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1. The role of skin tests with polyethylene glycol and polysorbate 80 in the vaccination campaign for COVID-19: results from an Italian multicenter survey

Author

Montera, M C, Giordano, A, Asperti, C, Aruanno, Arianna, Barzaghi, C E, Bignardi, D, Borrelli, P, Bommarito, L, Busa, Mattia Fernando, Calafiore, P, Carusi, V, Cinquini, M, Cortellini, G, Cocchi, Riccardo, D'Auria, F, De Caro, F, Demonte, A, Di Leo, E, Di Lizia, M, Di Rienzo, A, Fumagalli, Francesca, Kihlgren, P, Lodi Rizzini, F, Macchia, D, Manzotti, G, Marra, A M, Mileto, P, Mietta, S, Montagni, M, Nettis, E, Nucera, Eleonora, Peveri, S, Pivetta, D, Pirisi, M, Ramirez, G A, Rivolta, F, Rizzi, Angela, Savoia, Andrea Alessio, Pedicini, A, Scarpa, A, Zisa, G, Yacoub, M-R, Aruanno, A, Busa, M, Cocchi, R, Fumagalli, F, Nucera, E (ORCID:0000-0002-0565-7680), Rizzi, A (ORCID:0000-0002-6795-746X), Savoia, A, Montera, M C, Giordano, A, Asperti, C, Aruanno, Arianna, Barzaghi, C E, Bignardi, D, Borrelli, P, Bommarito, L, Busa, Mattia Fernando, Calafiore, P, Carusi, V, Cinquini, M, Cortellini, G, Cocchi, Riccardo, D'Auria, F, De Caro, F, Demonte, A, Di Leo, E, Di Lizia, M, Di Rienzo, A, Fumagalli, Francesca, Kihlgren, P, Lodi Rizzini, F, Macchia, D, Manzotti, G, Marra, A M, Mileto, P, Mietta, S, Montagni, M, Nettis, E, Nucera, Eleonora, Peveri, S, Pivetta, D, Pirisi, M, Ramirez, G A, Rivolta, F, Rizzi, Angela, Savoia, Andrea Alessio, Pedicini, A, Scarpa, A, Zisa, G, Yacoub, M-R, Aruanno, A, Busa, M, Cocchi, R, Fumagalli, F, Nucera, E (ORCID:0000-0002-0565-7680), Rizzi, A (ORCID:0000-0002-6795-746X), and Savoia, A

Abstract

Background. International guidelines suggested skin tests with Polyethylene-glycol (PEG) and polysorbate 80 (PS-80), to investigate a possible hypersensitivity to these excipients either to identify subjects at risk of developing allergic reactions to Covid-19 vaccines, or in patients with suspected IgE mediated hypersensitivity reactions (HR) to the Covid-19 vaccine. The main purpose of this study was to investigate the prevalence of PEG and PS sensitization in patients with a clinical history of HR to drugs containing PEG/PS and in patients with a suspected Covid-19 vaccine immediate HR. Methods. This was a multicenter retrospective study conducted by allergists belonging to 20 Italian medical centers. Skin testing was performed in 531 patients with either a clinical history of suspected hypersensitivity reaction (HR) to drugs containing PEG and/or PS-80 (group 1:362 patient) or a suspected HR to Covid-19 vaccines (group 2: 169 patient), as suggested by the AAIITO/SIAAIC guidelines for the "management of patients at risk of allergic reactions to Covid-19 vaccines" [1]. Results. 10/362 (0.02%) had positive skin test to one or both excipients in group 1, 12/169 (7.1%) in group 2 (p less than 0.01). In group 2 HRs to Covid-19 vaccines were immediate in 10/12 of cases and anaphylaxis occurred in 4/12 of patients. Conclusions. The positivity of skin test with PEG and or PS before vaccination is extremely rare and mostly replaceable by an accurate clinical history. Sensitization to PEG and PS has to be investigated in patients with a previous immediate HR to a Covid-19 vaccine, in particular in patients with anaphylaxis.

Published
2023

2. POS1418 ANTIGEN-SPECIFIC T-CELL DYNAMICS AND MULTIDIRECTIONAL IMMUNE DYSREGULATION IN SLE

Author

Ramirez, G. A., primary, Tassi, E., additional, Noviello, M., additional, Mazzi, B. A., additional, Moroni, L., additional, Sorce, A., additional, Citterio, L., additional, Zagato, L., additional, Tombetti, E., additional, Baldissera, E., additional, Colombo, G., additional, Yacoub, M. R., additional, Bozzolo, E., additional, Bonini, C., additional, Dagna, L., additional, and Manfredi, A., additional

Published
2023
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3. Clinical features associated with a doctor-diagnosis of bronchiectasis in the Severe Asthma Network in Italy (SANI) registry

Author

Malipiero, G., Paoletti, G., Blasi, F., Paggiaro, P., Senna, G., Latorre, M., Caminati, M., Carpagnano, G. E., Crimi, N., Spanevello, A., Aliberti, S., Canonica, G. W., Heffler, E., Bonavia, M., Bucca, C., Caiaffa, M. F., Calabrese, C., Camiciottoli, G, Caruso, C., Centanni, S., Conte, M. E., Corsico, A. G., Cosmi, L., Costantino, M. T., D'Alo, S., D'Amato, M., Del Giacco, S., Farsi, A., Favero, E., Foschino, B. M. P., Guarnieri, G., Guida, G., Lo Cicero, S., Lombardi, C., Macchia, L., Mazza, F., Menzella, F., Milanese, M., Montuschi, P., Montagni, M., Nucera, E., Parente, R., Passalacqua, G., Patella, V., Pelaia, G., Pini, L., Ricciardi, L., Ricciardolo, F. L. M., Richeldi, L., Ridolo, E., Rolla, G., Santus, P., Scichilone, N., Solidoro, P., Spadaro, G., Vianello, A., Viviano, V., Yacoub, M. R., and Zappa, M. C.

Subjects
Pulmonary and Respiratory Medicine, Severe asthma, Pediatrics, medicine.medical_specialty, bronchiectasis, macromolecular substances, registry, phenotypes, real-life, 03 medical and health sciences, 0302 clinical medicine, immune system diseases, Humans, Immunology and Allergy, Medicine, Registries, 030212 general & internal medicine, Bronchiectasis, business.industry, musculoskeletal, neural, and ocular physiology, Public Health, Environmental and Occupational Health, medicine.disease, Asthma, respiratory tract diseases, Italy, nervous system, 030228 respiratory system, Quality of Life, business
Abstract

Several severe asthma comorbidities have been identified: an emerging one is bronchiectasis. We evaluated the frequency of bronchiectasis on severe asthma in a real-life setting, through the 'Severe Asthma Network Italy' (SANI) registry.SANI registry encompasses demographic, clinical, functional and inflammatory data of Italian severe asthmatics. Data obtained by the enrolled patients were analyzed, focusing the attention on those patients with concomitant clinically relevant bronchiectasis.About 15.5% patients have bronchiectasis. Bronchiectasis diagnosis was associated with a higher prevalence of chronic rhinosinusitis with nasal polyps (54.6% vs. 38%, p = 0.001) and higher serum IgE levels (673.4 vs. 412.1 kUI/L, p = 0.013). Patients with bronchiectasis had worse asthma control (ACT: 16.7 vs 18.2, p = 0.013), worse quality of life (AQLQ: 4.08 vs. 4.60, p = 0.02) and lower lung function (FEVsevere asthma associated with bronchiectasis represents a particularly severe asthma variant, possibly driven by an eosinophilic endotype. We, therefore, suggest that bronchiectasis should necessarily be assessed in severe asthmatic patients.

Published
2020
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4. Post-COVID-19 follow-up clinic: Depicting chronicity of a new disease

Author

Rovere-Querini P., De Lorenzo R., Conte C., Brioni E., Lanzani C., Yacoub M. R., Chionna R., Martinenghi S., Vitali G., Tresoldi M., Ciceri F., Rovere-Querini, P., De Lorenzo, R., Conte, C., Brioni, E., Lanzani, C., Yacoub, M. R., Chionna, R., Martinenghi, S., Vitali, G., Tresoldi, M., and Ciceri, F.

Subjects
Male, Pneumonia, Viral, COVID-19, Outpatient, Follow up, Middle Aged, Ambulatory Care Facilities, Hospitalization, Betacoronavirus, Humans, Female, Prospective Studies, Coronavirus Infections, Pandemics, Aged, Follow-Up Studies
Abstract

Background and aim of the work: The coronavirus disease-19 (COVID-19) outbreak is posing considerable challenges to healthcare systems and societies worldwide. While the knowledge on the acute phase of the disease has rapidly expanded, little is known on the consequences of COVID-19 following clinical remission. We set up a multidisciplinary COVID-19 follow-up outpatient clinic to identify and address the clinical needs of COVID-19 survivors. Here we describe the features of our follow-up programme. Methods: The multidisciplinary assessment comprises a complete physical examination, respiratory evaluation (peripheral oxygen saturation, respiratory rate, dyspnoea assessment, lung ultrasound and pulmonary function), cardiovascular assessment (electrocardiography, echocardiography), nutritional assessment (anthropometrics, mini Nutritional Assessment screening tool), neurological examination including cognitive tests, and mental health assessment. All data are prospectively collected, and blood is sampled for biobanking. Results: Since 7 April to 5 June, 2020, 453 out of the 1388 COVID-19 survivors managed at our University Hospital have been evaluated at the Outpatient COVID-19 Follow-up Clinic. The characteristics of the follow-up cohort are similar to those of the whole cohort of COVID-19 in terms of demographics, comorbidities, and COVID-19 severity upon ED presentation, indicating that the follow-up cohort is representative of the whole cohort. Conclusions: Continuous patient monitoring might give an answer to the numerous unsolved questions about what comes next in this pandemic and beyond. This will help physicians and researchers establish strategies to face future pandemics and develop preventative and therapeutic strategies for similar hyperinflammatory conditions. (www.actabiomedica.it).

