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Gevaert P, Mullol J, Saenz R, Ko J, Steinke JW, Millette LA, Meltzer EO. Omalizumab improves sinonasal outcomes in patients with chronic rhinosinusitis with nasal polyps regardless of allergic status. Ann Allergy Asthma Immunol 2024; 132:355-362.e1. [PMID: 37951571 DOI: 10.1016/j.anai.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 11/01/2023] [Accepted: 11/03/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Patients with chronic rhinosinusitis with nasal polyps (CRSwNP) often have atopic comorbidities, including elevated IgE levels and comorbid asthma. Omalizumab, an IgE monoclonal antibody, is an effective treatment for CRSwNP, but the impact of allergy or asthma status on response to omalizumab in patients with CRSwNP has not been well studied. OBJECTIVE To evaluate the impact of allergy and asthma status on omalizumab treatment in patients with CRSwNP, this posthoc exploratory analysis assessed sinonasal outcomes from subgroups of patients included in POLYP 1 and POLYP 2 and the open-label extension (OLE) trials. METHODS Patients (N = 249) were grouped by the presence/absence of comorbid allergy (≥ 1 physician-reported allergic rhinitis, allergic sinusitis, food allergy, or atopic dermatitis), presence/absence of comorbid asthma, baseline serum total IgE (≥ 150 or <150 IU/mL), and baseline blood eosinophil levels (>300 or ≤ 300 cells/µL). Sinonasal outcomes were the nasal polyps score, nasal congestion score, and sino-nasal outcome test-22. RESULTS During POLYP 1 and POLYP 2 and the OLE, omalizumab treatment improved the nasal polyps score, nasal congestion score, and sino-nasal outcome test-22 score in patients with/without physician-reported allergic comorbidities, with/without asthma, with higher/lower total IgE levels, and with higher/lower blood eosinophil counts. In the OLE, the pattern of improvement was similar in patients who continued or switched to omalizumab. CONCLUSION In patients with CRSwNP, omalizumab improved sinonasal outcomes independent of allergic status, which suggests that a wide range of patients with different endotypes and phenotypes of CRSwNP may benefit from omalizumab treatment. TRIAL REGISTRATION Clinicaltrials.gov Identifier: NCT03280550, NCT03280537, NCT03478930.
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Affiliation(s)
- Philippe Gevaert
- Upper Airway Research Laboratory, Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium
| | - Joaquim Mullol
- Rhinology Unit and Smell Clinic, ENT Department, Hospital Clinic, The August Pi i Sunyer Biomedical Research Institute, Universitat de Barcelona, Centro de Investigación Biomédica en Red Instituto de Salud, Madrid, Spain
| | | | - Jinnie Ko
- Genentech, Inc., South San Francisco, California
| | | | | | - Eli O Meltzer
- Division of Allergy and Immunology, University of California, San Diego, La Jolla, California
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Meltzer EO, Mullol J, Ko J, Saenz R, Steinke JW, Millette LA, Gevaert P. Omalizumab improves sleep and health status for patients with chronic rhinosinusitis with nasal polyps: An analysis of randomized clinical trials. Int Forum Allergy Rhinol 2024. [PMID: 38197558 DOI: 10.1002/alr.23322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 12/04/2023] [Accepted: 12/28/2023] [Indexed: 01/11/2024]
Abstract
BACKGROUND Patients with chronic rhinosinusitis with nasal polyps (CRSwNP) have high incidence of sleep impairment. We evaluated the impact of omalizumab treatment on sleep characteristics and associated health status in patients with CRSwNP. METHODS Prespecified exploratory analysis assessed outcomes from patients included in the POLYP 1 and POLYP 2 phase 3 clinical trials and the open-label extension. Sleep was assessed by the sleep domain of the Sino-Nasal Outcome Test-22 (SNOT-22; MCID > 4 in patients with CRS) and the Medical Outcomes Study Sleep Scale (MOS-Sleep). Health status was assessed by Healthy Days Core Module (HDCM) and sinonasal-specific Patient Global Impression of Change (PGIC). RESULTS Omalizumab improved sleep as assessed by the SNOT-22 sleep domain. At week 24, adjusted mean (95%CI) SNOT-22 sleep scores had reduced from baseline by -8.5 (-9.9 to -7.1) with omalizumab versus -2.7 (-4.1 to -1.3) with placebo. At week 52 (all patents on OMA), adjusted mean (95%CI) SNOT-22 sleep scores had reduced from baseline by -10.1 (-11.4 to -8.7) with omalizumab. Improvements were observed in all eight items of the SNOT-22 sleep domain: difficulty falling asleep, fatigue, frustration/restlessness/irritability, lack good night's sleep, reduced concentration, reduced productivity, wake up tired, and wake up at night. In addition, omalizumab improved six of eight sleep outcomes on the MOS-Sleep scale. There were concurrent improvements in HDCM and PGIC. CONCLUSION Omalizumab improved sleep and self-reported health status in patients with CRSwNP. This contributes to evidence that omalizumab provides value for patients beyond the reduction of sinonasal symptoms.
