabriel García, Andrew Gillman, Moritz Groeger, Richard Harvey, Johan Hellgren, Thomas Higgins, Jonathan Hobson, Mattias Jangard, Arif Janjua, Naveed Kara, Sergey Karpischenko, Edward Kerwin, Fatimat Khanova, Shaun Kilty, Chang-Hoon Kim, Seontae Kim, Ludger Klimek, Craig LaForce, Samuel Leong, Bradley Marple, Anders Mårtensson, Jorge Maspero, Neil Massey, Jonathan Matz, Chad McDuffie, Corina Mella, Steven Miller, Ekaterina Mirzabekyan, Jonathan Moss, Nayla Mumneh, Robert Nathan, Adriana Neagos, Heidi Olze, Andrey Ovchinnikov, Randall Ow, Dmitriy Polyakov, Doinel Radeanu, Chae-Seo Rhee, Ramón Rojas, Jeffrey Rosenbloom, Sergei Ryazantsev, Chady Sader, Pablo Saez Scherbovsky, Guy Scadding, Rodney Schlosser, Heena Shah-Patel, Ronald Shealy, Ayesha Siddiqi, Stacey Silvers, Narinder Singh, Doron Sommer, Weily Soong, Leigh Sowerby, Peter Spafford, Catalin Stefan, Richard Sterling, Valeriy Svistushkin, Neetu Talreja, Galina Tarasova, Martha Tarpay, Alberto Tolcachier, Karin Toll Toll, Carolina van Schaik, Luke Webb, H James Wedner, Luis Wehbe, Soo Whan Kim, Barbara Wollenberg, Simon Wright, Vladimir Yakusevich, Anahí Yañez, Yury Yarin, David Yen, Hyo Yeol Kim, Ear, Nose and Throat, and AII - Inflammatory diseases

Subjects
Adult, Pulmonary and Respiratory Medicine, Nasal cavity, medicine.medical_specialty, Adolescent, Visual analogue scale, Population, Mometasone furoate, Antibodies, Monoclonal, Humanized, Placebo, 03 medical and health sciences, Nasal Polyps, 0302 clinical medicine, Double-Blind Method, Internal medicine, otorhinolaryngologic diseases, medicine, Humans, Nasal polyps, 030212 general & internal medicine, education, education.field_of_study, business.industry, medicine.disease, Treatment Outcome, medicine.anatomical_structure, 030228 respiratory system, Synapses, Nasal administration, business, Mepolizumab, medicine.drug
Abstract

Background: Chronic rhinosinusitis with nasal polyps affects approximately 2–4% of the general population, and long-term use of systemic corticosteroids is associated with adverse effects. The aim of this study was to assess the efficacy and safety of mepolizumab in adults with recurrent, refractory severe bilateral chronic rhinosinusitis with nasal polyps. Methods: SYNAPSE was a randomised, double-blind, placebo-controlled, parallel-group, phase 3 trial done at 93 centres, mainly hospitals, in 11 countries. Eligible patients were aged 18 years or older with recurrent, refractory, severe, bilateral nasal polyp symptoms (nasal obstruction symptom visual analogue scale [VAS] score of >5), were eligible for repeat nasal surgery (overall symptoms VAS score >7 and endoscopic nasal polyps score of ≥5, with a minimum score of 2 in each nasal cavity) despite standard of care treatment, and had to have at least one nasal surgery in the past 10 years. Patients were randomly assigned (1:1), using permuted block design, to receive either 100 mg mepolizumab subcutaneously or placebo once every 4 weeks, in addition to standard of care (mometasone furoate intranasal spray for at least 8 weeks before screening and during the study, saline nasal irrigations, systemic corticosteroids or antibiotics, or both), as required, for 52 weeks. Site staff, the central study team, and patients were masked to study treatment and absolute blood eosinophil counts. The coprimary endpoints were change from baseline in total endoscopic nasal polyp score at week 52 and in mean nasal obstruction VAS score during weeks 49–52, assessed in the intention-to-treat population (ITT). This study is registered with ClinicalTrials.gov, NCT03085797. Findings: From May 25, 2017, to Dec 12, 2018, 854 patients were screened for eligibility. 414 patients were randomly assigned with 407 included in the ITT population; 206 received mepolizumab and 201 received placebo. Total endoscopic nasal polyp score significantly improved at week 52 from baseline with mepolizumab versus placebo (adjusted difference in medians −0·73, 95% CI −1·11 to −0·34; p

Published
2021

21. Unified Airway Disease: A Contemporary Review and Introduction

Author

Wytske, Fokkens and Sietze, Reitsma

Subjects
Respiratory System, Humans, Comorbidity, Sinusitis, Asthma, Rhinitis
Abstract

Upper and lower airways diseases are very common, with population prevalence of 10% to 40%. The conditions are usually interlinked and referred to as "unified airway disease" or "the united airways." Especially in phenotypes with more severe disease, type 2 immunologic endotype is often noted. Comorbid upper and lower airway diseases are usually caused by similar underlying immunologic response. Any patient with rhinitis or rhinosinusitis should have their lower respiratory tract evaluated. A multidisciplinary approach in the diagnosis and treatment of airway disease is advised, especially, for more severe phenotypes.

Published
2022

22. A multicenter real‐life study on the multiple reasons for uncontrolled allergic rhinitis

Author

Peter Hellings, Pauline Van Bulck, Leen Cools, Wytske Fokkens, Patricia Kabobo, Luo Zhang, Glenis Scadding, Elina Toskala, Mysore S Soumya, Brecht Steelant, Dieudonné T. Nyembue, Ear, Nose and Throat, and AII - Inflammatory diseases

Subjects
China, medicine.medical_specialty, India, Physical examination, Disease, aeroallergens, rhinitis, Surveys and Questionnaires, medicine, Humans, Immunology and Allergy, Outpatient clinic, allergens, allergic rhinitis, Medical treatment, medicine.diagnostic_test, business.industry, University hospital, Rhinitis, Allergic, Chronic disease, Otorhinolaryngology, Emergency medicine, Democratic Republic of the Congo, Life study, business, chronic disease
Abstract

Background: : Recent data show uncontrolled disease in 35% of allergic rhinitis (AR) patients on medical treatment. The reasons for uncontrolled disease can arbitrarily be divided into disease-related, diagnosis-related, treatment-related, and patient-related factors. However, the relative importance of these factors in uncontrolled disease remains speculative. This explorative study aimed at determining the factors causing uncontrolled AR on four different continents worldwide, identifying the most common reasons for uncontrolled disease in AR. Methods: : Patients with uncontrolled AR (n = 430) were asked to fill out a questionnaire and underwent a clinical examination at the outpatient clinic in five university outpatient clinics (Leuven [Belgium], Beijing [China], Kinshasa [Congo], Bangalore [India], and Philadelphia [US]). Two independent physicians evaluated the reason or multiple reasons for uncontrolled disease. The study was coordinated from the University Hospital of Leuven. Results: : In uncontrolled AR patients, 76% of patients showed two or more reasons for uncontrolled disease according to the physicians’ evaluation. Disease-related factors (64%) were considered most often the reason for uncontrolled disease, followed by treatment- (56%), patient- (54%), and diagnosis-related (47%) factors. There is limited variability in observations across different centers worldwide. Conclusion: : We here define the multiple reasons for uncontrolled AR across different continents, with disease-related factors being most frequently associated with uncontrolled disease. A better understanding of uncontrolled disease will guide us in defining strategies to improve AR care.

Published
2021

23. Vaccines and Allergic reactions: The past, the current COVID-19 pandemic, and future perspectives

Author

Domingo Barber, Robyn E O'Hehir, Mihir Shah, Ronald L. Rabin, Markus Ollert, Wytske Fokkens, Oliver Pfaar, Menno C. van Zelm, Luo Zhang, Milena Sokolowska, Mübeccel Akdis, De Yun Wang, Cezmi A. Akdis, Thomas Eiwegger, Katharine Fast, Claudia Traidl-Hoffmann, Heimo Breiteneder, Zuzana Diamant, Ioana Agache, Kari C. Nadeau, Milos Jesenak, Mohamed H. Shamji, María José Torres, Vanitha Sampath, Stefan Vieths, Carmen Riggioni, Liam O'Mahony, Oscar Palomares, Grace Rabinowitz, Sharon Chinthrajah, William Collins, Surabhi Jain, and Tomas Chivato

Subjects
0301 basic medicine, Allergy, CHILDREN, Review Article, HYPERSENSITIVITY REACTIONS, SARS‐CoV‐2, 0302 clinical medicine, allergy, vaccine, Pandemic, Immunology and Allergy, PROTEIN-COUPLED RECEPTOR-X2, Review Articles, anaphylaxis, Vaccines, SARS-CoV-2, Vaccination, Safety profile, VACCINATION, COVID-19, Anaphylaxis, medicine.medical_specialty, COVID-19 Vaccines, Coronavirus disease 2019 (COVID-19), Hypersensitivity/diagnosis, Immunology, 03 medical and health sciences, COVID‐19, medicine, Hypersensitivity, Vaccines/adverse effects, Humans, MAST-CELL, Intensive care medicine, Pandemics, business.industry, Public health, GELATIN, ANTI-PEG ANTIBODIES, medicine.disease, 030104 developmental biology, 030228 respiratory system, Infectious disease (medical specialty), ADVERSE-REACTIONS, SAFETY DATA, business
Abstract

Vaccines are essential public health tools with a favorable safety profile and prophylactic effectiveness that have historically played significant roles in reducing infectious disease burden in populations, when the majority of individuals are vaccinated. The COVID-19 vaccines are expected to have similar positive impacts on health across the globe. While serious allergic reactions to vaccines are rare, their underlying mechanisms and implications for clinical management should be considered to provide individuals with the safest care possible. In this review, we provide an overview of different types of allergic adverse reactions that can potentially occur after vaccination and individual vaccine components capable of causing the allergic adverse reactions. We present the incidence of allergic adverse reactions during clinical studies and through post-authorization and post-marketing surveillance and provide plausible causes of these reactions based on potential allergenic components present in several common vaccines. Additionally, we review implications for individual diagnosis and management and vaccine manufacturing overall. Finally, we suggest areas for future research.