Published
2020

5. Severe asthma: One disease and multiple definitions

Author

Bagnasco, D., Paggiaro, P., Latorre, M., Folli, C., Testino, E., Bassi, A., Milanese, M., Heffler, E., Manfredi, A., Riccio, A. M., De Ferrari, L., Blasi, F., Canevari, R. F., Canonica, G. W., Passalacqua, G., Guarnieri, G., Patella, V., Maria Pia, F. B., Carpagnano, G. E., Colle, A. D., Scioscia, G., Gerolamo, P., Puggioni, F., Racca, F., Favero, E., Iannacone, S., Savi, E., Montagni, M., Camiciottoli, G., Allegrini, C., Lombardi, Celestino Pio, Spadaro, G., Detoraki, C., Menzella, F., Galeone, C., Ruggiero, P., Yacoub, M. R., Berti, Andrea, Scichilone, N., Durante, C., Costantino, M. T., Roncallo, C., Braschi, M., D'Adda, A., Ridolo, E., Triggiani, M., Parente, R., Maria, D. A., Verrillo, M. V., Rolla, G., Brussino, L., Frazzetto, A. V., Cristina, Z. M., Lilli, M., Crimi, N., Bonavia, M., Corsico, A. G., Grosso, A., Del Giacco, S., Deidda, M., Ricciardi, L., Isola, S., Cicero, F., Amato, G., Vita, F., Spanevello, A., Pignatti, P., Cherubino, F., Visca, D., Massimo Ricciardolo, F. L., Anna Carriero, V. M., Bertolini, Francesca, Santus, P., Barlassina, R., Airoldi, A., Guida, Maria Grazia, Nucera, Eleonora, Aruanno, A., Rizzi, Angela, Caruso, Cristiano, Colantuono, S., Senna, G., Caminati, M., Arcolaci, A., Vianello, A., Bianchi, F. C., Marchi, M. R., Centanni, S., Luraschi, S., Ruggeri, S., Rinaldo, R., Parazzini, E., Calabrese, Anna Chiara, Flora, M., Cosmi, L., Di Pietro, L., Maggi, E., Pini, L., Macchia, L., Di Bona, D., Richeldi, Luca, Condoluci, Carola, Fuso, Leonello, Bonini, Matteo, Farsi, A., Carli, G., Montuschi, Paolo, Santini, G., Conte, M. E., Turchet, E., Barbetta, C., Mazza, F., D'Alo, S., Pucci, S., Caiaffa, M. F., Minenna, E., D'Elia, L., Pasculli, C., Viviano, V., Tarsia, P., Rolo, J., Di Proietto, M., Lo Cicero, Stefano, Lombardi C. (ORCID:0000-0001-8910-6693), Berti A., Bertolini F., Guida G., Eleonora Nucera. (ORCID:0000-0002-0565-7680), Rizzi A. (ORCID:0000-0002-6795-746X), Caruso C., Calabrese C., Richeldi L. (ORCID:0000-0001-8594-1448), Condoluci C., Fuso L. (ORCID:0000-0002-1198-6712), Bonini M. (ORCID:0000-0002-3042-0765), Montuschi P. (ORCID:0000-0001-5589-1750), Lo Cicero S., Bagnasco, D., Paggiaro, P., Latorre, M., Folli, C., Testino, E., Bassi, A., Milanese, M., Heffler, E., Manfredi, A., Riccio, A. M., De Ferrari, L., Blasi, F., Canevari, R. F., Canonica, G. W., Passalacqua, G., Guarnieri, G., Patella, V., Maria Pia, F. B., Carpagnano, G. E., Colle, A. D., Scioscia, G., Gerolamo, P., Puggioni, F., Racca, F., Favero, E., Iannacone, S., Savi, E., Montagni, M., Camiciottoli, G., Allegrini, C., Lombardi, Celestino Pio, Spadaro, G., Detoraki, C., Menzella, F., Galeone, C., Ruggiero, P., Yacoub, M. R., Berti, Andrea, Scichilone, N., Durante, C., Costantino, M. T., Roncallo, C., Braschi, M., D'Adda, A., Ridolo, E., Triggiani, M., Parente, R., Maria, D. A., Verrillo, M. V., Rolla, G., Brussino, L., Frazzetto, A. V., Cristina, Z. M., Lilli, M., Crimi, N., Bonavia, M., Corsico, A. G., Grosso, A., Del Giacco, S., Deidda, M., Ricciardi, L., Isola, S., Cicero, F., Amato, G., Vita, F., Spanevello, A., Pignatti, P., Cherubino, F., Visca, D., Massimo Ricciardolo, F. L., Anna Carriero, V. M., Bertolini, Francesca, Santus, P., Barlassina, R., Airoldi, A., Guida, Maria Grazia, Nucera, Eleonora, Aruanno, A., Rizzi, Angela, Caruso, Cristiano, Colantuono, S., Senna, G., Caminati, M., Arcolaci, A., Vianello, A., Bianchi, F. C., Marchi, M. R., Centanni, S., Luraschi, S., Ruggeri, S., Rinaldo, R., Parazzini, E., Calabrese, Anna Chiara, Flora, M., Cosmi, L., Di Pietro, L., Maggi, E., Pini, L., Macchia, L., Di Bona, D., Richeldi, Luca, Condoluci, Carola, Fuso, Leonello, Bonini, Matteo, Farsi, A., Carli, G., Montuschi, Paolo, Santini, G., Conte, M. E., Turchet, E., Barbetta, C., Mazza, F., D'Alo, S., Pucci, S., Caiaffa, M. F., Minenna, E., D'Elia, L., Pasculli, C., Viviano, V., Tarsia, P., Rolo, J., Di Proietto, M., Lo Cicero, Stefano, Lombardi C. (ORCID:0000-0001-8910-6693), Berti A., Bertolini F., Guida G., Eleonora Nucera. (ORCID:0000-0002-0565-7680), Rizzi A. (ORCID:0000-0002-6795-746X), Caruso C., Calabrese C., Richeldi L. (ORCID:0000-0001-8594-1448), Condoluci C., Fuso L. (ORCID:0000-0002-1198-6712), Bonini M. (ORCID:0000-0002-3042-0765), Montuschi P. (ORCID:0000-0001-5589-1750), and Lo Cicero S.

Abstract

Introduction: There is, so far, no universal definition of severe asthma. This definition usually relies on: number of exacerbations, inhaled therapy, need for oral corticosteroids, and respiratory function. The use of such parameters varies in the different definitions used. Thus, according to the parameters chosen, each patient may result in having severe asthma or not. The aim of this study was to evaluate how the choice of a specific definition of severe asthma can change the allocation of patients. Methods: Data collected from the Severe Asthma Network Italy (SANI) registry were analyzed. All the patients included were then reclassified according to the definitions of U-BIOPRED, NICE, WHO, ATS/ERS, GINA, ENFUMOSA, and TENOR. Results: 540 patients, were extracted from the SANI database. We observed that 462 (86%) met the ATS/ERS criteria as well as the GINA criteria, 259 (48%) the U-Biopred, 222 (41%) the NICE, 125 (23%) the WHO, 313 (58%) the Enfumosa, and 251 (46%) the TENOR criteria. The mean eosinophil value were similar in the ATS/ERS, U-Biopred, and Enfumosa (528, 532 and 516 cells/mcl), higher in WHO and Tenor (567 and 570 cells/mcl) and much higher in the NICE classification (624 cells/mcl). Lung function tests resulted similarly in all groups, with WHO (67%) and ATS/ERS-GINA (73%), respectively, showing the lower and upper mean FEV1 values. Conclusions: The present observations clearly evidence the heterogeneity in the distribution of patients when different definitions of severe asthma are used. However, the recent definition of severe asthma, provided by the GINA document, is similar to that indicated in 2014 by ATS/ERS, allowing mirror reclassification of the patients examined. This lack of homogeneity could complicate the access to biological therapies. The definition provided by the GINA document, which reflects what suggested by ATS/ERS, could partially overcome the problem.

Published
2021

6. Economic impact of mepolizumab in uncontrolled severe eosinophilic asthma, in real life

Author

Bagnasco, D., Povero, M., Pradelli, L., Brussino, L., Rolla, G., Caminati, M., Menzella, F., Heffler, E., Canonica, G. W., Paggiaro, P., Senna, G., Milanese, M., Lombardi, C., Bucca, C., Manfredi, A., Canevari, R. F., Passalacqua, G., Guarnieri, G., Patella, V., Maria Pia, F. B., Carpagnano, E., Colle, A. D., Scioscia, G., Gerolamo, P., Latorre, M., Puggioni, F., Racca, F., Favero, E., Iannacone, S., Savi, E., Montagni, M., Camiciottoli, G., Allegrini, C., Spadaro, G., Detoraki, C., Galeone, C., Ruggiero, P., Yacoub, M. R., Berti, Andrea, Colombo, G., Scichilone, N., Durante, C., Costantino, M. T., Roncallo, C., Braschi, M., Blasi, F., D'Adda, A., Ridolo, E., Triggiani, M., Parente, R., Maria, D. A., Verrillo, M. V., Cristina, Z. M., Lilli, M., Crimi, N., Bonavia, M., Corsico, A. G., Grosso, A., Del Giacco, S., Deidda, M., Ricciardi, L., Isola, S., Cicero, F., Amato, G., Vita, F., Spanevello, A., Pignatti, P., Cherubino, F., Visca, D., Aletti, E., Massimo Ricciardolo, F. L., Anna Carriero, V. M., Bertolini, Francesca, Santus, P., Barlassina, R., Airoldi, A., Guida, Maria Grazia, Nucera, Eleonora, Aruanno, A., Rizzi, Angela, Caruso, C., Colantuono, S., Arcolaci, A., Vianello, A., Bianchi, F. C., Marchi, M. R., Centanni, S., Luraschi, S., Ruggeri, S., Rinaldo, R., Parazzini, E., Calabrese, Anna Chiara, Flora, M., Cosmi, L., Di Pietro, L., Maggi, E., Pini, L., Macchia, L., Di Bona, D., Richeldi, Luca, Condoluci, Carola, Fuso, Leonello, Bonini, Matteo, Farsi, A., Carli, G., Montuschi, Paolo, Santini, G., Conte, M. E., Turchet, E., Barbetta, C., Mazza, F., D'Alo, S., Pucci, S., Caiaffa, M. F., Minenna, E., D'Elia, L., Pasculli, C., Viviano, V., Tarsia, P., Rolo, J., Di Proietto, M., Lo Cicero, Stefano, Berti A., Bertolini F., Guida G., Eleonora N. (ORCID:0000-0002-0565-7680), Rizzi A. (ORCID:0000-0002-6795-746X), Calabrese C., Richeldi L. (ORCID:0000-0001-8594-1448), Condoluci C., Fuso L. (ORCID:0000-0002-1198-6712), Bonini M. (ORCID:0000-0002-3042-0765), Montuschi P. (ORCID:0000-0001-5589-1750), Lo Cicero S., Bagnasco, D., Povero, M., Pradelli, L., Brussino, L., Rolla, G., Caminati, M., Menzella, F., Heffler, E., Canonica, G. W., Paggiaro, P., Senna, G., Milanese, M., Lombardi, C., Bucca, C., Manfredi, A., Canevari, R. F., Passalacqua, G., Guarnieri, G., Patella, V., Maria Pia, F. B., Carpagnano, E., Colle, A. D., Scioscia, G., Gerolamo, P., Latorre, M., Puggioni, F., Racca, F., Favero, E., Iannacone, S., Savi, E., Montagni, M., Camiciottoli, G., Allegrini, C., Spadaro, G., Detoraki, C., Galeone, C., Ruggiero, P., Yacoub, M. R., Berti, Andrea, Colombo, G., Scichilone, N., Durante, C., Costantino, M. T., Roncallo, C., Braschi, M., Blasi, F., D'Adda, A., Ridolo, E., Triggiani, M., Parente, R., Maria, D. A., Verrillo, M. V., Cristina, Z. M., Lilli, M., Crimi, N., Bonavia, M., Corsico, A. G., Grosso, A., Del Giacco, S., Deidda, M., Ricciardi, L., Isola, S., Cicero, F., Amato, G., Vita, F., Spanevello, A., Pignatti, P., Cherubino, F., Visca, D., Aletti, E., Massimo Ricciardolo, F. L., Anna Carriero, V. M., Bertolini, Francesca, Santus, P., Barlassina, R., Airoldi, A., Guida, Maria Grazia, Nucera, Eleonora, Aruanno, A., Rizzi, Angela, Caruso, C., Colantuono, S., Arcolaci, A., Vianello, A., Bianchi, F. C., Marchi, M. R., Centanni, S., Luraschi, S., Ruggeri, S., Rinaldo, R., Parazzini, E., Calabrese, Anna Chiara, Flora, M., Cosmi, L., Di Pietro, L., Maggi, E., Pini, L., Macchia, L., Di Bona, D., Richeldi, Luca, Condoluci, Carola, Fuso, Leonello, Bonini, Matteo, Farsi, A., Carli, G., Montuschi, Paolo, Santini, G., Conte, M. E., Turchet, E., Barbetta, C., Mazza, F., D'Alo, S., Pucci, S., Caiaffa, M. F., Minenna, E., D'Elia, L., Pasculli, C., Viviano, V., Tarsia, P., Rolo, J., Di Proietto, M., Lo Cicero, Stefano, Berti A., Bertolini F., Guida G., Eleonora N. (ORCID:0000-0002-0565-7680), Rizzi A. (ORCID:0000-0002-6795-746X), Calabrese C., Richeldi L. (ORCID:0000-0001-8594-1448), Condoluci C., Fuso L. (ORCID:0000-0002-1198-6712), Bonini M. (ORCID:0000-0002-3042-0765), Montuschi P. (ORCID:0000-0001-5589-1750), and Lo Cicero S.