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Affiliation(s)
- Eli O Meltzer
- Division of Allergy and Immunology, University of California, San Diego, La Jolla, California, USA
| | - Joaquim Mullol
- Rhinology Unit & Smell Clinic, ENT Department, Hospital Clinic, IDIBAPS, Universitat de Barcelona, CIBERES, Barcelona, Catalonia, Spain
| | - Jinnie Ko
- Genentech, Inc., South San Francisco, California, USA
| | - Rebecca Saenz
- Genentech, Inc., South San Francisco, California, USA
| | | | | | - Philippe Gevaert
- Upper Airway Research Laboratory, Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium
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Skoner DP, Meltzer EO, Skoner J, Sacks HJ, Lumry WR. Evaluation of the ocular safety associated with the exhalation delivery system with fluticasone. Allergy Asthma Proc 2022; 43:70-77. [PMID: 34753535 DOI: 10.2500/aap.2022.43.210096] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background: Intranasal corticosteroids (INCS) are the cornerstone of treatment for chronic rhinosinusitis. Although INCS are generally considered safe and effective, there is a concern that chronic use may lead to ocular adverse effects. Objective: To assess ocular safety of the exhalation delivery system with fluticasone propionate (EDS-FLU) in patients with chronic rhinosinusitis with nasal polyps. Methods: Ocular safety data were collected during two randomized, double-blind, placebo controlled studies with open-label extensions. Ophthalmologists performed tonometry, slit-lamp, and visual acuity examinations to assess intraocular pressure (IOP) and the presence of cataracts. Ocular examinations were conducted before double-blind treatment, at the end of the 16-week double-blind phase, and at the end of the 8-week open-label phase. The results of pooled data from patients who received EDS-FLU 186 µg (n = 160), EDS-FLU 372 µg (n = 161), and EDS-placebo (n = 161) twice daily are reported here. Results: At the end of the double-blind phase, six patients developed elevated average IOP > 21 mm Hg: two patients (1.2%) in the EDS-placebo group, three patients (1.9%) in the EDS-FLU 186 µg group, and one patient (0.6%) in the EDS-FLU 372 µg group. In addition, 6 of 482 patients developed cataracts: 3 patients in the EDS-placebo group, 2 patients in the EDS-FLU 186 µg group, and 1 patient in the EDS-FLU 372 µg group. At the end of the open-label phase, two additional patients showed IOP > 21 mm Hg and two additional patients developed cataracts. Conclusion: No increased risk of elevated IOP was detected with EDS-FLU; the rate of cataract development was similar to EDS-placebo and to that reported with other INCS.Clinical trials NCT01622569 and NCT01624662, <ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="http://www.clinicaltrials.gov">www.clinicaltrials.gov</ext-link>.