Published
2021

26. Management of patients with chronic rhinosinusitis during the COVID‐19 pandemic—An EAACI position paper

Author

Jean Bousquet, Adam Chaker, Cezmi A. Akdis, Claus Bachert, Peter Valentin Tomazic, Marek Jutel, Sanna Toppila-Salmi, Valérie Hox, Wytske Fokkens, Carmen Rondon, Barbara Wollenberg, Banu Bozkurt, Jan Hagemann, Aspasia Karavelia, U Förster-Ruhrmann, Ralph Mösges, Cemal Cingi, Tilman Huppertz, Philippe Gevaert, Ioana Agache, Sven Becker, Ludger Klimek, HUS Inflammation Center, Department of Dermatology, Allergology and Venereology, University of Helsinki, and Helsinki University Hospital Area

Subjects
0301 basic medicine, medicine.medical_specialty, education, Immunology, MEDLINE, Cochrane Library, 03 medical and health sciences, Nasal Polyps, 0302 clinical medicine, Adrenal Cortex Hormones, Pandemic, medicine, Humans, Immunology and Allergy, biologics, Nasal polyps, Sinusitis, Risk factor, Intensive care medicine, Rhinitis, Biological Products, SARS-CoV-2, business.industry, chronic rhinosinusitis, Standard treatment, COVID-19, CRSwNP, medicine.disease, Dupilumab, Asthma, 3. Good health, 030104 developmental biology, 030228 respiratory system, 3121 General medicine, internal medicine and other clinical medicine, Chronic Disease, Position paper, business
Abstract

BackgroundChronic rhinosinusitis is regarded as a chronic airway disease. According to WHO recommendations, it may be a risk factor for COVID-19 patients. In most CRSwNP cases, the inflammatory changes affecting the nasal and paranasal mucous membranes are type-2 (T2) inflammation endotypes. MethodsThe current knowledge on COVID-19 and on treatment options for CRS was analyzed by a literature search in Medline, Pubmed, international guidelines, the Cochrane Library and the Internet. ResultsBased on international literature, on current recommendations by WHO and other international organizations as well as on previous experience, a panel of experts from EAACI and ARIA provided recommendations for the treatment of CRS during the COVID-19 pandemic. ConclusionIntranasal corticosteroids remain the standard treatment for CRS in patients with SARS-CoV-2 infection. Surgical treatments should be reduced to a minimum and surgery preserved for patients with local complications and for those with no other treatment options. Systemic corticosteroids should be avoided. Treatment with biologics can be continued with careful monitoring in noninfected patients and should be temporarily interrupted during the course of the COVID-19 infection.

Published
2021

27. International consensus statement on allergy and rhinology: rhinosinusitis 2021

Author

Jeffrey D. Suh, Adam S. DeConde, Robert C. Kern, Wilma Terezinha Anselmo-Lima, Sandra Y. Lin, Kristine A. Smith, James N. Palmer, Robert M. Naclerio, Alexander G. Chiu, Zachary M. Soler, Luke Rudmik, Richard Louis Voegels, Richard G. Douglas, Erin D. Wright, Peter H. Hwang, David B. Conley, Jeremiah A. Alt, Peter Hellings, Hwan Jung Roh, Manuel Bernal-Sprekelsen, Tanya M. Laidlaw, David N. Kennedy, Nobuyoshi Otori, Kevin C. Welch, Andrew P. Lane, Fuad M. Baroody, Michael G. Stewart, Peter-John Wormald, Desiderio Passali, Vijay R. Ramakrishnan, Joseph K. Han, Amber U Luong, Alkis J. Psaltis, Kornkiat Snidvongs, Amin R. Javer, Ralph Metson, Claus Bachert, David M. Poetker, Bradford A. Woodworth, De Yun Wang, Rakesh K. Chandra, Nithin D. Adappa, Bruce K. Tan, Zara M. Patel, John M. DelGaudio, Timothy L. Smith, Sanjay R. Parikh, Heung Man Lee, Anju T. Peters, Devyani Lal, Richard R. Orlandi, Eric H. Holbrook, Kevin C. McMains, Martin Desrosiers, David A. Gudis, Daniel L. Hamilos, Carl Philpott, Rodney J. Schlosser, Raymond Sacks, Stacey T. Gray, Rong San Jiang, Valerie J. Lund, Eugene H. Chang, Cornelis M. van Drunen, Noam A. Cohen, Joaquim Mullol, Benjamin S. Bleier, Bing Zhou, Jean Anderson Eloy, Claire Hopkins, Joshua M. Levy, Carol H. Yan, Jivianne T. Lee, Gretchen M. Oakley, Sarah K. Wise, Raj Sindwani, Todd T. Kingdom, Neil Bhattacharyya, Daniel M. Beswick, Pete S. Batra, Naweed I. Chowdhury, Ahmad R. Sedaghat, Richard J. Harvey, Murugappan Ramanathan, Wytske Fokkens, Brent A. Senior, Justin H. Turner, Martin J. Citardi, and Luo Zhang

Subjects
Rhinology, medicine.medical_specialty, Statement (logic), Disease, 03 medical and health sciences, 0302 clinical medicine, systematic review, medicine, Acute rhinosinusitis, Immunology and Allergy, 030223 otorhinolaryngology, Surgical treatment, rhinosinusitis, acute rhinosinusitis, Executive summary, business.industry, chronic rhinosinusitis, Evidence-based medicine, recurrent acute rhinosinusitis, Management algorithm, 030228 respiratory system, Otorhinolaryngology, Family medicine, business, evidence-based medicine, endoscopic sinus surgery
Abstract

I. Executive summary BACKGROUND: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR-RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR-RS-2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence-based findings of the document. Methods ICAR-RS presents over 180 topics in the forms of evidence-based reviews with recommendations (EBRRs), evidence-based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results ICAR-RS-2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence-based management algorithm is provided. Conclusion This ICAR-RS-2021 executive summary provides a compilation of the evidence-based recommendations for medical and surgical treatment of the most common forms of RS.

Published
2021

28. Complete Remission of Severe Eosinophilic Otitis Media With Dupilumab: A Case Report

Author

Sietze Reitsma, Rik J. L. van der Lans, Wytske Fokkens, Erik van Spronsen, Ear, Nose and Throat, AII - Inflammatory diseases, APH - Aging & Later Life, APH - Health Behaviors & Chronic Diseases, AII - Amsterdam institute for Infection and Immunity, and Other Research

Subjects
Adult, Male, medicine.medical_specialty, genetic structures, Hearing loss, Otoscopy, Antibodies, Monoclonal, Humanized, dupilumab, Eosinophilia, Eosinophilic, otorhinolaryngologic diseases, Humans, Medicine, Nasal polyps, Hearing Loss, Asthma, Otitis Media with Effusion, business.industry, Respiratory disease, Biological, medicine.disease, Dermatology, Dupilumab, Treatment Outcome, Otitis, Otorhinolaryngology, eosinophilic otitis media, Sensorineural hearing loss, human monoclonal antibody, sense organs, medicine.symptom, business
Abstract

Eosinophilic otitis media (EOM) is a difficult-to-treat otitis media (OM) characterized by eosinophilic accumulation in the middle ear mucosa and secretion. Associated sensorineural hearing loss can eventually lead to (functional) deafness. EOM is strongly associated with type 2 inflammation driven respiratory disease, i.e. asthma and chronic rhinosinusitis with nasal polyps (CRSwNP), for which biological treatment is available. This case report discusses a patient suffering from EOM with severe mixed hearing loss, nearing functional deafness. Dupilumab treatment resulted in complete and enduring remission of the EOM, enabling adequate hearing rehabilitation. Concurrent control of the comorbid asthma and CRSwNP was obtained. Laryngoscope, 131:2649-2651, 2021.

Published
2021

29. Dupilumab in CRSwNP: Responder Analysis Using Clinically Meaningful Efficacy Outcome Thresholds

Author

Chunpeng Fan, Isabelle Guillemin, Peter Hellings, Siddhesh Kamat, Stella E Lee, Wytske Fokkens, Chien-Chia Chuang, Claus Bachert, Asif H. Khan, Nadia Daizadeh, Nikhil Amin, Nicolas Duverger, Leda Mannent, and Ear, Nose and Throat

Subjects
Adult, Male, medicine.medical_specialty, SYMPTOMS, SURGERY, Computed tomography, CHRONIC RHINOSINUSITIS, Research & Experimental Medicine, Nasal congestion, Placebo, Antibodies, Monoclonal, Humanized, Nasal Polyps, Quality of life, Double-Blind Method, Internal medicine, Post-hoc analysis, Medicine and Health Sciences, Medicine, Humans, Nasal polyps, Patient Reported Outcome Measures, Sinusitis, Aged, Rhinitis, Science & Technology, nose and paranasal sinuses, medicine.diagnostic_test, business.industry, Outcome measures, Middle Aged, Adult rhinology, medicine.disease, Dupilumab, PREVALENCE, Treatment Outcome, Medicine, Research & Experimental, Otorhinolaryngology, quality of life, Chronic Disease, Female, medicine.symptom, business, Life Sciences & Biomedicine
Abstract

OBJECTIVES/HYPOTHESIS: Dupilumab, a fully human monoclonal antibody that blocks the shared interleukin (IL)-4/IL-13 receptor component, significantly improved outcomes for patients with chronic rhinosinusitis with nasal polyps (CRSwNP) in the SINUS-24 and SINUS-52 studies. This post hoc analysis evaluated dupilumab's effect on patient-reported symptoms and objective outcome measures using thresholds of clinically meaningful within-patient change from baseline. METHODS: Patients with CRSwNP receiving subcutaneous dupilumab or placebo every 2 weeks in SINUS-24/SINUS-52 were analyzed. Patients recorded severity of nasal congestion (NC), loss of smell (LoS), and anterior/posterior rhinorrhea (each within range 0-3) daily. Total Symptom Score (TSS) was calculated as a composite severity score (0-9) for these symptoms. Objective measures included University of Pennsylvania Smell Identification Test (UPSIT; 0-40), nasal polyps score (NPS; 0-8), and Lund-Mackay computed tomography score (LMK-CT; 0-24). Thresholds of within-patient change in scores from baseline at weeks 24 and 52 considered clinically meaningful were ≥1.0 (NC, LoS), ≥3.0 (TSS), ≥8.0 (UPSIT), ≥1.0 (NPS), and ≥5.0 (LMK-CT). RESULTS: A total of 724 and 303 patients were included in the week 24 and 52 analyses, respectively. Responder rates were significantly higher with dupilumab versus placebo at week 24 for NC (64% vs. 24%), LoS (63% vs. 14%), TSS (62% vs. 15%), UPSIT (54% vs. 6%), NPS (63% vs. 14%), and LMK-CT (59% vs. 3%); all P

Published
2022

30. Prevalence and impact of nasal hyperreactivity in chronic rhinosinusitis

Author

Brecht Steelant, Maria Doulaptsi, Laura Van Gerven, Leen Cools, Wytske Fokkens, Athanasia Milioni, Benoit Pugin, Jiannis Constantinidis, Peter Hellings, Emmanuel P. Prokopakis, Despo Ierodiakonou, Zinovia Tsinaslanidou, Ear, Nose and Throat, and AII - Inflammatory diseases

Subjects
medicine.medical_specialty, business.industry, Chronic rhinosinusitis, Immunology, Mucous membrane of nose, Nose, medicine.disease, Dermatology, Nasal Mucosa, Nasal Polyps, Chronic disease, medicine.anatomical_structure, Chronic Disease, Prevalence, Humans, Immunology and Allergy, Medicine, Nasal polyps, Sinusitis, business, Rhinitis
Published
2020

32. ERS member survey on COVID-19 symptomatology and personal protection: a construct to predict early COVID-19 disease

Author

Valerie J Lund, Sean Carrie, Wytske Fokkens, Sietze Reitsma, Ear, Nose and Throat, Amsterdam institute for Infection and Immunity, and AII - Infectious diseases

Subjects
early signs of disease, Coronavirus disease 2019 (COVID-19), business.industry, personal protection, General Medicine, Disease, covid-19, Otorhinolaryngology, RF1-547, Medicine, Construct (philosophy), business, anosmia, Clinical psychology
Abstract

Background: This paper reports on a survey performed amongst members of the European Rhinologic Society (ERS) in relation to COVID-19. The survey audited several items, such as (onset of) symptoms that could be a sign of COVID-19, number of patients seen with face-to-face consultation in an outpatient setting, surgeries done, whether personal protective equipment was used, and some personal data including country of practice. Results: Of the 507 respondents, 304 reported one or more complaints (60%); the most common were sore throat, headache, fatigue, stuffy nose and a dry cough. The pattern of complaints of cases tested for COVID-19 was used to create a symptom-based diagnostic construct for COVID-19. Two possibilities were used: (1) anosmia as the only complaint, or combined with either fever and/or shortness of breath (2) a combination of fever, headache, fatigue, dry cough, and coughing up sputum / thick phlegm from the lungs. With these two constructs most patients were adequately classified. A limited percentage of the respondents used/could use adequate personal protection equipment (PPE). In the respondents who were tested for COVID, none with a positive test reported adequate protection 75-100% of the time and 69% no adequate protection at all. Of those with a negative test only 26% reported no protection. Conclusion: This study underlines the importance of adequate protection for ENT surgeons, and especially rhinologists. Furthermore, anosmia is again confirmed as an important marker of COVID-19.