Abstract

Background and aims: Severe asthma is burdened by frequent exacerbations and use of oral corticosteroids (OCS) which worsen patients’ health and increase healthcare spending. Aim of this study was to assess the clinical and economic effect of adding mepolizumab (MEP) for the treatment of these patients. Methods: Patients >18 years old, referred to 8 asthma clinics, starting MEP between May 2017 and December 2018, were enrolled and followed-up for 12 months. Information in the 12 months before mepolizumab were collected retrospectively. The evaluation parameters included: OCS use, number of exacerbations/hospitalizations, concomitant therapies, comorbidity, and annual number of working days lost due to the disease. The primary objective was to compare the annual total cost per patient pre- and post-MEP. Secondary outcomes included rates of exacerbations and number of OCS-dependent patients. Results: 106 patients were enrolled in the study: 46 male, median age 58 years. Mean annual cost pre- and post-MEP (cost of biologic excluded) was €3996 and €1,527, respectively. Total savings due to MEP resulted in €2469 (95%CI 1945–2993), 62% due to exacerbations reduction and 33% due to productivity increase. Such savings could fund about 22% of the total cost of MEP for one year. The introduction of MEP induced a clinical benefit by reducing both OCS-dependent patients (OR = 0.12, 95%CI 0.06–0.23) and exacerbation rate (RR = 0.19, 95%CI 0.15–0.24). Conclusions: Patients with severe eosinophilic asthma experienced a clinical benefit in asthma control adding MEP to standard therapy. Biologic therapy can be, partially, funded by the savings produced by patients’ improvement.

Published
2021

7. Systemic allergic reactions induced by labile plant-food allergens: Seeking potential cofactors. A multicenter study

Author

Asero, R., Ariano, R., Aruanno, A., Barzaghi, C., Borrelli, P., Busa, M., Celi, G., Cinquini, M., Cortellini, G., D'Auria, F., De Carli, M., Di Paolo, C., Garzi, G., Lodi Rizzini, F., Magnani, M., Manzotti, G., Marra, A., Miceli Sopo, Stefano, Murzilli, F., Nucera, Eleonora, Pinter, E., Pravettoni, V., Rivolta, F., Rizzi, Angela, Saporiti, N., Scala, E., Villalta, D., Yacoub, M. -R., Zisa, G., Miceli Sopo S. (ORCID:0000-0002-8175-6146), Nucera E. (ORCID:0000-0002-0565-7680), Rizzi A. (ORCID:0000-0002-6795-746X), Asero, R., Ariano, R., Aruanno, A., Barzaghi, C., Borrelli, P., Busa, M., Celi, G., Cinquini, M., Cortellini, G., D'Auria, F., De Carli, M., Di Paolo, C., Garzi, G., Lodi Rizzini, F., Magnani, M., Manzotti, G., Marra, A., Miceli Sopo, Stefano, Murzilli, F., Nucera, Eleonora, Pinter, E., Pravettoni, V., Rivolta, F., Rizzi, Angela, Saporiti, N., Scala, E., Villalta, D., Yacoub, M. -R., Zisa, G., Miceli Sopo S. (ORCID:0000-0002-8175-6146), Nucera E. (ORCID:0000-0002-0565-7680), and Rizzi A. (ORCID:0000-0002-6795-746X)

Abstract

Background: Heat-and-pepsin-sensitive plant food allergens (PR-10 and profilin) sometimes cause systemic reaction. Objective: To detect the risk factors for systemic reactions induced by labile food allergens. Methods: A retrospective multicenter study was performed on patients with a documented history of systemic allergic reaction to labile plant food allergens and on age-matched controls with a history of oral allergy syndrome (OAS) induced by the same foods. Offending foods, their amount, and state (solid or liquid), and potential cofactors (nonsteroidal anti-inflammatory drugs, protonic pump inhibitors, exercise, alcohol, and fasting) were considered. Results: We studied 89 patients and 81 controls. Sensitization to PR-10 or profilin, IgE to Bet v 1 and/or Bet v 2, and foods causing OAS were similar in the two groups. Twenty patients experienced >1 systemic allergic reaction. Tree nuts, Rosaceae, Apiaceae, and soymilk were the main offending foods. Seventeen (19%) patients were taking a PPI when the systemic reaction occurred (vs 5% in controls; P <.025). The ingestion of the offending food in liquid form (soymilk) was frequent among patients (15%) but unusual among controls (2%; P <.025). Soy milk-induced systemic reactions were independent of PPI treatment. Fasting and excess of allergen, but not NSAID and exercise, were other relevant cofactors for systemic reactions. Systemic reactions occurred without any identifiable cofactor in 39 (44%) cases. Conclusion: PR-10- and profilin-induced systemic reactions are facilitated by PPI, ingestion of large amounts of unprocessed foods, and fasting. Soybean beverages represent a risk for PR-10 hypersensitive patients and should be avoided.

Published
2021

10. Reply to: Kow CS et al. Are severe asthma patients at higher risk of developing severe outcomes from COVID-19?

Author

Heffler, Enrico, Detoraki, Aikaterini, Contoli, Marco, Papi, Alberto, Paoletti, Giovanni, Malipiero, Giacomo, Brussino, Luisa, Crimi, Claudia, Morrone, Daniela, Padovani, Marianna, Guida, Giuseppe, Gerli, Alberto Giovanni, Centanni, Stefano, Senna, Gianenrico, Paggiaro, Pierluigi, Blasi, Francesco, Canonica, Giorgio Walter, SANI Working Group, Bonavia, M., Bucca, C., Caiaffa, M. F., Calabrese, C., Camiciottoli, G., Caruso, C., Conte, M. E., Corsico, A. G., Cosmi, L., Costantino, M. T., Crimi, N., D’Alò, S., D’Amato, M., Del Giacco, S., Farsi, A., Favero, E., Foschino, B. M. P., Guarnieri, G., Lo Cicero, S., Lombardi, C., Macchia, L., Mazza, F., Menzella, F., Milanese, M., Montuschi, P., Montagni, M., Nucera, E., Parente, R., Passalacqua, G., Patella, V., Pelaia, G., Pini, L., Puggioni, F., Ricciardi, L., Ricciardolo, F. L. M., Richeldi, L., Ridolo, E., Rolla, G., Santus, P., Scichilone, N., Solidoro, P., Spadaro, G., Vianello, A., Viviano, V., Yacoub, M. R., Zappa, M. C., Heffler E., Detoraki A., Contoli M., Papi A., Paoletti G., Malipiero G., Brussino L., Crimi C., Morrone D., Padovani M., Guida G., Gerli A.G., Centanni S., Senna G., Paggiaro P., Blasi F., Canonica G.W., Bonavia M., Bucca C., Caiaffa M.F., Calabrese C., Camiciottoli G., Caruso C., Conte M.E., Corsico A.G., Cosmi L., Costantino M.T., Crimi N., D'Alo S., D'Amato M., Del Giacco S., Farsi A., Favero E., Foschino B.M.P., Guarnieri G., Lo Cicero S., Lombardi C., Macchia L., Mazza F., Menzella F., Milanese M., Montuschi P., Montagni M., Nucera E., Parente R., Passalacqua G., Patella V., Pelaia G., Pini L., Puggioni F., Ricciardi L., Ricciardolo F.L.M., Richeldi L., Ridolo E., Rollav G., Santus P., Scichilone N., Solidoro P., Spadaro G., Vianello A., Viviano V., Yacoub M.R., and Zappa M.C.

Subjects
severe asthma, 2019-20 coronavirus outbreak, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Severe asthma, Immunology, Comorbidity, Settore MED/10 - Malattie Dell'Apparato Respiratorio, COVID-19, severe asthma, COPD, NO, Humans, SARS-CoV-2, Asthma, COVID-19, Internal medicine, Correspondence, medicine, COPD, Immunology and Allergy, COVID, business.industry, asthma, medicine.disease, Italy, business
Published
2020

11. Occupational rhinitis

Author

Moscato, G., Vandenplas, O., Van Wijk, R. Gerth, Malo, J. L., Quirce, S., Walusiak, J., Castano, R., De Groot, H., Folletti, I., Gautrin, D., Yacoub, M. R., Perfetti, L., and Siracusa, A.

Published
2008

12. Oral CorticoSteroid sparing with biologics in severe asthma: A remark of the Severe Asthma Network in Italy (SANI)

Author

Canonica, G. W., Blasi, F., Paggiaro, P., Senna, G., Passalacqua, G., Spanevello, A., Aliberti, S., Bagnasco, D., Bonavia, M., Bonini, Matteo, Brussino, L., Bucca, C., Caiaffa, M. F., Calabrese, Anna Chiara, Camiciottoli, G., Caminati, M., Carpagnano, G. E., Caruso, Corrado Maria Roberto, Centanni, S., Conte, M. E., Corsico, A. G., Cosmi, L., Costantino, M. T., Crimi, N., D'Alo, S., D'Amato, M., Del Giacco, S., Farsi, A., Favero, E., Foschino Barbaro, M. P., Guarnieri, G., Guida, Maria Grazia, Latorre, M., Lo Cicero, Stefano, Lombardi, Celestino Pio, Macchia, L., Mazza, F., Menzella, F., Milanese, M., Montagni, M., Montuschi, Paolo, Nucera, Eleonora, Parente, R., Patella, V., Pelaia, G., Pini, L., Puggioni, F., Ricciardi, L., Ricciardolo, F. L. M., Richeldi, Luca, Ridolo, E., Rolla, G., Santus, P., Scichilone, N., Spadaro, G., Vianello, A., Viviano, V., Yacoub, M. R., Zappa, M. C., Heffler, E., Bonini M. (ORCID:0000-0002-3042-0765), Calabrese C., Caruso C., Guida G., Lo Cicero S., Lombardi C. (ORCID:0000-0001-8910-6693), Montuschi P. (ORCID:0000-0001-5589-1750), Nucera E. (ORCID:0000-0002-0565-7680), Richeldi L. (ORCID:0000-0001-8594-1448), Canonica, G. W., Blasi, F., Paggiaro, P., Senna, G., Passalacqua, G., Spanevello, A., Aliberti, S., Bagnasco, D., Bonavia, M., Bonini, Matteo, Brussino, L., Bucca, C., Caiaffa, M. F., Calabrese, Anna Chiara, Camiciottoli, G., Caminati, M., Carpagnano, G. E., Caruso, Corrado Maria Roberto, Centanni, S., Conte, M. E., Corsico, A. G., Cosmi, L., Costantino, M. T., Crimi, N., D'Alo, S., D'Amato, M., Del Giacco, S., Farsi, A., Favero, E., Foschino Barbaro, M. P., Guarnieri, G., Guida, Maria Grazia, Latorre, M., Lo Cicero, Stefano, Lombardi, Celestino Pio, Macchia, L., Mazza, F., Menzella, F., Milanese, M., Montagni, M., Montuschi, Paolo, Nucera, Eleonora, Parente, R., Patella, V., Pelaia, G., Pini, L., Puggioni, F., Ricciardi, L., Ricciardolo, F. L. M., Richeldi, Luca, Ridolo, E., Rolla, G., Santus, P., Scichilone, N., Spadaro, G., Vianello, A., Viviano, V., Yacoub, M. R., Zappa, M. C., Heffler, E., Bonini M. (ORCID:0000-0002-3042-0765), Calabrese C., Caruso C., Guida G., Lo Cicero S., Lombardi C. (ORCID:0000-0001-8910-6693), Montuschi P. (ORCID:0000-0001-5589-1750), Nucera E. (ORCID:0000-0002-0565-7680), and Richeldi L. (ORCID:0000-0001-8594-1448)

Abstract

According to the data derived from several national and international registries, including SANI (Severe Asthma Network Italy), and considering the strong impact that frequent or regular use of oral corticosteroid has on quality of life (QoL) of severe asthmatics, as well as on the costs for managing corticosteroid-related diseases, oral corticosteroid sparing up to withdrawal should be considered a primary outcome in the management of severe asthma. New biologics have clearly demonstrated that this effect is possible, with concomitant reduction in the rate of exacerbations and in symptom control. Then, there is no reason for using so frequently oral corticosteroid before having explored all alternatives currently available for a large part of severe asthmatics.