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Affiliation(s)
- David P. Skoner
- From the Director, Section of Allergy and Immunology, West Virginia University Children's Hospital, Morgantown, West Virginia
| | - Eli O. Meltzer
- Clinical Professor, Department of Pediatrics, Division of Allergy/Immunology, University of California San Diego School of Medicine, San Diego, California
| | | | - Harry J. Sacks
- Medical Affairs, OptiNose US, Inc., Yardley, Pennsylvania
| | - William R. Lumry
- Clinical Professor, Department of Internal Medicine, University of Texas Southwestern Medical School, Dallas, Texas; and
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Meltzer EO, Rosario NA, Van Bever H, Lucio L. Fexofenadine: review of safety, efficacy and unmet needs in children with allergic rhinitis. Allergy Asthma Clin Immunol 2021; 17:113. [PMID: 34727966 PMCID: PMC8561980 DOI: 10.1186/s13223-021-00614-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 10/08/2021] [Indexed: 12/29/2022] Open
Abstract
Allergic rhinitis (AR) is the most common undiagnosed chronic condition in children. Moderate/severe AR symptoms significantly impair quality of life, and cause sleep disruption, absenteeism and decreased productivity. Additionally, untreated AR predisposes children to asthma and other chronic conditions. Although intranasal corticosteroids are the most effective pharmacologic treatment for AR, oral antihistamines are often preferred. First-generation antihistamines may be chosen to relieve AR symptoms as they are inexpensive and widely available; however, they cause sedative and cardiovascular negative effects due to poor receptor selectivity. Therefore, second-generation antihistamines were developed to reduce adverse effects while retaining efficacy. There are fewer clinical trials in children than adults, therefore, efficacy and safety data is limited, particularly in children under 6 years, highlighting the need to generate these data in young children with AR. Fexofenadine, a highly selective second-generation antihistamine, effectively alleviates symptoms of AR, is non-sedating due to decreased blood-brain barrier permeability, and is devoid of cardiovascular side effects. Importantly, fexofenadine relieves the ocular symptoms of allergic conjunctivitis, which occur concomitantly with AR, improving quality of life. Overall, fexofenadine displays a favorable safety profile and results in greater treatment satisfaction in children compared with other second-generation antihistamines. This review aimed to evaluate and compare the safety and efficacy of fexofenadine with other available first- and second-generation antihistamines in children with AR.
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Affiliation(s)
- Eli O. Meltzer
- grid.266100.30000 0001 2107 4242Department of Pediatrics, Division of Allergy and Immunology, University of California, La Jolla, San Diego, CA USA
| | - Nelson Augusto Rosario
- grid.20736.300000 0001 1941 472XDepartamento de Pediatria, Universidade Federal Do Parana, Curitiba, PR Brazil
| | - Hugo Van Bever
- grid.4280.e0000 0001 2180 6431Department of Pediatrics, Division of Rheumatology, Immunology, Allergy, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Luiz Lucio
- Medical Department, Sanofi Consumer Healthcare, AI, Traira 456, Santana de Parnaiba-SP, Brazil, São Paulo, 06540 365 Brazil
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Meltzer EO, Wallace D, Friedman HS, Navaratnam P, Scott EP, Nolte H. Meta-analyses of the efficacy of pharmacotherapies and sublingual allergy immunotherapy tablets for allergic rhinitis in adults and children. Rhinology 2021; 59:422-432. [PMID: 34463311 DOI: 10.4193/rhin21.054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Treatment options for seasonal and perennial allergic rhinitis (SAR/PAR) include pharmacotherapies and allergy immunotherapy. These meta-analyses evaluated the efficacy of pharmacotherapies and sublingual immunotherapy tablets (SLIT-tablets) versus placebo on nasal symptoms associated with SAR and PAR. METHODS Randomized, double-blind, placebo-controlled trials were identified from systematic PubMED/EMBASE searches through 7/18/2019 (PROSPERO protocol CRD42018105632). The primary outcome was mean numerical difference in total nasal symptom score (TNSS; 0-12) between active treatment and placebo at the end of the assessment period. Random-effects meta-analyses estimated the mean difference for each medication group weighted by the inverse of the trial variance. Publication bias assessments and sensitivity analyses were conducted. RESULTS Rescue symptom-relieving pharmacotherapy was prohibited in most pharmacotherapy trials but was allowed in all SLIT-tablet trials. For adult/adolescent SAR, the mean numerical difference (95% CI) in TNSS versus placebo was: intranasal corticosteroids (INCS)=1.38 (1.18, 1.58; 39 trials); combination intranasal antihistamine/INCS=1.34 (1.15, 1.54; 4 trials); intranasal antihistamines=0.72 (0.56, 0.89; 13 trials); oral antihistamine=0.62 (0.35, 0.90; 18 trials); SLIT-tablets=0.57 (0.41, 0.73; 4 trials); and montelukast=0.48 (0.36, 0.60; 10 trials). For adult/adolescent PAR, mean difference in TNSS versus placebo (95% CI) was: INCS=0.82 (0.66, 0.97; 14 trials); SLIT-tablets=0.65 (0.42, 0.88; 3 trials); and oral antihistamine=0.27 (0.11, 0.42; 3 trials). The number of eligible trials limited meta-analyses for pediatric SAR/PAR. CONCLUSIONS All treatments significantly improved nasal symptoms versus placebo. SLIT-tablets provided improvement in TNSS despite access to rescue symptom-relieving pharmacotherapy. Extensive trial heterogeneity and strong indications of publication bias preclude the comparison of treatment effects among treatment classes.