Published
2020

33. 2019 ARIA Care pathways for allergic rhinitis – Egypt

Author

Zeinab A El-Sayed, Shereen S. El-Sayed, Shereen M. Reda, Anna Bedbrook, Gabriel Onorato, Wytske Fokkens, Wienczyslawa Czarlewski, Elham Hossny, Jean Bousquet, Tari Haahtela, Arunas Valiulis, Ludger Klimek, Rasha El-Owaidy, Claus Bachert, Oliver Pfaar, Peter Hellings, Nikolaos G. Papadopoulos, M. T. Ventura, Nhan Pham-Thi, and Yehia El-Gamal

Subjects
03 medical and health sciences, medicine.medical_specialty, 0302 clinical medicine, 030228 respiratory system, business.industry, Family medicine, Medicine, 030212 general & internal medicine, business
Published
2020

34. ARIA-Leitlinie 2019: Behandlung der allergischen Rhinitis im deutschen Gesundheitssystem

Author

Thomas Werfel, Petra Staubach, Norbert Mülleneisen, Sanna Toppila-Salmi, Marek Jutel, Anna Bedbrook, Wolfgang Czech, Eckard Hamelmann, Adam Chaker, Vera Mahler, Torsten Zuberbier, Uta Rabe, Johannes Ring, Matthias V. Kopp, Holger Seyfarth, Jean Bousquet, Wienczylawa Czarlewski, Joaquim Mullol, R. Buhl, Karl Hörmann, Carsten B. Schmidt-Weber, Joachim Saloga, Thomas Bieber, Wolfgang Wehrmann, Thomas Fuchs, Peter Hellings, Sebastian Strieth, Wolfgang Schlenter, Claus Bachert, Jörg Fischer, Thilo Jakob, Annette Sperl, Nikolaos G. Papadopoulos, Wytske Fokkens, Christian Vogelberg, Oliver Pfaar, Désirée Larenas-Linnemann, Michael Gerstlauer, Hans F. Merk, Randolf Brehler, Thomas B. Casale, Giorgio Walter Canonica, Holger Wrede, Katja Nemat, Andrea Wallrafen, Sven Becker, Thomas Spindler, Ludger Klimek, Victoria Cardona, Kirsten Jung, Ingrid Casper, and Regina Treudler

Subjects
Integrated care pathway, Gynecology, medicine.medical_specialty, business.industry, Cost effectiveness, Allergic diseases, Health care system, Allergic asthma, Specific immunotherapy, Allergen-specific immunotherapy, Double blind, medicine, Immunology and Allergy, Sublingual immunotherapy, business
Abstract

Die Anzahl der von Allergien betroffenen Patienten nimmt weltweit zu. Hiermit gehen erhebliche Kosten fur die Gesundheits- und Sozialsysteme durch allergische Erkrankungen einher. Integrierte Versorgungskonzepte sind erforderlich, die innerhalb der nationalen Gesundheitssysteme eine umfassende Versorgung ermoglichen. Die ARIA-Initiative entwickelt international gultige Leitlinien fur allergische Atemwegserkrankungen. ARIA dient der verbesserten Versorgung von Patienten mit Allergien und chronischen Atemwegserkrankungen. In Zusammenarbeit mit anderen internationalen Initiativen, nationalen Fachgesellschaften und Patientenorganisationen im Bereich Allergien und Atemwegserkrankungen wurde eine realitatsnahe, integrative Versorgungsleitlinie („integrated care pathways“, ICPs) fur eine digital unterstutzte, integrative, individualisierte Behandlung von allergischer Rhinitis (AR) mit komorbidem Asthma entwickelt, die in der vorliegenden Arbeit auf das deutsche Gesundheitssystem ubertragen wird. Die vorliegende ICP-Versorgungsleitlinie umfasst wesentliche Bereiche der Versorgung von Patienten mit AR mit und ohne Asthma einschlieslich der Sicht von Patienten und weiterer versorgungsnaher Gesundheitsdienstleister. Eine umfassende ICP-Leitlinie kann die Versorgungsrealitat wesentlich besser abbilden als herkommliche Leitlinienmodelle.

Published
2020

35. ARIA-Leitlinie 2019: Behandlung der allergischen Rhinitis im deutschen Gesundheitssystem

Author

Thomas Werfel, Joachim Saloga, Christian Vogelberg, Andrea Wallrafen, Wolfgang Czech, Hans F. Merk, Oliver Pfaar, Michael Gerstlauer, Adam Chaker, Thomas B. Casale, Uta Rabe, Jörg Fischer, Norbert Mülleneisen, Torsten Zuberbier, Wolfgang Wehrmann, Jean Bousquet, Karl Hörmann, Annette Sperl, Carsten B. Schmidt-Weber, Désirée Larenas-Linnemann, Wytske Fokkens, Thilo Jakob, Giorgio Walter Canonica, Katja Nemat, Randolf Brehler, Nikolaos G. Papadopoulos, Sebastian Strieth, Thomas Bieber, Marek Jutel, Sanna Toppila-Salmi, Thomas Fuchs, Sven Becker, Petra Staubach, Holger Wrede, Wolfgang Schlenter, Joaquim Mullol, Matthias V. Kopp, Holger Seyfarth, Vera Mahler, Claus Bachert, Anna Bedbrook, Thomas Spindler, R. Buhl, Peter Hellings, Victoria Cardona, Regina Treudler, Johannes Ring, Wienczylawa Czarlewski, Eckard Hamelmann, Ludger Klimek, Kirsten Jung, and Ingrid Casper

Subjects
Gynecology, 030207 dermatology & venereal diseases, 03 medical and health sciences, medicine.medical_specialty, 0302 clinical medicine, 030228 respiratory system, business.industry, medicine, Immunology and Allergy, business
Abstract

Die Anzahl der von Allergien betroffenen Patienten nimmt weltweit zu. Hiermit gehen erhebliche Kosten fur die Gesundheits- und Sozialsysteme durch allergische Erkrankungen einher. Integrierte Versorgungskonzepte sind erforderlich, die innerhalb der nationalen Gesundheitssysteme eine umfassende Versorgung ermoglichen. Die ARIA-Initiative entwickelt international gultige Leitlinien fur allergische Atemwegserkrankungen. ARIA dient der verbesserten Versorgung von Patienten mit Allergien und chronischen Atemwegserkrankungen. In Zusammenarbeit mit anderen internationalen Initiativen, nationalen Fachgesellschaften und Patientenorganisationen im Bereich Allergien und Atemwegserkrankungen wurde eine realitatsnahe, integrative Versorgungsleitlinie („integrated care pathways“, ICPs) fur eine digital unterstutzte, integrative, individualisierte Behandlung von allergischer Rhinitis (AR) mit komorbidem Asthma entwickelt, die in der vorliegenden Arbeit auf das deutsche Gesundheitssystem ubertragen wird. Die vorliegende ICP-Versorgungsleitlinie umfasst wesentliche Bereiche der Versorgung von Patienten mit AR mit und ohne Asthma einschlieslich der Sicht von Patienten und weiterer versorgungsnaher Gesundheitsdienstleister. Eine umfassende ICP-Leitlinie kann die Versorgungsrealitat wesentlich besser abbilden als herkommliche Leitlinienmodelle.

Published
2019

36. Efficacy and safety of dupilumab in patients with severe chronic rhinosinusitis with nasal polyps (LIBERTY NP SINUS-24 and LIBERTY NP SINUS-52): results from two multicentre, randomised, double-blind, placebo-controlled, parallel-group phase 3 trials

Author

Anders Cervin, Heribert Staudinger, M. Zhang, Xin Lu, Leon S. Greos, George D. Yancopoulos, Chunpeng Fan, Naimish Patel, Gianluca Pirozzi, Steven Draikiwicz, Neil M.H. Graham, G. Walter Canonica, Pierluigi Paggiaro, Claus Bachert, Joaquim Mullol, Heidi Olze, Stella E. Lee, Joseph K. Han, Tanya M. Laidlaw, Neil Stahl, Nikhil Amin, Asif Khan, Wytske Fokkens, Seong H. Cho, Claire Hopkins, Shigeharu Fujieda, Marcella Ruddy, Siddhesh Kamat, John V. Bosso, Peter Hellings, Jorge Maspero, David M. Weinreich, Leda Mannent, Martin Desrosiers, Ear, Nose and Throat, and AII - Inflammatory diseases

Subjects
Adult, Male, medicine.medical_specialty, Injections, Subcutaneous, Population, 030204 cardiovascular system & hematology, Nasal congestion, Antibodies, Monoclonal, Humanized, Placebo, Severity of Illness Index, Placebos, 03 medical and health sciences, Nasal Polyps, 0302 clinical medicine, Adrenal Cortex Hormones, Internal medicine, medicine, Humans, Nasal polyps, 030212 general & internal medicine, Sinusitis, Adverse effect, education, Asthma, education.field_of_study, business.industry, Antibodies, Monoclonal, General Medicine, Atopic dermatitis, Middle Aged, medicine.disease, Dupilumab, Treatment Outcome, Chronic Disease, Quality of Life, Female, medicine.symptom, business
Abstract