Published
2020

13. Chronic rhinosinusitis with nasal polyps impact in severe asthma patients: Evidences from the Severe Asthma Network Italy (SANI) registry

Author

Canonica, G. W., Malvezzi, L., Blasi, F., Paggiaro, P., Mantero, M., Senna, G., Heffler, E., Bonavia, M., Caiaffa, P., Calabrese, C., Camiciottoli, G., Caruso, C., Centanni, S., Conte, M. E., Corsico, A. G., Cosmi, L., Costantino, M. T., Crimi, N., D'Alonzo, Silvia, D'Amato, M., Del Giacco, S., Favero, E., Farsi, A., Foschino, B. P. M., Guarnieri, G., Guida, G., Latorre, M., Lombardi, C., Macchia, Gabriella, Menzella, F., Milanese, M., Montuschi, Paolo, Nucera, Eleonora, Parente, R., Passalacqua, G., Patella, V., Pelaia, G., Pini, L., Ricciardolo, F. L. M., Ricciardi, L., Richeldi, Luca, Ridolo, E., Marolla, Giovanna, Santus, P., Scichilone, N., Solidoro, P., Spadaro, G., Spanevello, A., Vianello, A., Yacoub, M. R., Zappa, M. C., D'Alo S., Macchia L., Montuschi P. (ORCID:0000-0001-5589-1750), Nucera E. (ORCID:0000-0002-0565-7680), Richeldi L. (ORCID:0000-0001-8594-1448), Rolla G., Canonica, G. W., Malvezzi, L., Blasi, F., Paggiaro, P., Mantero, M., Senna, G., Heffler, E., Bonavia, M., Caiaffa, P., Calabrese, C., Camiciottoli, G., Caruso, C., Centanni, S., Conte, M. E., Corsico, A. G., Cosmi, L., Costantino, M. T., Crimi, N., D'Alonzo, Silvia, D'Amato, M., Del Giacco, S., Favero, E., Farsi, A., Foschino, B. P. M., Guarnieri, G., Guida, G., Latorre, M., Lombardi, C., Macchia, Gabriella, Menzella, F., Milanese, M., Montuschi, Paolo, Nucera, Eleonora, Parente, R., Passalacqua, G., Patella, V., Pelaia, G., Pini, L., Ricciardolo, F. L. M., Ricciardi, L., Richeldi, Luca, Ridolo, E., Marolla, Giovanna, Santus, P., Scichilone, N., Solidoro, P., Spadaro, G., Spanevello, A., Vianello, A., Yacoub, M. R., Zappa, M. C., D'Alo S., Macchia L., Montuschi P. (ORCID:0000-0001-5589-1750), Nucera E. (ORCID:0000-0002-0565-7680), Richeldi L. (ORCID:0000-0001-8594-1448), and Rolla G.

Abstract

Background: The clinical and laboratory features of patients enrolled in the Severe Asthma Network in Italy (SANI) registry, a web-based observatory collecting demographic, clinical, functional and inflammatory data of patients with severe asthma were evaluated, with a special emphasis to chronic rhinosinusitis with nasal polyposis (CRSwNP). Methods: For each eligible patients the following information has been collected: demographic data, clinical features, asthma control in the previous month according to the GINA (Global INitiative for Asthma) Guidelines and standardized questionnaires, concomitant regular and on demand treatments and inflammatory markers. Results: 695 patients with severe asthma enrolled in 66 SANI centers were analyzed. The prevalence of chronic rhinosinusitis with nasal polyposis was 40.6%. Atopic dermatitis and bronchiectasis was significantly more frequent in patients with CRSwNP than in subjects without nasal polyposis; similarly, FeNO values are significantly higher in subject with CRSwNP than in patients without nasal polyposis. Finally, patients with CRSwNP had a significantly higher number of asthma exacerbations per year, more days on oral corticosteroids and were more likely to be OCS long term users. Conclusion: OCS sparing is needed in patients with severe asthma, mainly in subjects with CRSwNP, adopting adequate strategies such as a better adherence to the treatment with inhaled therapy according to the GINA recommendations, the use of biologic agents and a multidisciplinary approach of the patient.

Published
2020

16. Ruolo della terapia anti IgE nelle rinosinusiti croniche

Author

TRIMARCHI, MATTEO, BUSSI, MARIO, Yacoub, M. R. ., Biafora, M., Ramirez, G. A. ., Trimarchi, M., Yacoub, M. R., Biafora, M., Ramirez, G. A., Bussi, M., Ernesto Pasquini, Trimarchi, Matteo, Yacoub, M. R. ., Ramirez, G. A. ., and Bussi, Mario

Published
2016

17. Patients with breakthrough reactions to iodinated contrast media have low incidence of positive skin tests

Author

Berti, A., Della-Torre, E., Yacoub, M. R., Tombetti, E., valentina canti, Sabbadini, M. G., Colombo, G., Berti, A, DELLA TORRE, E, Yacoub, M, Tombetti, E, Canti, V, Sabbadini, Mg, and Colombo, G.

Subjects
Adult, Hypersensitivity, Immediate, Male, Histamine Antagonists, Contrast Media, Reproducibility of Results, intradermal tests, Intradermal Tests, Middle Aged, Patch Tests, skin tests, hypersensitivity, iodinated contrast media, breakthrough reactions, Drug Hypersensitivity, Predictive Value of Tests, Recurrence, Risk Factors, Humans, Female, Hypersensitivity, Delayed, Glucocorticoids, Aged, Retrospective Studies
Abstract

The term "breakthrough reactions" designates repeated hypersensitivity reactions to iodinated contrast media (ICM) despite premedication with glucocorticoids and antihistamines. We aimed to retrospectively evaluate the rate of positive skin test (STs) in our cohort of patients with previous breakthrough reactions to different ICMs.A series of 35 patients, who experienced at least one breakthrough reaction to ICM and who underwent STs within 6 months from the reaction were studied, and results were compared to a control group of patients with a first hypersensitivity reaction occurred without premedication. Skin prick tests (SPT), intradermal tests (IDT) and patch tests (PT) at different dilutions, with a set of three to four ICM were performed.Of the 35 patients with prior breakthrough reactions, 57% had an immediate reaction (IR) and 43% had a non-immediate reaction (NIR). Patients who experienced the first hypersensitivity IR or NIR, later had one or more breakthrough IR or NIR, respectively. Overall, 29% (10/35) of patients with prior breakthrough reactions resulted positive to STs compared to 57% (16/28) of the control group (p0.05). No significant difference in allergy history, age, sex, other clinical / demographic features nor chronic use of ACE-inhibitor, beta-blockers or NSAIDs was observed.This preliminary finding suggests that patients with prior breakthrough reactions have significantly lower immunologically proven ICM reactions (positive STs) if compared to non-breakthrough patients. According to that, a considerable number of breakthrough reactions seems to be non-allergic hypersensitivity reactions or reactions which could be mostly prevented by a proper, well-timed skin testing. Larger prospective studies are needed to confirm these results, with a more careful analysis of patients' risk factors, a laboratory assessment that includes an in vitro allergy diagnostics, and hopefully a drug provocation test for selected cases.

Published
2016

21. Occupational rhinitis.

Author

UCL - (MGD) Service de pneumologie, Moscato, G, Vandenplas, Olivier, Gerth Van Wijk, R, Malo, J L, Quirce, S, Walusiak, J, Castano, R, De Groot, H, Folletti, I, Gautrin, D, Yacoub, M R, Perfetti, L, Siracusa, A, UCL - (MGD) Service de pneumologie, Moscato, G, Vandenplas, Olivier, Gerth Van Wijk, R, Malo, J L, Quirce, S, Walusiak, J, Castano, R, De Groot, H, Folletti, I, Gautrin, D, Yacoub, M R, Perfetti, L, and Siracusa, A

Abstract

The present document is the result of a consensus reached by a panel of experts from European and nonEuropean countries on Occupational Rhinitis (OR), a disease of emerging relevance, which has received little attention in comparison to occupational asthma. The document covers the main items of OR including epidemiology, diagnosis, management, socio-economic impact, preventive strategies and medicolegal issues. An operational definition and classification of OR tailored to that of occupational asthma, as well as a diagnostic algorithm based on steps allowing different levels of diagnostic evidence, are proposed. The needs for future research are pointed out. Key messages are issued for each item.

Published
2008

25. Proposal of a skin tests based approach for the prevention of recurrent hypersensitivity reactions to iodinated contrast media

Author

Emanuel Della Torre, Berti, A., Yacoub, M. R., Guglielmi, B., Tombetti, E., Sabbadini, M. G., Voltolini, S., Colombo, G., DELLA TORRE, E, Berti, A, Yacoub, Mr, Guglielmi, B, Tombetti, E, Sabbadini, Mg, Voltolini, S, and Colombo, G

Subjects
Adult, Male, Iodine Compounds, Contrast Media, Reproducibility of Results, Intradermal Tests, Middle Aged, Drug Hypersensitivity, Young Adult, Predictive Value of Tests, Recurrence, Risk Factors, Critical Pathways, Humans, Female, Algorithms, Aged, Skin Tests
Abstract

The purpose of the present work is to evaluate the efficacy of an approach that combines clinical history, skin tests results, and premedication, in preventing recurrent hypersensitivity reactions to iodinated contrast media (ICM). Skin Prick tests, Intradermal tests, and Patch tests were performed in 36 patients with a previous reaction to ICM. All patients underwent a second contrast enhanced radiological procedure with an alternative ICM selected on the basis of the proposed approach. After alternative ICM re-injection, only one patient presented a mild NIR. The proposed algorithm, validated in clinical settings where repeated radiological exams are needed, offers a safe and practical approach for protecting patients from recurrent hypersensitivity reactions to ICM.

26. SIRM-SIAAIC consensus, an Italian document on management of patients at risk of hypersensitivity reactions to contrast media

Author

Laura Romanini, Francesco Gaeta, Matteo Passamonti, Stefano Pucci, Giovanni Cerri, Antonino Romano, Cristoforo Incorvaia, Marina Mauro, Fulvio Stacul, Mona-Rita Yacoub, Eustacchio Nettis, Rocco Luigi Valluzzi, Eleonora Savi, Michele Galluzzo, Sergio Testi, Paolo Ricci, Oliviero Rossi, Elisabetta Di Leo, Emanuele Grassedonio, Patrizia Bonadonna, Paolo Montuschi, Erminia Ridolo, Maria Teresa Costantino, Alfonso Reginelli, Costantino, M. T., Romanini, L., Gaeta, F., Stacul, F., Valluzzi, R. L., Passamonti, M., Bonadonna, P., Cerri, G., Pucci, S., Ricci, P., Savi, E., Galluzzo, M., Mauro, M., Grassedonio, E., Yacoub, M. R., Reginelli, A., Testi, S., Ridolo, E., Nettis, E., Di Leo, E., Rossi, O., Montuschi, P., Incorvaia, C., Romano, A., Costantino M.T., Romanini L., Gaeta F., Stacul F., Valluzzi R.L., Passamonti M., Bonadonna P., Cerri G., Pucci S., Ricci P., Savi E., Galluzzo M., Mauro M., Grassedonio E., Yacoub M.R., Reginelli A., Testi S., Ridolo E., Nettis E., Di Leo E., Rossi O., Montuschi P., Incorvaia C., and Romano A.

