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Plaza V, Trigueros JA, Carretero JA, Ojanguren Arranz I, Vega Chicote JM, Almonacid Sánchez C, Bartra Tomás J, Cisneros Serrano C, Domínguez Juncal L, Domínguez-Ortega J, Figueroa Rivero J, Soto Campos JG, Macías Fernández E, Martínez S, Montoro Lacomba J, Quirce S. The use of triple therapy in asthma. The GEMA-FORUM V task force. J Investig Allergol Clin Immunol 2024; 34:0. [PMID: 38334050 DOI: 10.18176/jiaci.0975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024] Open
Affiliation(s)
- V Plaza
- Director del Comité Ejecutivo de la Guía Española para el Manejo del Asma (GEMA). Servei de Pneumologia i Al·lèrgia. Hospital de la Santa Creu i Sant Pau. Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau). Universitat Autònoma de Barcelona.Barcelo
| | - J A Trigueros
- Medicina de Familia. Centro de Salud Buenavista. Toledo, Spain
| | - J A Carretero
- Servicio de Neumología. Hospital Royo Villanova. Zaragoza, Spain
| | - I Ojanguren Arranz
- Servicio de Neumología. Hospital Universitari Vall d´Hebron. Barcelona, Spain
| | - J M Vega Chicote
- UGC de Alergología. Hospital Regional Universitario. Málaga, Spain
| | - C Almonacid Sánchez
- Servicio de Neumología. Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - J Bartra Tomás
- Servicio de Neumología y Alergia. Hospital Clínic de Barcelona. Barcelona, Spain
| | - C Cisneros Serrano
- Servicio de Neumología. Hospital Universitario de La Princesa. Instituto de Investigación La Princesa. Madrid, Spain
| | - L Domínguez Juncal
- Servicio de Neumología. Complejo Hospitalario Universitario A Coruña (CHUAC). A Coruña, Spain
| | - J Domínguez-Ortega
- Servicio de Alergología. Hospital Universitario La Paz. Instituto de Investigación Hospital Universitario La Paz (IdiPAZ) y CIBER de Enfermedades Respiratorias (CIBERES). Madrid, Spain
| | - J Figueroa Rivero
- Sección de Alergología. Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria. Las Palmas, Spain
| | - J G Soto Campos
- UGC de Neumología y Alergia. Hospital Universitario de Jerez. Jerez de la Frontera, Spain
| | - E Macías Fernández
- Servicio de Neumología. Hospital Clínico Universitario de Valladolid. Valladolid, Spain
| | - S Martínez
- Servicio de Neumología. Hospital Comarcal de la Vega Baja. Alicante, Spain
| | - J Montoro Lacomba
- Servicio de Alergología. Hospital Arnau de Vilanova-Liria. Valencia, Spain
| | - S Quirce
- Servicio de Alergología. Hospital Universitario La Paz. Instituto de Investigación Hospital Universitario La Paz (IdiPAZ) y CIBER de Enfermedades Respiratorias (CIBERES). Madrid, Spain
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Casas-Saucedo R, de la Cruz C, Araujo-Sánchez G, Gelis S, Jimenez T, Riggioni S, San Bartolomé C, Pascal M, Bartra Tomás J, Muñoz-Cano R. Risk Factors in Severe Anaphylaxis: Which Matters The Most, Food or Cofactors? J Investig Allergol Clin Immunol 2021; 32:282-290. [PMID: 33944786 DOI: 10.18176/jiaci.0698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND AND OBJECTIVE The prevalence of anaphylactic shock, the most severe manifestation of anaphylaxis, remains unknown. Risk factors and biomarkers have not been fully identified. Objective: To identify risk factors in anaphylactic shock patients. METHODS Using lipid transfer protein (LTP)allergy as a model, the characteristics of patients who developed anaphylaxis and anaphylactic shock were compared. Demographics, pollen sensitization, foods ingested up to 2 hours before the reaction onset, and the presence of a cofactor were recorded. Culprit foods were identified by compatible clinical history and positive allergological work-up (skin prick test and/or sIgE). RESULTS 150 reactions were evaluated, suffered by 55 patients with An (134 reactions) and 12 with AnS (16 reactions). Patients in the anaphylaxis group experienced twice as many reactions (mean [SD] 2.4[2.5] in An vs 1.3[1.5) in AnS, p<0.02). No relationship between any food group and reaction severity was found. The most frequent food involved in both groups of patients was the combination of several plant-derived foods ("plant food mix"), followed by peach and nuts. Indeed, in the "plant food mix" reactions the presence of a cofactor was more often observed than in other food groups. On the other hand, cofactors were not present in peach- and nuts-related reactions. Exercise was the most frequent cofactor in all groups. CONCLUSION In our series, the severity of the reactions was not determined by the kind of food or presence of a cofactor. Anaphylactic shock seems an infrequent presentation that may be related with other individual-related factors that need further evaluation.