Background: Patients with chronic rhinosinusitis with nasal polyps (CRSwNP) generally have a high symptom burden and poor health-related quality of life, often requiring recurring systemic corticosteroid use and repeated sinus surgery. Dupilumab is a fully human monoclonal antibody that inhibits signalling of interleukin (IL)-4 and IL-13, key drivers of type 2 inflammation, and has been approved for use in atopic dermatitis and asthma. In these two studies, we aimed to assess efficacy and safety of dupilumab in patients with CRSwNP despite previous treatment with systemic corticosteroids, surgery, or both. Methods: LIBERTY NP SINUS-24 and LIBERTY NP SINUS-52 were two multinational, multicentre, randomised, double-blind, placebo-controlled, parallel-group studies assessing dupilumab added to standard of care in adults with severe CRSwNP. SINUS-24 was done in 67 centres in 13 countries, and SINUS-52 was done in 117 centres in 14 countries. Eligible patients were 18 years or older with bilateral CRSwNP and symptoms despite intranasal corticosteroid use, receiving systemic corticosteroids in the preceding 2 years, or having had sinonasal surgery. Patients in SINUS-24 were randomly assigned (1:1) to subcutaneous dupilumab 300 mg or placebo every 2 weeks for 24 weeks. Patients in SINUS-52 were randomly assigned (1:1:1) to dupilumab 300 mg every 2 weeks for 52 weeks, dupilumab every 2 weeks for 24 weeks and then every 4 weeks for the remaining 28 weeks, or placebo every 2 weeks for 52 weeks. All patients were randomly assigned centrally with a permuted block randomisation schedule. Randomisation was stratified by asthma or non-steroidal anti-inflammatory drug-exacerbated respiratory disease status at screening, previous surgery at screening, and country. Patients with or without comorbid asthma were included. Coprimary endpoints were changes from baseline to week 24 in nasal polyp score (NPS), nasal congestion or obstruction, and sinus Lund-Mackay CT scores (a coprimary endpoint in Japan), done in an intention-to-treat population. Safety was assessed in a pooled population of both dupilumab groups in SINUS-52 up to week 24 and the dupilumab group in SINUS-24 and the placebo groups in both studies until week 24. The trials are complete and registered at ClinicalTrials.gov, NCT02912468 and NCT02898454. Findings: Between Dec 5, 2016, and Aug 3, 2017, 276 patients were enrolled in SINUS-24, with 143 in the dupilumab group and 133 in the placebo group receiving at least one study drug dose. Between Nov 28, 2016, and Aug 28, 2017, 448 patients were enrolled in SINUS-52, with 150 receiving at least one dose of dupilumab every 2 weeks, 145 receiving at least one dose of dupilumab every 2 weeks for 24 weeks and every 4 weeks until week 52, and 153 receiving at least one dose of placebo. Dupilumab significantly improved the coprimary endpoints in both studies. At 24 weeks, least squares mean difference in NPS of dupilumab treatment versus placebo was −2·06 (95% CI −2·43 to −1·69; p

Published
2019

37. Legends of allergy and immunology: Niels Mygind

Author

Wytske Fokkens, Ear, Nose and Throat, and AII - Inflammatory diseases

Subjects
Allergy, business.industry, sinusitis, Immunology, Common cold, medicine.disease, common cold, ENT (rhinitis, allergy diagnosis, nasal corticosteroids, nasal polyps...), allergy treatment, medicine, Immunology and Allergy, Nasal polyps, business, Sinusitis
Published
2021

38. Mometasone furoate and fluticasone furoate are equally effective in restoring nasal epithelial barrier dysfunction in allergic rhinitis

Author

Wytske Fokkens, Brecht Steelant, Tine Wils, María Vicario, Ricard Farré, Peter Hellings, Emmanuel P. Prokopakis, Maria Doulaptsi, Katleen Martens, Ear, Nose and Throat, AII - Inflammatory diseases, Institut Català de la Salut, [Doulaptsi M] Department of Otorhinolaryngology, Head and Neck Surgery, University of Crete School of Medicine, Heraklion, Crete, Greece. KU Leuven Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research group, Leuven, Belgium. [Wils T, Martens K] KU Leuven Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research group, Leuven, Belgium. [Hellings PW] KU Leuven Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research group, Leuven, Belgium. University Hospitals Leuven, Clinical Department of Otorhinolaryngology, Head and Neck Surgery, Leuven, Belgium. Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, The Netherlands. University of Ghent, Department of Otorhinolaryngology, Laboratory of Upper Airways Research, Ghent, Belgium. [Farré R] KU Leuven, Department of Chronic Diseases, Metabolism and Ageing, Translational Research Center for Gastrointestinal Disorders, Leuven, Belgium. [Vicario M] Unitat de Recerca en Malalties Digestives, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Servei de Gastroenterologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain, and Vall d'Hebron Barcelona Hospital Campus

Subjects
Pulmonary and Respiratory Medicine, SPRAY, células::células epiteliales [ANATOMÍA], Allergy, medicine.medical_treatment, Immunology, Respiratory Tract Diseases::Nose Diseases::Rhinitis::Rhinitis, Allergic [DISEASES], Mometasone furoate, Otros calificadores::Otros calificadores::/farmacoterapia [Otros calificadores], Pharmacology, Occludin, Other subheadings::Other subheadings::/drug therapy [Other subheadings], Otros calificadores::/efectos de los fármacos [Otros calificadores], Fluticasone propionate, Article, Allergic rhinitis, chemistry.chemical_compound, Cells::Epithelial Cells [ANATOMY], medicine, Medicaments - Efectes fisiològics, Immunology and Allergy, Fluorescein, Other subheadings::/drug effects [Other subheadings], Tight junctions, Epithelial integrity, Fluticasone furoate, Cèl·lules epitelials, Science & Technology, Tight junction, business.industry, enfermedades respiratorias::enfermedades nasales::rinitis::rinitis alérgica [ENFERMEDADES], RC581-607, Epithelium, Cytokine, medicine.anatomical_structure, chemistry, Rinitis - Tractament, Nasal administration, Immunologic diseases. Allergy, business, Life Sciences & Biomedicine, medicine.drug
Abstract

Rinitis alérgica; Integridad epitelial; Furoato de mometasona Rinitis al·lèrgica; Integritat epitelial; Furoat de mometasona Allergic rhinitis; Epithelial integrity; Mometasone furoate Tight junction defects (TJ) have been associated with a defective epithelial barrier function in allergic rhinitis (AR). Intranasal corticosteroids are potent drugs frequently used to treat AR and are shown to restore epithelial integrity by acting on TJs and by reducing type 2 cytokine production. However, the effect of different classes of intranasal corticosteroids on the epithelial barrier has not been studied. Therefore, we compared the effect of 2 intranasal corticosteroids, ie, fluticasone furoate (FF) and mometasone furoate (MF) on epithelial barrier function. Both FF and MF similarly increased trans-epithelial electrical resistance of primary nasal epithelial cell cultures from AR patients. In a house dust mite-induced allergic asthma mouse model, FF and MF had similar beneficial effects on fluorescein isothiocyanate–dextran 4 kDa mucosal permeability, eosinophilic infiltration and IL-13 levels. Both molecules increased mRNA expression of the TJ proteins occludin and zonula occludens-1, thereby restoring epithelial barrier function. Lastly, we showed that long-term FF treatment also increased expression of occludin in AR patients compared to controls. In conclusion, both FF and MF effectively restore epithelial barrier function by increasing expression of TJ proteins in AR patients. This work was supported by an unrestricted grant from GSK. BS is supported by the Fund for Scientific Research Flanders (FWO), Belgium.

Published
2021

39. Therapeutic Options for Chronic Rhinosinusitis in N-ERD Patients

Author

Rik J. L. van der Lans, Sietze Reitsma, and Wytske Fokkens

Subjects
Drug, N-ERD, medicine.medical_specialty, media_common.quotation_subject, medicine.medical_treatment, Disease, NSAID (non-steroidal anti-inflammatory drug), aspirin therapy, Internal medicine, otorhinolaryngologic diseases, medicine, Nasal polyps, Pulmonologists, media_common, Desensitization (medicine), business.industry, chronic rhinosinusitis, Respiratory disease, aspirin desensitization, General Medicine, RC581-607, respiratory system, medicine.disease, Antileukotriene, Allergists, Immunologic diseases. Allergy, business, biological
Abstract

Patients with non-steroidal anti-inflammatory drug (NSAID)-exacerbated respiratory disease (N-ERD) often suffer from chronic rhinosinusitis (CRS) with nasal polyps, a form of primary diffuse Type 2 CRS. Although this disease is also seen in NSAID-tolerant patients, CRS in N-ERD often is more severe and more treatment resistant; local nasal therapy (nasal corticosteroids) and endoscopic sinus surgery are employed like in NSAID-tolerant patients, but with limited and/or short-lived effects. This mini-review gives an overview of the current additional treatment options for CRS in N-ERD. As such diets, aspirin therapy after desensitization, antileukotriene therapy and biologicals are discussed based on the current body of literature. Selecting the right treatment strategy depends on shared-decision making, local availability and cooperation between ENT-surgeons, allergists, and pulmonologists.

Published
2021

40. Highlights in the advances of chronic rhinosinusitis

Author

Sietze Reitsma, De Yun Wang, Wytske Fokkens, and Xinni Xu

Subjects
0301 basic medicine, medicine.medical_specialty, Endotype, Coronavirus disease 2019 (COVID-19), Chronic rhinosinusitis, Immunology, Disease, 03 medical and health sciences, 0302 clinical medicine, Nasal Polyps, Disease severity, medicine, otorhinolaryngologic diseases, Immunology and Allergy, EPOS2020, Humans, Nasal polyps, endotype, Sinusitis, Intensive care medicine, Rhinitis, business.industry, SARS-CoV-2, chronic rhinosinusitis, biomarkers, COVID-19, respiratory system, medicine.disease, Integrated care, 030104 developmental biology, 030228 respiratory system, biologicals, Chronic Disease, Position paper, business
Abstract

Chronic rhinosinusitis (CRS) is a complex upper airway inflammatory disease with a broad spectrum of clinical variants. As our understanding of the disease pathophysiology evolves, so too does our philosophy towards the approach and management of CRS. Endotyping is gaining favour over phenotype-based classifications, owing to its potential in prognosticating disease severity and delivering precision treatment. Endotyping is especially useful in challenging CRS with nasal polyposis cases, for whom novel treatment options such as biologicals are now available. The latest European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS2020) reflects these changes with updated rhinosinusitis classifications and new integrated care pathways. With the Coronavirus Disease 2019 (COVID-19) pandemic, physicians and rhinologists have to balance the responsibility of managing their patients' upper airway whilst adequately protecting themselves from droplet and aerosol transmission. This review summarises the key updates from EPOS2020, endotype-based classification and biomarkers. The role of biologicals in CRS and the lessons we can draw from their use in severe asthma will be examined. Finally, the principles of CRS management during COVID-19 will also be discussed.