Subjects
lcsh:Immunologic diseases. Allergy, radiologic contrast media, hypersensitivity reactions, low-osmolar contrast agents, diagnosis, management, medicine.medical_specialty, Allergy, Hypersensitivity reactions, Referral, Immunology, Review, Culprit, Radiologic contrast media, 03 medical and health sciences, 0302 clinical medicine, Diagnosis, Hypersensitivity reaction, medicine, Immunology and Allergy, Medical history, In patient, Low-osmolar contrast agents, Intensive care medicine, Molecular Biology, business.industry, Low-osmolar contrast agent, medicine.disease, Management, 030228 respiratory system, Radiological weapon, Premedication, business, lcsh:RC581-607, Anaphylaxis, Diagnosi, 030215 immunology
Abstract

Hypersensitivity reactions (HRs) to contrast media (CM) can be distinguished in immune-mediated (including allergic reactions) and non-immune-mediated reactions, even if clinical manifestations could be similar. Such manifestations range from mild skin eruptions to severe anaphylaxis, making it important for radiologists to know how to identify and manage them. A panel of experts from the Società Italiana di Radiologia Medica e Interventistica (SIRM) and the Società Italiana di Allergologia, Asma e Immunologia Clinica (SIAAIC) provided a consensus document on the management of patients who must undergo radiological investigations with CM. Consensus topics included: the risk stratification of patients, the identification of the culprit CM and of a safe alternative by an allergy workup, as well as the use of premedication and the correct procedure to safely perform an elective (i.e., scheduled) or urgent examination. The most important recommendations are: (1) in all patients, a thorough medical history must be taken by the prescribing physician and/or the radiologist to identify at-risk patients; (2) in patients with hypersensitivity reactions to CM, the radiologist must consider an alternative, non-contrast imaging study with a comparable diagnostic value, or prescribe a different investigation with another class of CM; (3) if such options are not feasible, the radiologist must address at-risk patients to a reference centre for an allergy evaluation; (4) if timely referral to an allergist is not viable, it is recommended to use a CM other than the responsible one, taking into account cross-reactivity patterns; in the case of patients with histories of severe reactions, the presence of an anesthesiologist is also recommended and a premedication is suggested.

Published
2020
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27. Drug reaction with eosinophilia and systemic symptoms (DRESS) in patients with COVID-19

Author

Lorenzo Dagna, Fabio Ciceri, Emanuel Della-Torre, Moreno Tresoldi, Paolo Scarpellini, Mona-Rita Yacoub, Giuseppe A. Ramirez, Ramirez, G. A., Della-Torre, E., Tresoldi, M., Scarpellini, P., Ciceri, F., Dagna, L., and Yacoub, M. -R.

Subjects
Male, Microbiology (medical), medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Critical Illness, MEDLINE, Comorbidity, Drug reaction with eosinophilia and systemic symptoms, Internal medicine, Eosinophilia, medicine, Humans, In patient, Prospective Studies, Prospective cohort study, Letter to the Editor, Aged, Retrospective Studies, SARS-CoV-2, business.industry, COVID-19, Retrospective cohort study, General Medicine, Middle Aged, medicine.disease, Hospitalization, Infectious Diseases, Drug Hypersensitivity Syndrome, Female, Observational study, business
Published
2021
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28. Severe asthma: One disease and multiple definitions

Author

Maria Teresa Costantino, Luigi Macchia, Angelo Corsico, Andrea Airoldi, Carla Galeone, Zappa Maria Cristina, Paolo Tarsia, Foschino Barbaro Maria Pia, Silvia Ruggeri, Pierluigi Paggiaro, Lorenzo Cosmi, A. Farsi, Vitina Maria Anna Carriero, Arianna Bassi, Francesca Bertolini, Giovanni Passalacqua, Fulvia Chieco Bianchi, Carlo Lombardi, Salvatore Lo Cicero, Giovanni Rolla, Carmen Durante, Rocco Rinaldo, Elena Parazzini, Arianna Aruanno, Maria Rita Marchi, Chiara Folli, Alessandra Arcolaci, Carlo Pasculli, Fabio Luigi Massimo Ricciardolo, Vittorio Viviano, Alvise Berti, Stefano Del Giacco, Andrea Manfredi, Roberta Barlassina, Agata Valentina Frazzetto, Pierachille Santus, Luisa Brussino, Anna del Colle, Marco Bonavia, Dina Visca, Nicola Scichilone, Patrizia Pignatti, Enrico Heffler, Francesca Racca, Giuseppe Santini, Nucera Eleonora, Giovanna Elisiana Carpagnano, Linda Di Pietro, Stefano Centanni, Maria Elisabetta Conte, Vincenzo Patella, Monna Rita Yacoub, Diego Bagnasco, Nunzio Crimi, Anna Maria Riccio, Stefania Isola, Margherita Deidda, Gabriella Guarnieri, Giuseppe Guida, Elena Minenna, Manuela Latorre, Gianna Camiciottoli, Maria Vittoria Verrillo, Luca Richeldi, Marcello Montagni, Francesca Cicero, Maria Filomena Caiaffa, Antonio Spanevello, Cecilia Calabrese, Carlo Barbetta, Elisabetta Favero, Gianenrico Senna, Giuliana Amato, Amelia Grosso, Federica Vita, Francesco Blasi, Luisa Ricciardi, Carola Condoluci, Massimo Triggiani, Enrico Maggi, Mariacarmela Di Proietto, Giulia Carli, Roberta Parente, Eleonora Savi, Chiara Roncallo, Paolo Montuschi, Luciana D'Elia, Francesco Mazza, Simona D’Alo, Patrizia Ruggiero, Francesca Puggioni, Matteo Bonini, Simone Luraschi, Francesco Menzella, Leonello Fuso, Marco Caminati, Martina Flora, Mariachiara Braschi, Cristiano Caruso, Angela Rizzi, Sandra Iannacone, Rikki Frank Canevari, Andrea Vianello, D’Amato Maria, Manlio Milanese, Stefania Colantuono, Giorgio Walter Canonica, Giulia Scioscia, Laura Pini, Elisa Testino, Erminia Ridolo, Joyce Rolo, Elisa Turchet, Pelaia Gerolamo, Danilo Di Bona, Laura De Ferrari, Francesca Cherubino, Alice D’Adda, Marianna Lilli, Giuseppe Spadaro, Stefano Pucci, Caterina Detoraki, Chiara Allegrini, Bagnasco, D., Paggiaro, P., Latorre, M., Folli, C., Testino, E., Bassi, A., Milanese, M., Heffler, E., Manfredi, A., Riccio, A. M., De Ferrari, L., Blasi, F., Canevari, R. F., Canonica, G. W., Passalacqua, G., Guarnieri, G., Patella, V., Maria Pia, F. B., Carpagnano, G. E., Colle, A. D., Scioscia, G., Gerolamo, P., Puggioni, F., Racca, F., Favero, E., Iannacone, S., Savi, E., Montagni, M., Camiciottoli, G., Allegrini, C., Lombardi, C., Spadaro, G., Detoraki, C., Menzella, F., Galeone, C., Ruggiero, P., Yacoub, M. R., Berti, A., Scichilone, N., Durante, C., Costantino, M. T., Roncallo, C., Braschi, M., D'Adda, A., Ridolo, E., Triggiani, M., Parente, R., Maria, D. A., Verrillo, M. V., Rolla, G., Brussino, L., Frazzetto, A. V., Cristina, Z. M., Lilli, M., Crimi, N., Bonavia, M., Corsico, A. G., Grosso, A., Del Giacco, S., Deidda, M., Ricciardi, L., Isola, S., Cicero, F., Amato, G., Vita, F., Spanevello, A., Pignatti, P., Cherubino, F., Visca, D., Massimo Ricciardolo, F. L., Anna Carriero, V. M., Bertolini, F., Santus, P., Barlassina, R., Airoldi, A., Guida, G., Eleonora, N., Aruanno, A., Rizzi, A., Caruso, C., Colantuono, S., Senna, G., Caminati, M., Arcolaci, A., Vianello, A., Bianchi, F. C., Marchi, M. R., Centanni, S., Luraschi, S., Ruggeri, S., Rinaldo, R., Parazzini, E., Calabrese, C., Flora, M., Cosmi, L., Di Pietro, L., Maggi, E., Pini, L., Macchia, L., Di Bona, D., Richeldi, L., Condoluci, C., Fuso, L., Bonini, M., Farsi, A., Carli, G., Montuschi, P., Santini, G., Conte, M. E., Turchet, E., Barbetta, C., Mazza, F., D'Alo, S., Pucci, S., Caiaffa, M. F., Minenna, E., D'Elia, L., Pasculli, C., Viviano, V., Tarsia, P., Rolo, J., Di Proietto, M., Lo Cicero, S., Bagnasco D., Paggiaro P., Latorre M., Folli C., Testino E., Bassi A., Milanese M., Heffler E., Manfredi A., Riccio A.M., De Ferrari L., Blasi F., Canevari R.F., Canonica G.W., Passalacqua G., Guarnieri G., Patella V., Maria Pia F.B., Carpagnano G.E., Colle A.D., Scioscia G., Gerolamo P., Puggioni F., Racca F., Favero E., Iannacone S., Savi E., Montagni M., Camiciottoli G., Allegrini C., Lombardi C., Spadaro G., Detoraki C., Menzella F., Galeone C., Ruggiero P., Yacoub M.R., Berti A., Scichilone N., Durante C., Costantino M.T., Roncallo C., Braschi M., D'Adda A., Ridolo E., Triggiani M., Parente R., Maria D.A., Verrillo M.V., Rolla G., Brussino L., Frazzetto A.V., Cristina Z.M., Lilli M., Crimi N., Bonavia M., Corsico A.G., Grosso A., Del Giacco S., Deidda M., Ricciardi L., Isola S., Cicero F., Amato G., Vita F., Spanevello A., Pignatti P., Cherubino F., Visca D., Massimo Ricciardolo F.L., Anna Carriero V.M., Bertolini F., Santus P., Barlassina R., Airoldi A., Guida G., Eleonora N., Aruanno A., Rizzi A., Caruso C., Colantuono S., Senna G., Caminati M., Arcolaci A., Vianello A., Bianchi F.C., Marchi M.R., Centanni S., Luraschi S., Ruggeri S., Rinaldo R., Parazzini E., Calabrese C., Flora M., Cosmi L., Di Pietro L., Maggi E., Pini L., Macchia L., Di Bona D., Richeldi L., Condoluci C., Fuso L., Bonini M., Farsi A., Carli G., Montuschi P., Santini G., Conte M.E., Turchet E., Barbetta C., Mazza F., D'Alo S., Pucci S., Caiaffa M.F., Minenna E., D'Elia L., Pasculli C., Viviano V., Tarsia P., Rolo J., Di Proietto M., Lo Cicero S., Bagnasco, D, Paggiaro, P, Latorre, M, Folli, C, Testino, E, Bassi, A, Milanese, M, Heffler, E, Manfredi, A, Riccio, A, De Ferrari, L, Blasi, F, Frank Canevari, R, Canonica, G, Passalacqua, G, Guarnieri, G, Patella, V, Foschino Barbaro, M, Carpagnano, G, del Colle, A, Scioscia, G, Gerolamo, P, Puggioni, F, Racca, F, Favero, E, Iannacone, S, Savi, E, Montagni, M, Camiciottoli, G, Allegrini, C, Lombardi, C, Spadaro, G, Detoraki, C, Menzella, F, Galeone, C, Ruggiero, P, Yacoub, R, Verrillo, M, Rolla, G, and Lo Cicero, S

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, Severe asthma, Immunology, Nice, Disease, Settore MED/10 - Malattie Dell'Apparato Respiratorio, Article, Pulmonary function testing, Internal medicine, Biological treatment, Classification, Definition, medicine, Immunology and Allergy, Respiratory function, computer.programming_language, Biological therapies, business.industry, Settore MED/09 - MEDICINA INTERNA, RC581-607, Severe asthma, Classification, Definition, Biological treatment, Biological treatment, Classification, Definition, Severe asthma, Immunologic diseases. Allergy, business, computer
Abstract

Introduction There is, so far, no universal definition of severe asthma. This definition usually relies on: number of exacerbations, inhaled therapy, need for oral corticosteroids, and respiratory function. The use of such parameters varies in the different definitions used. Thus, according to the parameters chosen, each patient may result in having severe asthma or not. The aim of this study was to evaluate how the choice of a specific definition of severe asthma can change the allocation of patients. Methods Data collected from the Severe Asthma Network Italy (SANI) registry were analyzed. All the patients included were then reclassified according to the definitions of U-BIOPRED, NICE, WHO, ATS/ERS, GINA, ENFUMOSA, and TENOR. Results 540 patients, were extracted from the SANI database. We observed that 462 (86%) met the ATS/ERS criteria as well as the GINA criteria, 259 (48%) the U-Biopred, 222 (41%) the NICE, 125 (23%) the WHO, 313 (58%) the Enfumosa, and 251 (46%) the TENOR criteria. The mean eosinophil value were similar in the ATS/ERS, U-Biopred, and Enfumosa (528, 532 and 516 cells/mcl), higher in WHO and Tenor (567 and 570 cells/mcl) and much higher in the NICE classification (624 cells/mcl). Lung function tests resulted similarly in all groups, with WHO (67%) and ATS/ERS-GINA (73%), respectively, showing the lower and upper mean FEV1 values. Conclusions The present observations clearly evidence the heterogeneity in the distribution of patients when different definitions of severe asthma are used. However, the recent definition of severe asthma, provided by the GINA document, is similar to that indicated in 2014 by ATS/ERS, allowing mirror reclassification of the patients examined. This lack of homogeneity could complicate the access to biological therapies. The definition provided by the GINA document, which reflects what suggested by ATS/ERS, could partially overcome the problem.