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Affiliation(s)
- E O Meltzer
- Allergy and Asthma Medical Group and Research Center, University of California School of Medicine, San Diego, CA, USA
| | - D Wallace
- Nova Southeastern Allopathic Medical School, Davie, FL, USA
| | | | | | - E P Scott
- Scott Medical Communications, Tyler, TX, USA
| | - H Nolte
- ALK-Abello, Bedminster, NJ, USA
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Meltzer EO, Zeiger RS, Dicpinigaitis P, Bernstein JA, Oppenheimer JJ, Way NA, Li VW, Boggs R, Doane MJ, Urdaneta E, Weaver JP, Schelfhout J, Fonseca E. Prevalence and Burden of Chronic Cough in the United States. J Allergy Clin Immunol Pract 2021; 9:4037-4044.e2. [PMID: 34333189 DOI: 10.1016/j.jaip.2021.07.022] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 06/14/2021] [Accepted: 07/06/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Chronic cough is a common complaint but there are little population-based data on its burden in the United States. OBJECTIVE To determine the prevalence of chronic cough and its burden on individuals and the health care system. METHODS This was a survey of respondents who completed the 2018 National Health and Wellness Survey and questions about sleep and health care resource use. Chronic cough was defined as having a daily cough for 8 or more weeks. Respondents without chronic cough were selected through propensity score matching. Chronic cough prevalence was estimated using poststratification sampling weights calculated using U.S. Census data and post-data Horvitz-Thompson sampling weights to adjust for sampling bias. RESULTS Of 74,977 National Health and Wellness Survey respondents, 3,654 had experienced chronic cough in the previous 12 months, for a weighted prevalence of 5.0%. Respondents with chronic cough were older and more predominantly female than respondents without chronic cough (both P < .001). Compared with matched respondents without chronic cough, those with chronic cough had lower mean scores on the Medical Outcomes Study 36-item Short Form Survey v2 physical (P < .001) and mental (P < .001) component summary scores. More respondents with chronic cough than matched controls experienced severe anxiety and severe depression in the past 2 weeks, work productivity impairment, impaired sleep quality and daytime sleepiness, as well as more emergency department visits and hospitalizations in the past 6 months (P < .001 for all comparisons). CONCLUSIONS The burden of chronic cough manifests itself as reduced health-related quality of life, increased anxiety and depression, impaired sleep and work productivity, and greater health care utilization.
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Affiliation(s)
- Eli O Meltzer
- Department of Pediatrics, University of California, San Diego, Calif.
| | - Robert S Zeiger
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, Calif
| | | | - Jonathan A Bernstein
- Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio
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Winders T, DuBuske L, Bukstein DA, Meltzer EO, Wallace D, Rance K. Shifts in allergy practice in a COVID-19 world: Implications of pre-COVID-19 national health care provider and patient surveys of treatments for nasal allergies. Allergy Asthma Proc 2021; 42:301-309. [PMID: 34030767 DOI: 10.2500/aap.2021.42.210035] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background: Most U.S. patient and health care provider surveys with regard to nasal allergy treatments were conducted before sublingual immunotherapy (SLIT)-tablets and allergy immunotherapy (AIT) shared decision-making tools were available. Objective: Patient and health care provider surveys with regard to current perceptions of nasal allergy burden, symptoms, and treatments were conducted to compare with previous surveys and provide insight into the use of SLIT-tablets and AIT shared decision-making tools. Methods: From November-December 2019, adults (N = 510) diagnosed with nasal allergies and health care providers (N = 304) who treated nasal allergies in the United States completed surveys with regard to nasal allergy management. Results: Of the patient respondents, 42% reported that their symptoms were only somewhat controlled and 48% had avoided activities because of their nasal allergies. In all, 38% were using only over-the-counter (OTC) medications for treatment, and 42%, 7%, and 8% had ever received subcutaneous immunotherapy (SCIT), sublingual allergy drops, or SLIT-tablets, respectively; 56% and 85% reported that they had never discussed SCIT or SLIT, respectively, with their health care provider. Of the health care provider respondents, 45%, 58%, and 20% were very likely to discuss OTC medications, SCIT, or SLIT, respectively. Allergists were more inclined to discuss SCIT with their patients than other health care providers (82% versus 33%, respectively). Most allergists (67%) and other health care providers (62%) reported that they did not use an AIT shared decision-making tool, primarily because of unawareness. Conclusion: The patients with nasal allergies continued to report inadequate symptom control and activity impairment. SLIT-tablets and AIT shared decision-making tools were underused. In the coronavirus disease 2019 era, social distancing may limit office visits, which impacts SCIT administration and prompts increased use of telemedicine and a possible advantage for at-home-administered SLIT-tablets over SCIT.