Published
2021

41. Correction to 'ARIA guideline 2019: treatment of allergic rhinitis in the German health system'

Author

Hans F. Merk, Thomas B. Casale, Adam Chaker, Katja Nemat, Wienczylawa Czarlewski, Vera Mahler, Désirée Larenas-Linnemann, Torsten Zuberbier, Thilo Jakob, Johannes Ring, Thomas Werfel, Karl Hörmann, Kirsten Jung, Claus Bachert, Sebastian Strieth, Wolfgang Czech, Regina Treudler, Jean Bousquet, Randolf Brehler, Carsten B. Schmidt-Weber, Roland Buhl, Giorgio Walter Canonica, Wytske Fokkens, Thomas Bieber, Eckard Hamelmann, Sanna Toppila-Salmi, Ingrid Casper, Jörg Fischer, Anna Bedbrook, Wolfgang Schlenter, Petra Staubach, Annette Sperl, Norbert Mülleneisen, Victoria Cardona, Nikolaos G. Papadopoulos, Christian Vogelberg, Oliver Pfaar, Joaquim Mullol, Marek Jutel, Michael Gerstlauer, Sven Becker, Peter Hellings, Ludger Klimek, Thomas Spindler, Joachim Saloga, Wolfgang Wehrmann, Andrea Wallrafen, Matthias V. Kopp, Holger Seyfarth, Holger Wrede, Uta Rabe, and Thomas Fuchs

Subjects
German, medicine.medical_specialty, business.industry, Family medicine, Disclaimer, language, Immunology and Allergy, Medicine, Guideline, business, language.human_language
Abstract

Correction to: Allergo J Int 2019 https://doi.org/10.1007/s40629-019-00110-9 Affiliation and disclaimer have been misrepresented and are hereby corrected: Vera Mahler: Affiliation: Med. Faculty, Friedrich-Alexander-University (FAU) Erlangen-Nurnberg, Germany. Disclaimer: The views expressed in this …

Published
2020

42. Alergijski rinitis in njegov vpliv na astmo (ARIA) – glavni povzetek 2016: Integrirane klinične poti za napovedno medicino v vseh življenjskih obdobjih

Author

Ioana Agache, Klemen Jenko, Giorgio Walter Canonica, Peter Hellings, Alvaro A. Cruz, Bojan Madjar, Nissera Bajrović, Anna Bedbrook, Irma Rozman Sinur, Thomas B. Casale, Katja Triller, Mitja Košnik, Bolesław Samoliński, Antonija Poplas-Susič, Nadja Triller, Maja Jošt, Tanja Soklič-Košak, Wytske Fokkens, Anja Koren Jeverica, Claus Bachert, Nika Lalek, Karmen Kramer Vrščaj, Mihaela Zidarn, Peter Kopač, Jure Urbančič, Natalija Edelbaher, Samo Kreft, Jean Bousquet, Ear, Nose and Throat, and AII - Inflammatory diseases

Subjects
business.industry, lcsh:R, lcsh:Medicine, Disease, medicine.disease, integrirana klinična pot, Clinical decision support system, Predictive medicine, mobilna tehnologija, Nursing, General partnership, Health care, astma, bolezni dihalnih poti, Medicine, Social inequality, Mobile technology, alergijski rinitis, business, Asthma
Abstract

Pobudo »Alergijski rinitis in njegov vpliv na astmo« – (angl. Allergic Rhinitis and its Impact on Asthma, ARIA) – so leta 1999 ustanovili na delavnici Svetovne zdravstvene organizacije – World Health Organization (WHO). Njeni prvotni cilji so bili: 1. predlagati novo klasifikacijo alergijskega rinitisa, 2. spodbujati koncept večobolevnosti pri astmi in rinitisu ter 3. skupaj z vsemi deležniki razviti smernice, namenjene globalni uporabi v vseh državah in vsem skupinam bolnikov. Pobuda ARIA se uporablja v 70 državah, trenutno pa se osredinja na uporabo novih tehnologij za individualizirano in napovedno medicino. Mreža MASK – nadzorna mreža MACVIA (Proti kroničnim boleznim za aktivno staranje, franc. – Contre les Maladies Chroniques pour un Vieillissement Actif) in ARIA (angl. ARIA Sentinel NetworK) uporablja mobilno tehnologijo za razvoj klinične poti, ki bi bolnikom, multidisciplinarnim ekipam zdravnikov in raziskovalcem omogočila nadzor rinitisa in astme. Mobilna aplikacija (Android in iOS) je na voljo v 20 državah in 15 jezikih. Uporablja vizualno analogno lestvico za oceno nadzora nad simptomi in oceno delovne zmožnosti in ponuja sistem, ki pomaga pri kliničnem odločanju. Aplikacija omogoča povezovanje z zdravnikom ali drugimi zdravstvenimi delavci. Ta strategija upošteva priporočila Evropskega partnerstva za inovacije za aktivno in zdravo staranje (angl. European Innovation Partnership on Active and Healthy Ageing, EIP on AHA). Cilj novega pristopa pobude ARIA je zagotoviti aktivno in zdravo življenje bolnikov z rinitisom ne glede na njihovo starost, spol ali družbenogospodarski položaj zato, da bi se zmanjšali zdravstvena in družbena neenakost, ki sta posledici te bolezni.

Published
2019

43. Epidemiology of chronic rhinosinusitis in Bushehr, southwestern region of Iran: a GA2LEN study

Author

A Mallahzadeh, Shokrollah Farrokhi, Katayoun Vahdat, Wytske Fokkens, Afshin Ostovar, Alireza Raeisi, Ear, Nose and Throat, and AII - Inflammatory diseases

Subjects
Adult, medicine.medical_specialty, Chronic rhinosinusitis, Population, MEDLINE, Iran, Disease cluster, 03 medical and health sciences, 0302 clinical medicine, Nasal Polyps, Environmental health, Health care, Epidemiology, medicine, otorhinolaryngologic diseases, Humans, Sinusitis, 030223 otorhinolaryngology, education, Asthma, Rhinitis, education.field_of_study, business.industry, Public health, General Medicine, respiratory system, medicine.disease, Otorhinolaryngology, Chronic Disease, business
Abstract

Background Population-based studies using the European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS) criteria for the assessment of the chronic rhinosinusitis (CRS) prevalence play important roles in the development and promotion of public health policies. Methods A multistage, stratified cluster, random sampling method was used to select the study participants from individuals living in Bushehr, which is in the southwestern part of Iran. The standardized Global Allergy and Asthma European Network (GA2LEN) questionnaire was completed by 5,201 participants, and the CRS prevalence were compared among different groups of related factors using chi-squared tests. Results The overall CRS prevalence was 28.4% based on the EPOS criteria, while the self-reported physician-diagnosed CRS prevalence was 20.0%. There was no gender difference; however, CRS was more prevalent in smokers, individuals aged 25 - 34 years old, non-educated persons, and healthcare workers. CRS was also associated with asthma and allergic rhinitis. Conclusions The present study showed that the CRS prevalence in Iran was relatively high. These results support the idea that CRS is a major public health problem in Iran.

Published
2019

44. Erklärung von Vilnius zu chronischen Atemwegserkrankungen: multisektorale Versorgungswege, die angeleitetes Selbstmanagement, mHealth und Luftverschmutzung bei der Versorgung chronischer Atemwegserkrankungen einschließen

Author

Sergey Sargsyan, Svetlana Cebatori, Brigita Sitkauskiene, David Somekh, Wytske Fokkens, Algirdas Utkus, Roberta Savli, Michael Bewick, Davit Sergeenko, Ioana Agache, Algirdas Valiulis, Anna Bedbrook, Joanna Chorostowska-Wynimko, Violeta Kvedariene, Edvardas Danila, S. Pietikainen, Jonathan Grigg, Danielle Borelli, Ulana Suprun, Peter Hellings, Adamos Hadjipanayis, Andrew Bush, Valentina Vilc, Tomas Alasevicius, Rusudan Karseladze, Laimute Vaideliene, Jean Bousquet, Nils Billo, Arunas Valiulis, Aurelijus Veryga, Bolesław Samoliński, Kaja Julge, Joanna Banys, Lokesh Dubey, Susana Palkonen, Mikaela Odemyr, Lars Münter, Tari Haahtela, Nikolai Khaltaev, Eugenijus Lesinskas, Ivane Chkaidze, and Oleksander Katilov

Abstract

Hintergrund: Mehr als eine Milliarde Menschen leiden an chronischen Atemwegserkrankungen wie Asthma, COPD, Rhinitis und Rhinosinusitis. Diese verursachen enorme Belastungen und gelten als schwerwiegende nicht übertragbare Erkrankungen. Viele Patienten sind noch unbehandelt und die Kosten der Untätigkeit sind nicht akzeptabel. Am 23. März 2018 fand in Vilnius eine Konferenz unter der Schirmherrschaft des Gesundheitsministeriums und verschiedener wissenschaftlicher Fachgesellschaften statt, auf der multisektorale Versorgungswege vorgeschlagen wurden, die angeleitetes Selbstmanagement, mHealth und Luftverschmutzung bei der Versorgung bestimmter chronischer Atemwegserkrankungen (Rhinitis, chronische Rhinosinusitis, Asthma und COPD) einschließen. Das Treffen schloss mit der Erklärung von Vilnius, die von den Teilnehmern des EU-Gipfels zu chronischen Atemwegserkrankungen unter der Federführung von Euforea entwickelt wurde. Schlussfolgerung: Die Erklärung von Vilnius ist ein wichtiger Schritt im Kampf gegen die weltweite Luftverschmutzung und ihre Auswirkungen für Patienten mit chronischen Atemwegserkrankungen und sie spielt im Hinblick auf die EU-Gesundheitsstrategie eine wichtige Rolle, da sie einen Zusatznutzen zu dem bereits vorhandenen Wissen über die öffentliche Gesundheit liefert.

Published
2019

45. Next-generation care pathways for allergic rhinitis and asthma multimorbidity: a model for multimorbid non-communicable diseases -Meeting Report (Part 1)