Published
2021

29. Economic impact of mepolizumab in uncontrolled severe eosinophilic asthma, in real life

Author

Diego Bagnasco, Massimiliano Povero, Lorenzo Pradelli, Luisa Brussino, Giovanni Rolla, Marco Caminati, Francesco Menzella, Enrico Heffler, Giorgio Walter Canonica, Pierluigi Paggiaro, Gianenrico Senna, Manlio Milanese, Carlo Lombardi, Caterina Bucca, Andrea Manfredi, Rikki Frank Canevari, Giovanni Passalacqua, Gabriella Guarnieri, Vincenzo Patella, Foschino Barbaro Maria Pia, Elisiana Carpagnano, Anna del Colle, Giulia Scioscia, Pelaia Gerolamo, Manuela Latorre, Francesca Puggioni, Francesca Racca, Elisabetta Favero, Sandra Iannacone, Eleonora Savi, Marcello Montagni, Gianna Camiciottoli, Chiara Allegrini, Giuseppe Spadaro, Caterina Detoraki, Carla Galeone, Patrizia Ruggiero, Monna Rita Yacoub, Alvise Berti, Gisella Colombo, Nicola Scichilone, Carmen Durante, Maria Teresa Costantino, Chiara Roncallo, Mariachiara Braschi, Francesco Blasi, Alice D'Adda, Erminia Ridolo, Massimo Triggiani, Roberta Parente, D'Amato Maria, Maria Vittoria Verrillo, Zappa Maria Cristina, Marianna Lilli, Nunzio Crimi, Marco Bonavia, Angelo Guido Corsico, Amelia Grosso, Stefano Del Giacco, Margherita Deidda, Luisa Ricciardi, Stefania Isola, Francesca Cicero, Giuliana Amato, Federica Vita, Antonio Spanevello, Patrizia Pignatti, Francesca Cherubino, Dina Visca, Eleonora Aletti, Fabio Luigi Massimo Ricciardolo, Vitina Maria Anna Carriero, Francesca Bertolini, Pierachille Santus, Roberta Barlassina, Andrea Airoldi, Giuseppe Guida, Nucera Eleonora, Arianna Aruanno, Angela Rizzi, Cristiano Caruso, Stefania Colantuono, Alessandra Arcolaci, Andrea Vianello, Fulvia Chieco Bianchi, Maria Rita Marchi, Stefano Centanni, Simone Luraschi, Silvia Ruggeri, Rocco Rinaldo, Elena Parazzini, Cecilia Calabrese, Martina Flora, Lorenzo Cosmi, Linda Di Pietro, Enrico Maggi, Laura Pini, Luigi Macchia, Danilo Di Bona, Luca Richeldi, Carola Condoluci, Leonello Fuso, Matteo Bonini, Alessandro Farsi, Giulia Carli, Paolo Montuschi, Giuseppe Santini, Maria Elisabetta Conte, Elisa Turchet, Carlo Barbetta, Francesco Mazza, Simona D'Alo, Stefano Pucci, Maria Filomena Caiaffa, Elena Minenna, Luciana D'Elia, Carlo Pasculli, Vittorio Viviano, Paolo Tarsia, Joyce Rolo, Mariacarmela Di Proietto, Salvatore Lo Cicero, Bagnasco, D., Povero, M., Pradelli, L., Brussino, L., Rolla, G., Caminati, M., Menzella, F., Heffler, E., Canonica, G. W., Paggiaro, P., Senna, G., Milanese, M., Lombardi, C., Bucca, C., Manfredi, A., Canevari, R. F., Passalacqua, G., Guarnieri, G., Patella, V., Maria Pia, F. B., Carpagnano, E., Colle, A. D., Scioscia, G., Gerolamo, P., Latorre, M., Puggioni, F., Racca, F., Favero, E., Iannacone, S., Savi, E., Montagni, M., Camiciottoli, G., Allegrini, C., Spadaro, G., Detoraki, C., Galeone, C., Ruggiero, P., Yacoub, M. R., Berti, A., Colombo, G., Scichilone, N., Durante, C., Costantino, M. T., Roncallo, C., Braschi, M., Blasi, F., D'Adda, A., Ridolo, E., Triggiani, M., Parente, R., Maria, D. A., Verrillo, M. V., Cristina, Z. M., Lilli, M., Crimi, N., Bonavia, M., Corsico, A. G., Grosso, A., Del Giacco, S., Deidda, M., Ricciardi, L., Isola, S., Cicero, F., Amato, G., Vita, F., Spanevello, A., Pignatti, P., Cherubino, F., Visca, D., Aletti, E., Massimo Ricciardolo, F. L., Anna Carriero, V. M., Bertolini, F., Santus, P., Barlassina, R., Airoldi, A., Guida, G., Eleonora, N., Aruanno, A., Rizzi, A., Caruso, C., Colantuono, S., Arcolaci, A., Vianello, A., Bianchi, F. C., Marchi, M. R., Centanni, S., Luraschi, S., Ruggeri, S., Rinaldo, R., Parazzini, E., Calabrese, C., Flora, M., Cosmi, L., Di Pietro, L., Maggi, E., Pini, L., Macchia, L., Di Bona, D., Richeldi, L., Condoluci, C., Fuso, L., Bonini, M., Farsi, A., Carli, G., Montuschi, P., Santini, G., Conte, M. E., Turchet, E., Barbetta, C., Mazza, F., D'Alo, S., Pucci, S., Caiaffa, M. F., Minenna, E., D'Elia, L., Pasculli, C., Viviano, V., Tarsia, P., Rolo, J., Di Proietto, M., Lo Cicero, S., Bagnasco, Diego, Povero, Massimiliano, Pradelli, Lorenzo, Brussino, Luisa, Rolla, Giovanni, Caminati, Marco, Menzella, Francesco, Heffler, Enrico, Canonica, Giorgio Walter, Paggiaro, Pierluigi, Senna, Gianenrico, Milanese, Manlio, Lombardi, Carlo, Bucca, Caterina, Manfredi, Andrea, Canevari, Rikki Frank, Passalacqua, Giovanni, Guarnieri, Gabriella, Patella, Vincenzo, Foschino Barbaro, Maria Pia, Carpagnano, Elisiana, D' Amato, Maria, Verrillo, Mariavittoria, Zappa, Maria Cristina, Lo Cicero, Salvatore, Di Proietto, Maria Carmela, Walter Canonica, Giorgio, Frank Canevari, Rikki, Spadaro, Giuseppe, Bagnasco D., Povero M., Pradelli L., Brussino L., Rolla G., Caminati M., Menzella F., Heffler E., Canonica G.W., Paggiaro P., Senna G., Milanese M., Lombardi C., Bucca C., Manfredi A., Canevari R.F., Passalacqua G., Guarnieri G., Patella V., Maria Pia F.B., Carpagnano E., Colle A.D., Scioscia G., Gerolamo P., Latorre M., Puggioni F., Racca F., Favero E., Iannacone S., Savi E., Montagni M., Camiciottoli G., Allegrini C., Spadaro G., Detoraki C., Galeone C., Ruggiero P., Yacoub M.R., Berti A., Colombo G., Scichilone N., Durante C., Costantino M.T., Roncallo C., Braschi M., Blasi F., D'Adda A., Ridolo E., Triggiani M., Parente R., Maria D.A., Verrillo M.V., Cristina Z.M., Lilli M., Crimi N., Bonavia M., Corsico A.G., Grosso A., Del Giacco S., Deidda M., Ricciardi L., Isola S., Cicero F., Amato G., Vita F., Spanevello A., Pignatti P., Cherubino F., Visca D., Aletti E., Massimo Ricciardolo F.L., Anna Carriero V.M., Bertolini F., Santus P., Barlassina R., Airoldi A., Guida G., Eleonora N., Aruanno A., Rizzi A., Caruso C., Colantuono S., Arcolaci A., Vianello A., Bianchi F.C., Marchi M.R., Centanni S., Luraschi S., Ruggeri S., Rinaldo R., Parazzini E., Calabrese C., Flora M., Cosmi L., Di Pietro L., Maggi E., Pini L., Macchia L., Di Bona D., Richeldi L., Condoluci C., Fuso L., Bonini M., Farsi A., Carli G., Montuschi P., Santini G., Conte M.E., Turchet E., Barbetta C., Mazza F., D'Alo S., Pucci S., Caiaffa M.F., Minenna E., D'Elia L., Pasculli C., Viviano V., Tarsia P., Rolo J., Di Proietto M., and Lo Cicero S.

Subjects
OR, Odds Ratio, Pediatrics, Severe asthma, Exacerbation, Anti IL-5, Comorbidities, Mepolizumab, OCS, Pharmacoeconomics, gastroesophageal reflux disease, Settore MED/10 - MALATTIE DELL'APPARATO RESPIRATORIO, ICS, inhaled corticosteroid, Rate ratio, OCS, Oral Corticosteroids, law.invention, LAMA, long acting muscarinic antagonist, 0302 clinical medicine, Randomized controlled trial, fractional nitric oxide, Interquartile range, law, long acting beta 2 agonist, Odds Ratio, Immunology and Allergy, RR, Rate Ratio, 030223 otorhinolaryngology, Pharmacoeconomic, LOS, Length of stay, LOS, IQR, LAMA, MEP, Mepolizumab, OR, CI, SD, Standard Deviation, MEP, ACT, Asthma Control Test, Comorbiditie, CI, Confidence Intervals, medicine.drug, lcsh:Immunologic diseases. Allergy, Pulmonary and Respiratory Medicine, medicine.medical_specialty, interquartile range, long acting muscarinic antagonist, Immunology, LABA, LABA, long acting beta 2 agonist, Comorbidities, Mepolizumab, OCS, Pharmacoeconomics, Severe asthma, Anti IL-5, RR, Article, Rate Ratio, chronic obstructive pulmonary disease, 03 medical and health sciences, OCS, Oral Corticosteroid, Asthma Control Test, Confidence Intervals, FeNO, fractional nitric oxide, RCTs, Randomized Controlled Trial, medicine, COPD, GERD, gastroesophageal reflux disease, FeNO, IQR, interquartile range, SD, Asthma, RCTs, Oral Corticosteroids, business.industry, GERD, medicine.disease, ICS, inhaled corticosteroids, ACT, Comorbidity, Randomized Controlled Trials, CI, Confidence Interval, RCTs, Randomized Controlled Trials, COPD, chronic obstructive pulmonary disease, 030228 respiratory system, ICS, Standard Deviation, Length of stay, inhaled corticosteroids, lcsh:RC581-607, business
Abstract

Background and aims Severe asthma is burdened by frequent exacerbations and use of oral corticosteroids (OCS) which worsen patients’ health and increase healthcare spending. Aim of this study was to assess the clinical and economic effect of adding mepolizumab (MEP) for the treatment of these patients. Methods Patients >18 years old, referred to 8 asthma clinics, starting MEP between May 2017 and December 2018, were enrolled and followed-up for 12 months. Information in the 12 months before mepolizumab were collected retrospectively. The evaluation parameters included: OCS use, number of exacerbations/hospitalizations, concomitant therapies, comorbidity, and annual number of working days lost due to the disease. The primary objective was to compare the annual total cost per patient pre- and post-MEP. Secondary outcomes included rates of exacerbations and number of OCS-dependent patients. Results 106 patients were enrolled in the study: 46 male, median age 58 years. Mean annual cost pre- and post-MEP (cost of biologic excluded) was €3996 and €1,527, respectively. Total savings due to MEP resulted in €2469 (95%CI 1945–2993), 62% due to exacerbations reduction and 33% due to productivity increase. Such savings could fund about 22% of the total cost of MEP for one year. The introduction of MEP induced a clinical benefit by reducing both OCS-dependent patients (OR = 0.12, 95%CI 0.06–0.23) and exacerbation rate (RR = 0.19, 95%CI 0.15–0.24). Conclusions Patients with severe eosinophilic asthma experienced a clinical benefit in asthma control adding MEP to standard therapy. Biologic therapy can be, partially, funded by the savings produced by patients’ improvement.