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Affiliation(s)
- R Casas-Saucedo
- Allergy Section, Pneumology Department, Hospital Clinic, University of Barcelona, Barcelona, Spain.,IRCE - Institut d´Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,ARADyAL, Carlos III Health Institute
| | - C de la Cruz
- Allergy Section, Pneumology Department, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - G Araujo-Sánchez
- Allergy Section, Pneumology Department, Hospital Clinic, University of Barcelona, Barcelona, Spain.,IRCE - Institut d´Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,ARADyAL, Carlos III Health Institute
| | - S Gelis
- Allergy Section, Pneumology Department, Hospital Clinic, University of Barcelona, Barcelona, Spain.,IRCE - Institut d´Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - T Jimenez
- IRCE - Institut d´Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Allergy Section, Alicante General University Hospital-ISABIAL. Alicante, Spain
| | - S Riggioni
- Allergy Section, Pneumology Department, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - C San Bartolomé
- IRCE - Institut d´Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,ARADyAL, Carlos III Health Institute.,Immunology Department, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - M Pascal
- IRCE - Institut d´Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,ARADyAL, Carlos III Health Institute.,Immunology Department, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - J Bartra Tomás
- Allergy Section, Pneumology Department, Hospital Clinic, University of Barcelona, Barcelona, Spain.,IRCE - Institut d´Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,ARADyAL, Carlos III Health Institute
| | - R Muñoz-Cano
- Allergy Section, Pneumology Department, Hospital Clinic, University of Barcelona, Barcelona, Spain.,IRCE - Institut d´Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,ARADyAL, Carlos III Health Institute
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Giménez Arnau AM, Valero Santiago A, Bartra Tomás J, Jáuregui Presa I, Labrador Horrillo M, Miquel Miquel FJ, Ortiz de Frutos J, Sastre J, Silvestre Salvador JF, Ferrer Puga M. Therapeutic Strategy According to Differences in Response to Omalizumab in Patients With Chronic Spontaneous Urticaria. J Investig Allergol Clin Immunol 2018; 29:338-348. [PMID: 30222111 DOI: 10.18176/jiaci.0323] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Chronic spontaneous urticaria (CSU) is a heterogeneous condition that can severely impact quality of life. Consequently, rapid disease control is essential. First-line treatment of the symptoms of CSU is the licensed dose of second-generation H1 antihistamines. For second-line treatment, this dose may be increased by up to 4 times. In patients who fail to respond to higher doses of H1 antihistamines, omalizumab for up to 24 weeks is recommended to achieve disease control. After this 24-week period, the patient's response to omalizumab should be assessed in order to identify refractory patients. Optimal management of refractory patients has not been established. Therefore, the aim of the present consensus document, which was drafted by allergists and dermatologists with specific expertise in treating urticaria, was to define specific patient profiles based on differences in their response to omalizumab. We also developed a treatment algorithm based on the specific response profile. After a comprehensive literature review, a group meeting was held to discuss issues related to the therapeutic management of patients with CSU that had not been addressed in previous studies. The experts considered both the available evidence and their own clinical experience with omalizumab. We believe that implementation of the proposed algorithm will optimize management of CSU patients who are refractory to antihistamines, reduce disease-related costs, and improve quality of life.
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Affiliation(s)
- A M Giménez Arnau
- Dermatology Department, Hospital del Mar, Institut Mar D´Investigacions Mèdiques, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - A Valero Santiago
- Allergy Unit, Pneumology Department, Hospital Clínic, Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain and RETIC de Asma, Reacciones adversas y Alérgicas (ARADYAL)
| | - J Bartra Tomás
- Allergy Unit, Pneumology Department, Hospital Clínic, Barcelona, Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain and RETIC de Asma, Reacciones adversas y Alérgicas (ARADYAL)
| | - I Jáuregui Presa
- Allergy Department, Hospital Universitario Basurto, Bilbao, Spain
| | - M Labrador Horrillo
- Allergology Department, Hospital Universitari Vall d´Hebron, Barcelona, Spain and RETIC de Asma, Reacciones adversas y Alérgicas (ARADYAL)
| | | | - J Ortiz de Frutos
- Dermatology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - J Sastre
- Allergology Department, Fundación Jiménez Díaz, Madrid, Spain
| | | | - M Ferrer Puga
- Department of Allergy and Immunology, Clínica Universidad de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), RETIC de Asma, Reacciones adversas y Alérgicas (ARADYAL), Pamplona, Spain
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