Author

Elaine Colgan, Mario Sánchez-Borges, Jim Phillips, Ignacio J. Ansotegui, Bolesław Samoliński, Olga Lourenço, Giorgio Walter Canonica, F. Portejoie, Isabella Annesi-Maesano, Gabrielle L. Onorato, Victoria Cardona, João O. Malva, Eugene Cash, Christine Rolland, Hilary Pinnock, Samantha Walker, Yoshitaka Okamoto, Ana Maria Carriazo, Lorenzo Cecchi, Nikos G. Papadopoulos, Jean Bousquet, L. T. T. Le, João Fonseca, Oliver Pfaar, Luis Caraballo, Elísio Costa, Maritta Perala, Pablo Quinones-Delgado, Torsten Zuberbier, Holger J. Schünemann, Tomohisa Iinuma, Enrica Menditto, Maddalena Illario, Nils E. Billo, Arunas Valiulis, Sinthia Bosnic-Anticevich, Josep M. Antó, Nick A. Guldemond, Maria Teresa Ventura, Claus Bachert, Wytske Fokkens, Lars Münter, Mohamed H. Shamji, Ioana Agache, Ulysse Rodts, Daniel Laune, Sanna Toppila-Salmi, Joaquim Mullol, Ioanna Tsiligianni, Motohiro Ebisawa, Isabelle Bosse, Samuel Benveniste, Arzu Yorgancioglu, Alkis Togias, M. Bewick, Nhân Pham-Thi, Stephen R. Durham, Moises A. Calderon, Marina Erhola, Violeta Kvedariene, Omar S. Usmani, Alvaro A. Cruz, Anna Bedbrook, Abigail Phillips, Desiree Larenas-Linneman, Guy Brusselle, Gert Marien, Dana Wallace, David Somekh, Sian Williams, Wienczyslawa Czarlewski, Ludger Klimek, Piotr Kuna, Jean-Luc Fauquert, Rianne van der Kleij, Derek K. Chu, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Service de Pneumologie Allergologie [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Pasteur [Paris], Transilvania University of Brasov, Epidémiologie des maladies infectieuses et modélisation (ESIM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hospital Quiròn Bizkaia Erandio, Universitat Pompeu Fabra [Barcelona] (UPF), CIBER de Epidemiología y Salud Pública (CIBERESP), Ghent University Hospital, Centre de Recherche en Informatique (CRI), MINES ParisTech - École nationale supérieure des mines de Paris, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL), AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris], iQ4U consultants Ltd, University of Joensuu, The University of Sydney, Imperial College London, Humanitas Clinical and Research Center [Rozzano, Milan, Italy], Institute for Immunological Research (University of Cartagena), Vall d'Hebron University Hospital [Barcelona], Servicio Andaluz de Salud, Nova Southeastern University (NSU), Azienda Sanitaria di Prato, McMaster University [Hamilton, Ontario], DEPARTMENT OF HEALTH ( Social Services and Public Safety), Universidade do Porto, Universidade Federal da Bahia (UFBA), UCB Pharma, Colombes, Sagamihara National Hospital, National Institute for Health and Welfare [Helsinki], CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand, European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Academic Medical Center - Academisch Medisch Centrum [Amsterdam] (AMC), University of Amsterdam [Amsterdam] (UvA), Faculdade de Medicina da Universidade do Porto (FMUP), Erasmus University Medical Center [Rotterdam] (Erasmus MC), Chiba University Hospital, 'Federico II' University of Naples Medical School, Zentrum für Rhinologie und Allergologie [Wiesbaden, Germany], Medical University of Łódź (MUL), Vilnius University [Vilnius], Hospital Medica Sur [Mexico City, Mexico], KYomed INNOV, Ho Chi Minh City University of Technology (HCMUT), Faculty of Health Sciences and CICS-UB (Health Sciences Research Centre), University of Coimbra [Portugal] (UC), Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Department of Public Health [Copenhagen], Faculty of Health and Medical Sciences, University of Copenhagen = Københavns Universitet (KU)-University of Copenhagen = Københavns Universitet (KU), University of Manchester [Manchester], University of Athens Medical School [Athens], University of Oulu, Philipps University of Marburg, Cardiff University, University of Edinburgh, Regional Government for Equality, Medical University of Warsaw - Poland, Centro Medico-Docente La Trinidad, Department of Clinical Epidemiology and Biostatistics and Medicine, National Institute of Allergy and Infectious Diseases [Bethesda] (NIAID-NIH), National Institutes of Health [Bethesda] (NIH), University of Helsinki, University of Crete [Heraklion] (UOC), National Heart and Lung Institute [London] (NHLI), Imperial College London-Royal Brompton and Harefield NHS Foundation Trust, King's College Hospital (KCH), Leiden University Medical Center (LUMC), University of Bari Aldo Moro (UNIBA), Manisa Celal Bayar University, Humboldt-Universität zu Berlin, Association Asthme et Allergie, Health Services Management & Organisation (HSMO), University Hospital Montpellier, Montpellier, France, MACVIA-France, Fondation partenariale FMC VIA-LR, Montpellier, France, 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, EUFOREA, Brussels, Belgium, Charité, Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany, Berlin Institute of Health, Comprehensive Allergy Center, Department of Dermatology and Allergy, Berlin, Germany, Allergy Department, Pasteur Institute, Paris, France, Faculty of Medicine, Transylvania University, Brasov, Romania, Epidemiology of Allergic and Respiratory Diseases, Department Institute Pierre Louis of Epidemiology and Public Health, INSERM, Sorbonne Universités, Medical School Saint Antoine, Paris, France, Department of Allergy and Immunology, Hospital Quirónsalud Bizkaia, Erandio, Spain, ISGlobAL, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain, Universitat Pompeu Fabra (UPF), Barcelona, Spain, CIBER Epidemiolog a y Salud Pública (CIBERESP), Barcelona, Spain, Upper Airways Research Laboratory, ENT Dept., Ghent University Hospital, Ghent, Belgium, National Center of Expertise in Cognitive Stimulation (CEN STIMCO), Broca Hospital, Paris, France, Mines ParisTech CRI - PSL Research University, Fontainebleau, France, iQ4U Consultants Ltd., London, United Kingdom, Joensuu, Finland, Woolcock Institute of Medical Research, University of Sydney, Woolcock Emphysema Centre, Sydney Local Health District, Glebe, NSW, Australia, La Rochelle, France, Dept. of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium, Imperial College London, National Heart and Lung Institute, London, United Kingdom, Personalized Medicine Clinic Asthma and Allergy, Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy, Institute for Immunological Research, University of Cartagena, Campus de Zaragocilla, Edificio Biblioteca Primer piso, Cartagena, Colombia, Foundation for the Development of Medical and Biological Sciences (Fundemeb), Cartagena, Colombia, Allergy Section, Department of Internal Medicine, Hospital Vall d’Hebron and ARADyAL Research Network, Barcelona, Spain, Regional Ministry of Health of Andalusia, Seville, Spain, College of Psychology, Nova Southeastern University, School-related Psychological Assessments and Clinical Interventions Clinic, Ft Lauderdale, FL, United States, SOS Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy, Department of Health Research Methods, Evidence, and Impact, Division of Immunology and Allergy, Department of Medicine, McMaster University, Hamilton, ON, Canada, Department of Health, Social Services and Public Safety, Belfast, United Kingdom, UCIBIO, REQUIMTE, Faculty of Pharmacy, Competence Center on Active and Healthy Ageing of University of Porto (AgeUPNetWork), University of Porto, Porto, Portugal, ProAR-Nucleo de Excelencia em Asma, Federal University of Bahia, Brasil and WHO GARD Executive Committee, Bahia, Brazil, Medical Consulting Czarlewski, Levallois, France, Allergy and Clinical Immunology Section, National Heart and Lung Institute, Imperial College London, London, United Kingdom, Clinical Research Center for Allergy and Rheumatology, National Hospital Organization, Sagamihara National Hospital, Sagamihara, Japan, National Institute for Health and Welfare, Helsinki, Finland, CHU Clermont-Ferrand, Unité d’Allergologie de l’Enfant, Pôle Pédiatrique, Hôpital Estaing, Clermont-Ferrand, France, Department of Otorhinolaryngology, Amsterdam University Medical Centres, AMC, Amsterdam, Netherlands, CINTESIS, Center for Research in Health Technology and Information Systems, Faculdade de Medicina, Universidade do Porto, Medida, Lda, Porto, Portugal, Institute of Health Policy and Management iBMG, Erasmus University, Rotterdam, Netherlands, Dept. of Otorhinolaryngology, Chiba University Hospital, Chiba, Japan, Division for Health Innovation, Campania Region and Federico II University Hospital Naples (R and D and DISMET), Naples, Italy, Center for Rhinology and Allergology, Wiesbaden, Germany, Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland, Institute of Biomedical Sciences, Department of Pathology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania, Institute of Clinical Medicine, Clinic of Chest Diseases and Allergology, Faculty of Medicine, Vilnius, Lithuania, Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, México City, Mexico, KYomed INNOV, Montpellier, France, University of Medicine and Pharmacy, Hochiminh City, Viet Nam, Faculty of Health Sciences, CICS-UBI, Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal, Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Ageing@Coimbra EIP-AHA Reference Site, Coimbra, Portugal, CIRFF, Center of Pharmacoeconomics, University of Naples Federico II, Naples, Italy, Rhinology Unit and Smell Clinic, ENT Department, Hospital Cl nic, Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, University of Barcelona, Barcelona, Spain, Danish Committee for Health Education, Copenhagen East, Denmark, Division of Infection, Immunity and Respiratory Medicine, Royal Manchester Children’s Hospital, University of Manchester, Manchester, United Kingdom, Allergy Department, 2nd Pediatric Clinic, Athens General Children’s Hospital 'P and A Kyriakou', University of Athens, Athens, Greece, University of Oulu, Faculty of Medicine, Oulun Yliopisto, Finland, Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Phillipps-Universität Marburg, Germany, Department of Health and Social Services, Welsh Government, Cardiff, United Kingdom, Centre For Empowering Patients and Communities, Dublin, Ireland, Asthma UK Centre for Applied Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom, Agency for Social Services and Dependency, Regional Government for Equality, Social Policies and Conciliation of Andalucia, Seville, Spain, Association Asthme et Allergie, Paris, France, KanopyMed, Paris, France, Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland, Allergy and Clinical Immunology Department, Centro Medico-Docente La Trinidad, Caracas, Venezuela, Immunomodulation and Tolerance Group, Imperial College London, London, United Kingdom, Allergy and Clinical Immunology, Imperial College London, London, United Kingdom, European Health Futures Forum (EHFF), Dromahair, Ireland, Division of Allergy, Immunology, and Transplantation (DAIT), National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD, United States, Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland, Health Planning Unit, Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece, International Primary Care Respiratory Group IPCRG, Aberdeen, United Kingdom, National Heart and Lung Institute (NHLI), Imperial College London, Royal Brompton Hospital, Airways Disease Section, London, United Kingdom, Asthma UK, London, United Kingdom, Nova Southeastern University, Fort Lauderdale, FL, United States, Vilnius University, Faculty of Medicine, Institute of Clinical Medicine, Institute of Health Sciences, Vilnius, Lithuania, Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands, University of Bari Medical School, Unit of Geriatric Immunoallergology, Bari, Italy, Department of Pulmonary Diseases, Celal Bayar University, Faculty of Medicine, Manisa, Turkey, Universitätsmedizin Berlin, Humboldt-Uniersität zu Berlin, Berlin, Germany, Berlin Institute of Health, Comprehensive Allergy-Centre, Department of Dermatology and Allergy, Berlin, Germany, uBibliorum, Ear, Nose and Throat, AII - Inflammatory diseases, Institut Pasteur [Paris] (IP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Hospital Quirónsalud Bizkaia [Bilbao], Mines Paris - PSL (École nationale supérieure des mines de Paris), Universidade do Porto = University of Porto, Sagamihara National Hospital [Kanagawa, Japan], University of Copenhagen = Københavns Universitet (UCPH)-University of Copenhagen = Københavns Universitet (UCPH), Philipps Universität Marburg = Philipps University of Marburg, Centro Médico Docente La Trinidad, Helsingin yliopisto = Helsingfors universitet = University of Helsinki, Università degli studi di Bari Aldo Moro = University of Bari Aldo Moro (UNIBA), Humboldt University Of Berlin, Salvy-Córdoba, Nathalie, Universiteit Leiden, Bousquet, J., Pham-Thi, N., Bedbrook, A., Agache, I., Annesi-Maesano, I., Ansotegui, I., Anto, J. M., Bachert, C., Benveniste, S., Bewick, M., Billo, N., Bosnic-Anticevich, S., Bosse, I., Brusselle, G., Calderon, M. A., Canonica, G. W., Caraballo, L., Cardona, V., Carriazo, A. M., Cash, E., Cecchi, L., Chu, D. K., Colgan, E., Costa, E., Cruz, A. A., Czarlewski, W., Durham, S., Ebisawa, M., Erhola, M., Fauquert, J. -L., Fokkens, W. J., Fonseca, J. A., Guldemond, N., Iinuma, T., Illario, M., Klimek, L., Kuna, P., Kvedariene, V., Larenas-Linneman, D., Laune, D., Le, L. T. T., Lourenco, O., Malva, J. O., Marien, G., Menditto, E., Mullol, J., Munter, L., Okamoto, Y., Onorato, G. L., Papadopoulos, N. G., Perala, M., Pfaar, O., Phillips, A., Phillips, J., Pinnock, H., Portejoie, F., Quinones-Delgado, P., Rolland, C., Rodts, U., Samolinski, B., Sanchez-Borges, M., Schunemann, H. J., Shamji, M., Somekh, D., Togias, A., Toppila-Salmi, S., Tsiligianni, I., Usmani, O., Walker, S., Wallace, D., Valiulis, A., Van Der Kleij, R., Ventura, M. T., Williams, S., Yorgancioglu, A., and Zuberbier, T.