Published
2021

30. Allergy and dimethyl fumarate treatment in a patient with multiple sclerosis

Author

Massimo Filippi, Stefano Gelibter, Mona-Rita Yacoub, Lorenzo Dagna, Mario Orrico, Lucia Moiola, Gelibter, S., Orrico, M., Moiola, L., Dagna, L., Filippi, M., and Yacoub, M. R.

Subjects
medicine.medical_specialty, Allergy, Multiple Sclerosis, Urticaria, Side effect, Dimethyl Fumarate, Dimethyl fumarate, Sensitization, Multiple sclerosis, chemistry.chemical_compound, Multiple Sclerosis, Relapsing-Remitting, medicine, Hypersensitivity, Humans, business.industry, medicine.disease, Dermatology, medicine.anatomical_structure, Neurology, chemistry, Neurology (clinical), business, Immunosuppressive Agents
Published
2020

31. Chronic rhinosinusitis with nasal polyps impact in severe asthma patients: Evidences from the Severe Asthma Network Italy (SANI) registry

Author

Canonica, Gw, Blasi, F., Paggiaro, PL. Senna G. E., Passalacqua, G., Spanevello, A., Aliberti, S., Bagnasco, D., Bonavia, M. Bonini M., Bucca, C., Brussino, L., Caiaffa, M. F., Calabrese, C., Camiciottoli, G., Caminati, M., Carpagnano, G. E., Caruso, C., Centanni, S., Conte, M. E., Corsico, A. G., Cosmi, L., Costantino, M. T., Crimi, N., D’Alo, S., D’Amato, M., Del Giacco, S., Farsi, A., Favero, E., Foschino Barbaro, M. P., Guarnieri, G., Guida, G., Latorre, M., Lo Cicero, S., Lombardi, C., Macchia, L., Mazza, F., Menzella, F., Milanese, M., Montagn, i. M., Montuschi, P., Nucera, E., Parente, R., Patella, V., Pelaia, G., Pini, L., Puggioni, F., Ricciardi, L., Ricciardolo, F. L. M., Richeldi, L., Ridolo, E., Rolla, G., Santus, P., Scichilone, N., Spadaro, G., Yacoub, Mr., Vianello, A., Viviano, V., Zappa, M. C., Heffler, E., Canonica, G. W., Malvezzi, L., Blasi, F., Paggiaro, P., Mantero, M., Senna, G., Heffler, E., Bonavia, M., Caiaffa, P., Calabrese, C., Camiciottoli, G., Caruso, C., Centanni, S., Conte, M. E., Corsico, A. G., Cosmi, L., Costantino, M. T., Crimi, N., D'Alo, S., D'Amato, M., Del Giacco, S., Favero, E., Farsi, A., Foschino, B. P. M., Guarnieri, G., Latorre, M., Lombardi, C., Macchia, L., Menzella, F., Milanese, M., Montuschi, P., Nucera, E., Parente, R., Passalacqua, G., Patella, V., Pelaia, G., Pini, L., Ricciardolo, F. L. M., Ricciardi, L., Richeldi, L., Ridolo, E., Rolla, G., Santus, P., Scichilone, N., Solidoro, P., Spadaro, G., Spanevello, A., Vianello, A., Yacoub, M. R., Zappa, M. C., Canonica G.W., Malvezzi L., Blasi F., Paggiaro P., Mantero M., Senna G., Heffler E., Bonavia M., Caiaffa P., Calabrese C., Camiciottoli G., Caruso C., Centanni S., Conte M.E., Corsico A.G., Cosmi L., Costantino M.T., Crimi N., D'Alo S., D'Amato M., Del Giacco S., Favero E., Farsi A., Foschino B.P.M., Guarnieri G., Guida G., Latorre M., Lombardi C., Macchia L., Menzella F., Milanese M., Montuschi P., Nucera E., Parente R., Passalacqua G., Patella V., Pelaia G., Pini L., Ricciardolo F.L.M., Ricciardi L., Richeldi L., Ridolo E., Rolla G., Santus P., Scichilone N., Solidoro P., Spadaro G., Spanevello A., Vianello A., Yacoub M.R., and Zappa M.C.

Subjects
Pulmonary and Respiratory Medicine, Adult, Male, medicine.medical_specialty, Severe asthma, Databases, Factual, Administration, Oral, Comorbidity, Settore MED/10 - Malattie Dell'Apparato Respiratorio, Nitric Oxide, Severity of Illness Index, Comorbidities, Oral corticosteroid, Adrenal Cortex Hormones, Internal medicine, Severity of illness, Oral corticosteroids, medicine, Prevalence, Nasal polyps, Humans, Registries, Sinusitis, Asthma, Aged, Rhinitis, Internet, Bronchiectasis, business.industry, Nasal polyp, Settore MED/09 - MEDICINA INTERNA, Atopic dermatitis, Middle Aged, medicine.disease, Comorbidities, Nasal polyps, Oral corticosteroids, Severe asthma, Italy, Concomitant, Chronic Disease, Disease Progression, Female, Comorbiditie, business
Abstract

Background The clinical and laboratory features of patients enrolled in the Severe Asthma Network in Italy (SANI) registry, a web-based observatory collecting demographic, clinical, functional and inflammatory data of patients with severe asthma were evaluated, with a special emphasis to chronic rhinosinusitis with nasal polyposis (CRSwNP). Methods For each eligible patients the following information has been collected: demographic data, clinical features, asthma control in the previous month according to the GINA (Global INitiative for Asthma) Guidelines and standardized questionnaires, concomitant regular and on demand treatments and inflammatory markers. Results 695 patients with severe asthma enrolled in 66 SANI centers were analyzed. The prevalence of chronic rhinosinusitis with nasal polyposis was 40.6%. Atopic dermatitis and bronchiectasis was significantly more frequent in patients with CRSwNP than in subjects without nasal polyposis; similarly, FeNO values are significantly higher in subject with CRSwNP than in patients without nasal polyposis. Finally, patients with CRSwNP had a significantly higher number of asthma exacerbations per year, more days on oral corticosteroids and were more likely to be OCS long term users. Conclusion OCS sparing is needed in patients with severe asthma, mainly in subjects with CRSwNP, adopting adequate strategies such as a better adherence to the treatment with inhaled therapy according to the GINA recommendations, the use of biologic agents and a multidisciplinary approach of the patient.

Published
2020

33. Impact of asthma on severe food-induced allergic reactions: a systematic review and meta-analysis.

Author

Cilona MB, Ramirez GA, Asperti C, Ferlito A, Benanti G, Nannipieri S, Abdul Hadi RM, Capellini C, Dagna L, Cottini M, and Yacoub MR

Abstract

Summary: Background. Food allergy can range from mild to severe, life-threatening reactions with various symptoms and organ involvement. The impact of asthma on severe food-induced allergic reactions is not completely understood. In the hypothesis that asthma increases the risk of severe food-induced allergic reactions, the aim of this study is to compare the incidence of severe food-induced allergic reactions in patients with history of asthma compared with patients without history of asthma. Methods. We performed a systematic research on electronic databases, including PubMed, Scopus, and Web of Science. Observational studies, studies reporting medical characteristics of patients diagnosed with food allergy, and studies reporting medical history of patients with allergic reactions were included. The primary outcome was the incidence of severe food-induced allergic reactions in patients with history of asthma compared with patients without history of asthma. The protocol of this review was registered in PROSPERO (CRD42023448293). Results. Eight studies with a total of 90,367 patients met the inclusion criteria and were included, with a total population of 28,166 of patients with food allergy. The incidence of severe food-induced allergic reactions in patients with history of asthma compared with patients without history of asthma was increased (OR = 1.28; 95% CI 1.03-1.59; p = 0.03; I2 = 59%). Conclusions. Individuals with both food allergy and asthma are at high risk of severe, potentially fatal allergic reactions. Healthcare professionals should prioritize prevention and management strategies for these subjects.

Published
2024
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34. The role of skin tests with polyethylene glycol and polysorbate 80 in the vaccination campaign for COVID-19: results from an Italian multicenter survey.

Author

Montera MC, Giordano A, Asperti C, Aruanno A, Barzaghi CE, Bignardi D, Borrelli P, Bommarito L, Busa M, Calafiore P, Carusi V, Cinquini M, Cortellini G, Cocchi R, D'Auria F, De Caro F, Demonte A, Di Leo E, Di Lizia M, Di Rienzo A, Fumagalli F, Kihlgren P, Lodi Rizzini F, Macchia D, Manzotti G, Marra AM, Mileto P, Mietta S, Montagni M, Nettis E, Nucera E, Peveri S, Pivetta D, Pirisi M, Ramirez GA, Rivolta F, Rizzi A, Savoia A, Pedicini A, Scarpa A, Zambito M, Zisa G, and Yacoub MR

Subjects
Humans, Polysorbates adverse effects, Polyethylene Glycols adverse effects, COVID-19 Vaccines adverse effects, Excipients adverse effects, Retrospective Studies, Immunization Programs, Skin Tests, Italy epidemiology, COVID-19 epidemiology, COVID-19 prevention & control, Anaphylaxis diagnosis, Anaphylaxis epidemiology, Hypersensitivity, Immediate
Abstract

Summary: Background. International guidelines suggested skin tests with Polyethylene-glycol (PEG) and polysorbate 80 (PS-80), to investigate a possible hypersensitivity to these excipients either to identify subjects at risk of developing allergic reactions to Covid-19 vaccines, or in patients with suspected IgE mediated hypersensitivity reactions (HR) to the Covid-19 vaccine. The main purpose of this study was to investigate the prevalence of PEG and PS sensitization in patients with a clinical history of HR to drugs containing PEG/PS and in patients with a suspected Covid-19 vaccine immediate HR. Methods. This was a multicenter retrospective study conducted by allergists belonging to 20 Italian medical centers. Skin testing was performed in 531 patients with either a clinical history of suspected hypersensitivity reaction (HR) to drugs containing PEG and/or PS-80 (group 1:362 patient) or a suspected HR to Covid-19 vaccines (group 2: 169 patient), as suggested by the AAIITO/SIAAIC guidelines for the "management of patients at risk of allergic reactions to Covid-19 vaccines" [1]. Results. 10/362 (0.02%) had positive skin test to one or both excipients in group 1, 12/169 (7.1%) in group 2 (p less than 0.01). In group 2 HRs to Covid-19 vaccines were immediate in 10/12 of cases and anaphylaxis occurred in 4/12 of patients. Conclusions. The positivity of skin test with PEG and or PS before vaccination is extremely rare and mostly replaceable by an accurate clinical history. Sensitization to PEG and PS has to be investigated in patients with a previous immediate HR to a Covid-19 vaccine, in particular in patients with anaphylaxis.

Published
2024
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35. Hypersensitivity reactions to iodinate contrast media in Italy: a retrospective study. Characteristics of patients and risk factors.

Author

Voltolini S, Cofini V, Murzilli F, Bignardi D, Borro M, Calamari M, Caruso C, Cittadini G, Contatore M, Cortellini G, Desideri G, Di Paolo C, Lippolis D, Lobene M, Manzotti G, Meucci E, Necozione S, Ramirez GA, Rollandi GA, Yacoub MR, and Bilò MB

Subjects
Female, Humans, Male, Middle Aged, Retrospective Studies, Risk Factors, Skin Tests, Contrast Media adverse effects, Drug Hypersensitivity diagnosis, Drug Hypersensitivity epidemiology, Drug Hypersensitivity etiology
Abstract

Summary: Objective. The purpose of the study was to describe the characteristics of patients experiencing hypersensitivity reactions (HRs) to iodinated contrast media (ICM) in a large Italian population and to investigate potential risks factors in order to obtain a risk stratification, helpful in the management of these patients. Methods. Data of 407 patients investigated in 9 Italian Allergy Centers for suspected HRs to ICM were analyzed and compared with a control group of 152 subjects that tolerated one or more ICM-enhanced examinations. The univariate and multivariate logistic regression model was used to evaluate associated factors. Results. The mean age of reactive patients was 61 years and 60% were female; 67% of patients reported immediate reactions and 35% experienced the reaction, more frequently with immediate onset, at the first examination in life. Iomeprol, iopromide and iodixanol were the most frequent culprit agents and 20% of patients showed a positive skin test result. Previous adverse reactions to ICM were reported by 15.6% of patients, whereas 35% of subjects experienced the reaction, more frequently immediate, after the first ICM-enhanced examination in their life. The multivariate analysis showed that male gender and age > 65 were associated with ICM reactions as protective factors [OR adja = 0.51; 95% CI: 0.33-0.77 and OR adja = 0.60; 95% CI: 0.39-0.92 respectively]. Cardio-vascular disease [OR adja = 2.06; 95% CI: 1.22-3.50)], respiratory allergy [OR adja = 2.30; 95% CI: 1.09-4.83)] and adverse drug reactions [OR adja = 1.99; 95% CI: 1.05-3.77)] were identified as risk factors for ICM reactions. Food allergy was not significantly associated with reactions [OR adja = 1.51; 5% CI: 0.41-5.56]. Conclusions. This is the largest study on Italian patients experiencing hypersensitivity reactions to ICM. Most results are in line with other studies, showing some association with factors that could influence the incidence of hypersensitivity reactions but not allowing an easy risk stratification.

Published
2022
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36. Histamine release positive test associates with disease remission in chronic spontaneous urticaria: a proof-of-concept study.

Author

Berti A, Yacoub MR, Stahl Skov P, Falkencrone S, Casati L, Burastero S, Sabbadini MG, and Colombo G

Subjects
Adolescent, Adult, Aged, Chronic Disease, Female, Humans, Male, Mast Cells immunology, Mast Cells metabolism, Middle Aged, Phenotype, Predictive Value of Tests, Proof of Concept Study, Prospective Studies, Quality of Life, Remission Induction, Severity of Illness Index, Surveys and Questionnaires, Time Factors, Treatment Outcome, Urticaria immunology, Urticaria metabolism, Young Adult, Histamine Antagonists therapeutic use, Histamine Release drug effects, Immunologic Tests, Mast Cells drug effects, Urticaria diagnosis, Urticaria drug therapy
Abstract

Summary: Background. Histamine release (HR) test has previously been shown to predict the presence of endogenous histamine-releasing factors in chronic spontaneous urticaria (CSU). Objectives and methods. Twenty CSU patients unresponsive to antihistamine treatment were enrolled in order to evaluate the correlations between HR test results and demographic features, quality of life, disease activity, clinical course, and autologous serum and plasma skin tests (ASST and APST). Results. All patients with positive HR test (9/9, 100%) had a more severe disease activity at onset (urticaria activity score, UAS > 2) when compared to negative HR test patients (5/11; p = 0.04). Quality of life questionnaire's results were not substantially different between HR positive and negative subgroups at baseline (p > 0.05), and results of HR test and ASST/APST did not co-segregate (p > 0.05). After 12 months, patients with a positive HR test had a significant reduction of disease activity (p = 0.003) whereas patients with a negative HR test did not (p > 0.05), leading to disease remission and antihistamine treatment withdrawal in 67% (6/9) of positive HR test patients versus 18% (2/11) of negative HR test patients (p = 0.027). Conclusions. Positive HR test may predict spontaneous CSU remission at 12 months.

Published
2017
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37. Proposal of a skin tests based approach for the prevention of recurrent hypersensitivity reactions to iodinated contrast media.

Author

Della-Torre E, Berti A, Yacoub MR, Guglielmi B, Tombetti E, Sabbadini MG, Voltolini S, and Colombo G

Subjects
Adult, Aged, Algorithms, Critical Pathways, Drug Hypersensitivity diagnosis, Drug Hypersensitivity etiology, Female, Humans, Intradermal Tests, Male, Middle Aged, Predictive Value of Tests, Recurrence, Reproducibility of Results, Risk Factors, Young Adult, Contrast Media adverse effects, Drug Hypersensitivity prevention & control, Iodine Compounds adverse effects, Skin Tests
Abstract

The purpose of the present work is to evaluate the efficacy of an approach that combines clinical history, skin tests results, and premedication, in preventing recurrent hypersensitivity reactions to iodinated contrast media (ICM). Skin Prick tests, Intradermal tests, and Patch tests were performed in 36 patients with a previous reaction to ICM. All patients underwent a second contrast enhanced radiological procedure with an alternative ICM selected on the basis of the proposed approach. After alternative ICM re-injection, only one patient presented a mild NIR. The proposed algorithm, validated in clinical settings where repeated radiological exams are needed, offers a safe and practical approach for protecting patients from recurrent hypersensitivity reactions to ICM.

Published
2015

38. Omega-5 gliadin anaphylaxis: an integrated diagnostic approach.

Author

Yacoub MR, Savi E, Burastero SE, Dal Farra S, Mason C, Pecora S, and Colombo G

Subjects
Antigens, Plant, Humans, Immunoglobulin E blood, Male, Middle Aged, Allergens immunology, Anaphylaxis diagnosis, Gliadin immunology
Abstract

We report the case of a 62-year old man who presented a wheat-dependent, exercise-induced anaphylaxis (WDEIA). The case illustrates the usefulness of skin prick test not only with wheat extract, but also with native gliadin extract. Moreover we confirm the value of recombinant IgE dosage with rTri a 19 omega-5 gliadin in the diagnostic pathway of this condition.

Published
2011

39. Multiple drug hypersensivity: insight into the underlying mechanism and correlation with autoimmune diseases.

Author

Colombo G, Yacoub MR, Burastero SE, Garattini E, Girlanda S, Saporiti N, Salvo F, and Sabbadini MG

Subjects
Adolescent, Adult, Aged, Aged, 80 and over, Anti-Bacterial Agents adverse effects, Anti-Bacterial Agents immunology, Anti-Inflammatory Agents, Non-Steroidal adverse effects, Anti-Inflammatory Agents, Non-Steroidal immunology, Autoantibodies immunology, Autoimmune Diseases epidemiology, Autoimmune Diseases immunology, Chronic Disease epidemiology, Drug Hypersensitivity epidemiology, Drug Hypersensitivity immunology, Female, Hashimoto Disease complications, Hashimoto Disease epidemiology, Humans, Italy, Male, Middle Aged, Receptors, IgE immunology, Serum immunology, Skin Tests, Urticaria complications, Urticaria epidemiology, Young Adult, Autoimmune Diseases complications, Drug Hypersensitivity complications, Drug Hypersensitivity etiology
Abstract

Background: Subjects with drug hypersensitivity are sometimes simultaneously reactive to several drugs. This nosological entity is defined as multiple drug hypersensivity (MDH). Urticaria and angioedema are the commonest clinical manifestations of hypersensitivity drug reactions (HDR). These clinical signs are also pathognomonic of chronic idiopathic urticaria (CIU), whose pathogenetic mechanisms are still largely unknown. The diagnostic algorithm of CIU includes autologous serum skin test (ASST) and autologous plasma skin test (APST), which demonstrated a high positive and negative predictive value, in multiple nonsteroidal anti-inflammatory drugs (NSAIDs) intolerance., Objective: to explore the underlying mechanism of MDH and to assess the correlation between such tests and autoimmune diseases (AD)., Methods: Twenty eight subjects with MDH referred to our Allergy/Immunology Unit were enrolled from May 2006 to May 2007. Eight healthy subjects served as controls. In addition to common diagnostic tools used in the diagnostic algorithm of MDH, enrolled subjects also underwent ASST and APST., Results: Patients were predominantly female (23 female vs. 5 male; mean age 52.2 years). In 61% of cases MDH was associated with either CIU or AD. NSAIDs and antibiotics were the major causes of HIDR, both implied in 54% of subjects. The proportions of MDH-subjects with positive ASST and APST were 46.4% and 28.6%, respectively. All patients with MDH+AD+CIU (4/4) presented apositive ASST., Conclusions: In patients with MDH, ASST proved to be frequently positive, as previously described for multiple NSAIDs intolerance. In ASST-positive subjects, the activity of several drugs appears to add up FceRI-specific autoantibodies in the induction of the release of allergic mediators.

Published
2009

40. Effectiveness of omalizumab in a patient with severe asthma and atopic dermatitis.

Author

Incorvaia C, Pravettoni C, Mauro M, Yacoub MR, Tarantini F, and Riario-Sforza GG

Subjects
Adult, Antibodies, Anti-Idiotypic, Antibodies, Monoclonal, Humanized, Asthma complications, Dermatitis, Atopic complications, Female, Humans, Omalizumab, Treatment Outcome, Anti-Allergic Agents therapeutic use, Antibodies, Monoclonal therapeutic use, Asthma drug therapy, Dermatitis, Atopic drug therapy
Abstract

The anti-IgE antibody omalizumab is currently indicated in severe asthma not controlled by standard drug therapy. Recently, new indications for omalizumab were suggested, which include atopic dermatitis (AD), a skin disorder characterized by elevated levels of IgE. We report the case of a 39-year old woman with severe asthma and severe AD, both resistant to conventional drug treatment. The patient had a IgE level of 1304 kU/L, which exceeded the recommended maximum level for treating asthma with omalizumab (stated in 700 Ku/L) but was far lower than previously reported in cases of AD treated with anti-IgE. The treatment consisted of a dose of omalizumab 375 mg every two weeks, and induced a rapid improvement of asthma, with no need of other drugs after three months, along with a progressive decline of severity of AD, which after five months was completely cured. These findings suggest the usefulness of omalizumab in patients with concomitant severe asthma and AD, also considering the pharmaco-economic balance obtained by withdrawing the multiple drugs used to treat both diseases.

Published
2008
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41. World Trade Center disaster: short- and medium-term health outcome.

Author

Moscato G and Yacoub MR

Subjects
Humans, Respiratory Tract Diseases etiology, September 11 Terrorist Attacks
Abstract

Several studies related to September 11 World Trade Center (WTC) terrorist attack have been conducted in order to monitor physical and mental health in the population at risk in the short and medium-term. In this paper the main health consequences in the exposed subjects 6 years after the disaster, including ocular, gastrointestinal, respiratory and psychological effects are described and discussed.

Published
2007
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