Subjects
Pulmonary and Respiratory Medicine, Allergy, medicine.medical_specialty, Allergic and chronic respiratory diseases, [SDV.IMM] Life Sciences [q-bio]/Immunology, Allergic rhinitis - Asthma - Multimorbidity, Health care system, Health literacy, 03 medical and health sciences, 0302 clinical medicine, SDG 3 - Good Health and Well-being, Health care, medicine, Patient participation, mHealth, Asthma, Rhinitis, [SDV.EE]Life Sciences [q-bio]/Ecology, environment, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Newsletter of GARD Section, business.industry, Environmental exposure, medicine.disease, 3. Good health, Integrated care, [SDV.EE] Life Sciences [q-bio]/Ecology, environment, 030228 respiratory system, 13. Climate action, Family medicine, [SDV.IMM]Life Sciences [q-bio]/Immunology, 030211 gastroenterology & hepatology, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; 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 for integrated care with organizational health literacy. MASK (Mobile Airways Sentinel NetworK) (1), a new development of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, and POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EIT Health) (2), in collaboration with professional and patient organizations in the field of allergy and airway diseases, are proposing real-life integrated care pathways (ICPs) (3)-centred around the patient with rhinitis and using mHealth monitoring of environmental exposure (4).An expert meeting took place at the Pasteur Institute in Paris, December 3, 2018. The aim was to discuss next-generation care pathways: (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) assessed by mobile technology.The EU (5) and global political agendas are of great importance in supporting health care transformation. MASK has been recognized by DG Santé as a Good Practice (6) in the field of digitally-enabled, integrated, person-centred care.The one-day meeting objectives were clear (Figure 1). The meeting was followed by a workshop. The present paper reports the background of the two-day meeting.

Published
2019

46. Recent developments and highlights in rhinitis and allergen immunotherapy

Author

Sietze Reitsma, De Yun Wang, Wytske Fokkens, and Soma Subramaniam

Subjects
0301 basic medicine, Allergen immunotherapy, medicine.medical_specialty, business.industry, Non-allergic rhinitis, Immunology, medicine.disease, Dermatology, 03 medical and health sciences, Phenotype, 030104 developmental biology, 0302 clinical medicine, 030228 respiratory system, Desensitization, Immunologic, medicine, Humans, Immunology and Allergy, Precision Medicine, business, Rhinitis
Abstract

This review paper aims to provide an overview of recent developments in the field of allergic and non-allergic rhinitis, as well as allergen immunotherapy. Recent advances in phenotyping and endotyping various forms of rhinitis have brought us one step closer towards tailoring treatment more appropriately for a given patient. Updates on local allergic rhinitis are also covered. Allergen immunotherapy (AIT) is an area of significant interest, with multiple original papers and recent position papers and guidelines published. Evidence related to the application of AIT in seasonal and perennial allergic rhinitis (AR), local allergic rhinitis and novel and expanded applications is discussed in the publication.

Published
2018

47. Differentiation of COVID-19 signs and symptoms from allergic rhinitis and common cold: An ARIA-EAACI-GA

Author

Jere Reijula, De Yun Wang, Ralph Mösges, Tomohisa Iinuma, Jean Luc Fauquert, Nelson Rosario, Yehia El-Gamal, René Maximiliano Gómez, Tari Haahtela, Vincenzo Patella, Lorenzo Cecchi, Petr Panzner, Yoshitaka Okamoto, Oliver Pfaar, Luis Caraballo, Paulo Augusto Moreira Camargos, Filip Raciborski, Florin Mihaltan, Ken Ohta, Brian J. Lipworth, Kimi Okubo, Juan Carlos Ivancevich, Fulvio Braido, Ioana Agache, Frederico S. Regateiro, Neven Miculinic, Tuula Vasankari, R. Emuzyte, Arunas Valiulis, Yousser Mohammad, Torsten Zuberbier, Osman M. Yusuf, Ewa Jassem, Cezmi A. Akdis, Jean Bousquet, Alessandro Fiocchi, Jan Hagemann, Claus Bachert, Davor Plavec, K. S. Bennoor, Marek Jutel, Désirée Larenas-Linnemann, Stephen Montefort, Stefano Del Giacco, Przemyslaw Kardas, Erkka Valovirta, Mark S. Dykewicz, Antonio Valero, Wienczyslawa Czarlewski, Thomas B. Casale, Gabrielle L. Onorato, Omer Kalayci, Ludger Klimek, Joaquin Sastre, João Fonseca, Siân Williams, Karl Christian Bergmann, Marek Niedoszytko, Bilun Gemicioglu, Mario E. Zernotti, Musa Khaitov, H. Neffen, Robert M. Naclerio, Joaquim Mullol, Ana Pereira, Piotr Kuna, Michael Makris, Maria Teresa Ventura, Ioanna Tsiligianni, Dirceu Solé, Arzu Yorgancioglu, Charlotte Suppli-Ulrik, M. Gotua, Emmanuel P. Prokopakis, Dana Wallace, Jorge Maspero, Wytske Fokkens, Eckard Hamelmann, Antonino Romano, Dejan Dokic, Todor A. Popov, Violeta Kvedariene, Derek K. Chu, Anna Bedbrook, Dermot Ryan, Motohiro Ebisawa, Tomas Chivato, Giovanni Passalacqua, Menachem Rottem, Mário Morais-Almeida, Victoria Cardona, Bolesław Samoliński, Cristiana Stellato, Nikolaos G. Papadopoulos, Milan Sova, Jaime Correia-de-Sousa, Sietze Reitsma, Cemal Cingi, Francesca Puggioni, Robyn E O'Hehir, HUS Inflammation Center, Department of Dermatology, Allergology and Venereology, HUS Internal Medicine and Rehabilitation, Department of Public Health, Clinicum, Keuhkosairauksien yksikkö, Helsinki University Hospital Area, University of Helsinki, University Medical Center of the Johannes Gutenberg-University Mainz, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), University of Wrocław [Poland] (UWr), Swiss Institute of Allergy and Asthma Research (SIAF), Universität Zürich [Zürich] = University of Zurich (UZH), Transilvania University of Brasov, Humboldt University Of Berlin, Medical Consulting Czarlewski, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), MASK-air, Ghent University Hospital, Sun Yat-Sen University [Guangzhou] (SYSU), Karolinska Institutet [Stockholm], National Institute of Diseases of the Chest and Hospital (NIDCH), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Ospedale Policlinico San Martino [Genoa], Universidade Federal de Minas Gerais = Federal University of Minas Gerais [Belo Horizonte, Brazil] (UFMG), University of Cartagena, Foundation for the Development of Medical and Biological Sciences (FUNDEMEB), Vall d'Hebron University Hospital [Barcelona], Allergy Unit [Malaga, Spain] (National Network ARADyAL), Hospital Regional Universitario de Málaga = Regional University Hospital of Malaga [Spain], University of South Florida [Tampa] (USF), Azienda Usl Toscana centro [Firenze], CEU-San Pablo University and HM-Hospitals School of Medicine, McMaster University [Hamilton, Ontario], Eskisehir Osmangazi University, Universidade do Minho = University of Minho [Braga], Life and Health Sciences Research Institute [Braga] (ICVS), University of Minho [Braga], The International Primary Care Respiratory Group (IPCRG), Università degli Studi di Cagliari = University of Cagliari (UniCa), Sts. Cyril and Methodius University, Saint Louis University School of Medicine [St Louis], Sagamihara National Hospital [Kanagawa, Japan], Ain Shams University (ASU), Vilnius University [Vilnius], Service de Pédiatrie Générale [CHU Clermont-Ferrand], CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Bambino Gesù Children’s Hospital [Rome, Italy], Academic Medical Center - Academisch Medisch Centrum [Amsterdam] (AMC), University of Amsterdam [Amsterdam] (UvA), European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Center of Research in Health Technologies and Information Systems (CINTESIS), Universidade do Porto = University of Porto, CUF Porto Hospital, Cerrahpasa Faculty of Medicine, Istanbul University, ALAS Medical Institute, Center for Allergy and Immunology Research [Tbilisi], Helsingin yliopisto = Helsingfors universitet = University of Helsinki, Universität Bielefeld = Bielefeld University, Chiba University Hospital, Servicio de Alergia e ImmunologiaBuenos Aires (Clinica Santa Isabel), Medical University of Gdańsk, Faculty of Medicine [Hacettepe University], Hacettepe University = Hacettepe Üniversitesi, Medical University of Łódź (MUL), Federal Medicobiological Agency [Moscow, Russian Federation], Hospital Medica Sur [Mexico City, Mexico], Ninewells Hospital and Medical School [Dundee], University General Hospital ' Attikon ' [Athens, Greece], Argentine Association of Allergy and Immunology, Marius Nasta Institute of Pneumology, Tishreen University, Université de Damas = Damascus University, University of Malta [Malta], Hospital CUF Descobertas, Clinical Research International Ltd [Hamburg, Germany] (CRI), Johns Hopkins University School of Medicine [Baltimore], Nemours/Alfred I. du Pont Hospital for Children, Monash University [Melbourne], Tokyo National Hospital, Nippon Medical School [Tokyo, Japon], Medicine Charles University and General Faculty Hospital in Prague, Royal Manchester Children's Hospital, University of Manchester [Manchester], Università degli studi di Genova = University of Genoa (UniGe), 'Santa Maria della Speranza' Hospital, Philipps Universität Marburg = Philipps University of Marburg, J.J. Strossmayer University of Osijek, Children’s Hospital Srebrnjak [Zagreb, Croatia], St. Ivan Rilski University Hospital, University of Crete [Heraklion] (UOC), IRCCS Humanitas [Rozzano, Italy], Medical University of Warsaw - Poland, Centro Hospitalar e Universitário [Coimbra], Amsterdam UMC - Amsterdam University Medical Center, Istituto di Ricovero e Cura a Carattere Scientifico [Troina, Italy] (IRCCS), Oasi Maria Santissima Srl [Troina, Italy], Clinica G.B. Morgagni (Fondazione Mediterranea), Pontifical Catholic University of Paraná (PUCPR), Pontifícia Universidade Católica do Paraná (PUCPR), Ha’Emek Medical Center [Afula, Israel], Pediatric Endocrine Institute [Afula, Israel], Usher Institute of Population Health Sciences and Informatics [Edinburgh, U.K.], University of Edinburgh, Federal University of Sao Paulo (Unifesp), University Hospital Olomouc [Czech Republic], University of Salerno (UNISA), Copenhagen University Hospital, Universitat de Barcelona (UB), European Academy of Paediatrics (EAP/UEMS-SP), University of Turku, Suomen Terveystalo Allergy Clinic, Finnish Lung Health Association, Università degli studi di Bari Aldo Moro = University of Bari Aldo Moro (UNIBA), Nova Southeastern University (NSU), Yong Loo Lin School of Medicine [Singapore], Department of Biology, Faculty of Sciences & Liberal Arts, Celal Bayar University, Manisa Celal Bayar University, The Allergy & Asthma Institute, Pakistan (IPCRG), Universidad Nacional de Villa María, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Allergiezentrum Wiesbaden, Salvy-Córdoba, Nathalie, Ear, Nose and Throat, and AII - Inflammatory diseases

Subjects
0301 basic medicine, Allergy, MESH: Asthma, Common Cold, allergic rhinitis, common cold, cough, COVID-19, smell, Consensus, Humans, SARS-CoV-2, Asthma, Rhinitis, Allergic, Disease, Care, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Immunology and Allergy, MESH: COVID-19, Rhinitis, [SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, Common cold, 3. Good health, MESH: Rhinitis, Allergic, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Original Article, medicine.symptom, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Immunology, Signs and symptoms, Asymptomatic, 03 medical and health sciences, Allergic, COVID‐19, Internal medicine, medicine, MESH: SARS-CoV-2, MESH: Consensus, MESH: Humans, business.industry, Rhinitis, Sinusitis, and Upper Airway Disease, CARE, medicine.disease, 030104 developmental biology, 030228 respiratory system, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, 3121 General medicine, internal medicine and other clinical medicine, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, ORIGINAL ARTICLES, Airway, business, MESH: Common Cold
Abstract

Background Although there are many asymptomatic patients, one of the problems of COVID-19 is early recognition of the disease. COVID-19 symptoms are polymorphic and may include upper respiratory symptoms. However, COVID-19 symptoms may be mistaken with the common cold or allergic rhinitis. An ARIA-EAACI study group attempted to differentiate upper respiratory symptoms between the three diseases. Methods A modified Delphi process was used. The ARIA members who were seeing COVID-19 patients were asked to fill in a questionnaire on the upper airway symptoms of COVID-19, common cold and allergic rhinitis. Results Among the 192 ARIA members who were invited to respond to the questionnaire, 89 responded and 87 questionnaires were analysed. The consensus was then reported. A two-way ANOVA revealed significant differences in the symptom intensity between the three diseases (p < .001). Conclusions This modified Delphi approach enabled the differentiation of upper respiratory symptoms between COVID-19, the common cold and allergic rhinitis. An electronic algorithm will be devised using the questionnaire.

Published
2021

48. Vaccines and Allergic reactions: the past, the current COVID-19 pandemic, and future perspectives

Author

Menno C. van Zelm, Wytske Fokkens, Oscar Palomares, Sharon Chinthrajah, Mihir Shah, Liam O'Mahony, Oliver Pfaar, Katie Fast, Grace Rabinowitz, Robyn E O'Hehir, Surabhi Jain, Ioana Agache, Domingo Barber Hernández, Ronald L. Rabin, De Yun Wang, Tomas Chivato, Kari C. Nadeau, María José Torres, Milena Sokolowska, William Collins, Thomas Eiwegger, Carmen Riggioni, Zuzana Diamant, Markus Ollert, Luo Zhang, Vanitha Sampath, Claudia Traidl-Hoffmann, Cezmi A. Akdis, Milos Jesenak, Mohamed H. Shamji, and Stefan Vieths

Subjects
Vaccination, Safety profile, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Vaccine manufacturing, Infectious disease (medical specialty), business.industry, Public health, Incidence (epidemiology), Pandemic, medicine, Intensive care medicine, business
Abstract

Vaccines are essential public health tools with a favorable safety profile and prophylactic effectiveness that have historically played significant roles in reducing infectious disease burden in populations, when the majority of individuals are vaccinated. The COVID-19 vaccines are expected to have similar positive impacts on health across the globe. While serious allergic reactions to vaccines are rare, their underlying mechanisms and implications for clinical management should be considered to provide individuals with the safest care possible. In this review, we provide an overview of different types of allergic adverse reactions that can potentially occur after vaccination and individual vaccine components capable of causing the allergic adverse reactions. We present the incidence of allergic adverse reactions during clinical studies and through post-authorization and post-marketing surveillance and provide plausible causes of these reactions based on potential allergenic components present in several common vaccines. Additionally, we review implications for individual diagnosis and management and vaccine manufacturing overall. Finally, we suggest areas for future research.

Published
2021

49. Induction of IL-10-producing type 2 innate lymphoid cells by allergen immunotherapy is associated with clinical response

Author

Mongkol Lao-araya, Stephen R. Durham, Oliver Hunewald, Anke-Hilse Maitland-van der Zee, Balthasar A. Heesters, Janice A. Layhadi, Gemma Vilà-Nadal, Korneliusz Golebski, Esther H. Steveling-Klein, Mohamed H. Shamji, Rachael C.Y. Li, Suzanne M. Bal, Wytske Fokkens, Cornelis M. van Drunen, Feng He, Umit Murat Sahiner, Susanne J. H. Vijverberg, Markus Ollert, Oleksandra Fedina, Madison M. Lenormand, Hergen Spits, Guillem Montamat, Pulmonology, AII - Inflammatory diseases, APH - Personalized Medicine, Ear, Nose and Throat, Experimental Immunology, AII - Infectious diseases, and UU BETA RESEARCH

Subjects
Male, 0301 basic medicine, Allergy, group 2 innate lymphoid cells, medicine.medical_treatment, Medizin, medicine.disease_cause, Immune tolerance, 0302 clinical medicine, Allergen, retinoic acid, Immunology and Allergy, Lymphocytes, Receptors, Immunologic, Vitamin A, Innate lymphoid cell, food and beverages, Middle Aged, Interleukin-10, STAT Transcription Factors, Interleukin 10, Treatment Outcome, Infectious Diseases, 1107 Immunology, 030220 oncology & carcinogenesis, IL-10, Pollen, Female, immunotherapy, Signal Transduction, Adult, KLRG1, Allergen immunotherapy, Immunology, innate lymphoid cells, Biology, Poaceae, Young Adult, 03 medical and health sciences, Th2 Cells, Double-Blind Method, Immune Tolerance, medicine, otorhinolaryngologic diseases, Humans, Lectins, C-Type, Janus Kinases, Sublingual Immunotherapy, Innate immune system, Rhinitis, Allergic, Seasonal, Immunotherapy, Allergens, Placebo Effect, medicine.disease, allergy, Immunity, Innate, allergen specific immunotherapy, 030104 developmental biology, plasticity
Abstract

The role of innate immune cells in allergen immunotherapy that confers immune tolerance to the sensitizing allergen is unclear. Here, we report a role of interleukin-10-producing type 2 innate lymphoid cells (IL-10+ ILC2s) in modulating grass-pollen allergy. We demonstrate that KLRG1+ but not KLRG1– ILC2 produced IL-10 upon activation with IL-33 and retinoic acid. These cells attenuated Th responses and maintained epithelial cell integrity. IL-10+ KLRG1+ ILC2s were lower in patients with grass-pollen allergy when compared to healthy subjects. In a prospective, double-blind, placebo-controlled trial, we demonstrated that the competence of ILC2 to produce IL-10 was restored in patients who received grass-pollen sublingual immunotherapy. The underpinning mechanisms were associated with the modification of retinol metabolic pathway, cytokine-cytokine receptor interaction, and JAK-STAT signaling pathways in the ILCs. Altogether, our findings underscore the contribution of IL-10+ ILC2s in the disease-modifying effect by allergen immunotherapy.

Published
2021

50. Steroid-resistant human inflammatory ILC2s are marked by CD45RO and elevated in type 2 respiratory diseases

Author

Geertje M. de Boer, Joannah R. Fergusson, Balthasar A. Heesters, Menno van Nimwegen, Gert-Jan Braunstahl, Gerdien A. Tramper-Stranders, Chantal M. A. Kradolfer, A. Paul Nagtegaal, Wilfred F. J. van IJcken, Wytske Fokkens, Danny Huylebroeck, Korneliusz Golebski, Itziar Martinez-Gonzalez, Esmee K. van der Ploeg, Sophie van Tol, Suzanne M. Bal, Brendon P. Scicluna, Rudi W. Hendriks, Cornelis M. van Drunen, Hergen Spits, Marjolein J. W. de Bruijn, Ralph Stadhouders, UU BETA RESEARCH, Cell biology, Pulmonary Medicine, Otorhinolaryngology and Head and Neck Surgery, Center of Experimental and Molecular Medicine, Epidemiology and Data Science, AII - Inflammatory diseases, Ear, Nose and Throat, and Experimental Immunology

Subjects
Adult, Male, Adolescent, medicine.medical_treatment, Population, Immunology, Drug Resistance, chemical and pharmacologic phenomena, Severity of Illness Index, Transcriptome, Young Adult, 03 medical and health sciences, Nasal Polyps, 0302 clinical medicine, Immune system, SDG 3 - Good Health and Well-being, Amphiregulin, immune system diseases, BATF, Humans, Medicine, Immunology and Allergy, Lymphocytes, education, Glucocorticoids, STAT5, Aged, 030304 developmental biology, 0303 health sciences, education.field_of_study, biology, business.industry, Innate lymphoid cell, hemic and immune systems, General Medicine, Middle Aged, Asthma, Immunity, Innate, 3. Good health, Cytokine, biology.protein, Leukocyte Common Antigens, Female, business, 030215 immunology
Abstract

Group 2 innate lymphoid cells (ILC2s) orchestrate protective type 2 immunity and have been implicated in various immune disorders. In the mouse, circulatory inflammatory ILC2s (iILC2s) were identified as a major source of type 2 cytokines. The human equivalent of the iILC2 subset remains unknown. Here, we identify a human inflammatory ILC2 population that resides in inflamed mucosal tissue and is specifically marked by surface CD45RO expression. CD45RO+ ILC2s are derived from resting CD45RA+ ILC2s upon activation by epithelial alarmins such as IL-33 and TSLP, which is tightly linked to STAT5 activation and up-regulation of the IRF4/BATF transcription factors. Transcriptome analysis reveals marked similarities between human CD45RO+ ILC2s and mouse iILC2s. Frequencies of CD45RO+ inflammatory ILC2 are increased in inflamed mucosal tissue and in the circulation of patients with chronic rhinosinusitis or asthma, correlating with disease severity and resistance to corticosteroid therapy. CD45RA-to-CD45RO ILC2 conversion is suppressed by corticosteroids via induction of differentiation toward an immunomodulatory ILC2 phenotype characterized by low type 2 cytokine and high amphiregulin expression. Once converted, however, CD45RO+ ILC2s are resistant to corticosteroids, which is associated with metabolic reprogramming resulting in the activation of detoxification pathways. Our combined data identify CD45RO+ inflammatory ILC2s as a human analog of mouse iILC2s linked to severe type 2 inflammatory disease and therapy resistance.

Published
2021

Catalog

Books, media, physical & digital resources
See catalog results