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Affiliation(s)
| | - Lawrence DuBuske
- Division of Allergy and Immunology, Department of Medicine, The George Washington University School of Medicine and Health Sciences, Washington, D.C
| | | | - Eli O. Meltzer
- Division of Allergy and Immunology, Department of Pediatrics, University of California San Diego School of Medicine, La Jolla, California
| | - Dana Wallace
- Department of Clinical Sciences, Nova Southeastern Allopathic Medical School, Davie, Florida; and
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Bousquet J, Pfaar O, Agache I, Bedbrook A, Akdis CA, Canonica GW, Chivato T, Al-Ahmad M, Abdul Latiff AH, Ansotegui IJ, Bachert C, Baharuddin A, Bergmann KC, Bindslev-Jensen C, Bjermer L, Bonini M, Bosnic-Anticevich S, Bosse I, Brough HA, Brussino L, Calderon MA, Caraballo L, Cardona V, Carreiro-Martins P, Casale T, Cecchi L, Cepeda Sarabia AM, Chkhartishvili E, Chu DK, Cirule I, Cruz AA, Czarlewski W, Del Giacco S, Demoly P, Devillier P, Dokic D, Durham SL, Ebisawa M, El-Gamal Y, Emuzyte R, Gamkrelidze A, Fauquert JL, Fiocchi A, Fokkens WJ, Fonseca JA, Fontaine JF, Gawlik R, Gelincik A, Gemicioglu B, Gereda JE, Gerth van Wijk R, Gomez RM, Gotua M, Grisle I, Guzmán MA, Haahtela T, Halken S, Heffler E, Hoffmann-Sommergruber K, Hossny E, Hrubiško M, Irani C, Ivancevich JC, Ispayeva Z, Julge K, Kaidashev I, Kalayci O, Khaitov M, Klimek L, Knol E, Kowalski ML, Kraxner H, Kull I, Kuna P, Kvedariene V, Kritikos V, Lauerma A, Lau S, Laune D, Levin M, Larenas-Linnemann DE, Lodrup Carlsen KC, Lombardi C, Lourenço OM, Mahboub B, Malling HJ, Manning P, Marshall GD, Melén E, Meltzer EO, Miculinic N, Milenkovic B, Moin M, Montefort S, Morais-Almeida M, Mortz CG, Mösges R, Mullol J, Namazova Baranova L, Neffen H, Nekam K, Niedoszytko M, Odemyr M, O'Hehir RE, Ollert M, O'Mahony L, Ohta K, Okamoto Y, Okubo K, Pajno GB, Palomares O, Palkonen S, Panzner P, G Papadopoulos N, Park HS, Passalacqua G, Patella V, Pawankar R, Pham-Thi N, Plavec D, Popov TA, Recto M, Regateiro FS, Riggioni C, Roberts G, Rodriguez-Gonzales M, Rosario N, Rottem M, Rouadi PW, Ryan D, Samolinski B, Sanchez-Borges M, Serpa FS, Sastre J, Scadding GK, Shamji MH, Schmid-Grendelmeier P, Schünemann HJ, Sheikh A, Scichilone N, Sisul JC, Sofiev M, Solé D, Sooronbaev T, Soto-Martinez M, Soto-Quiros M, Sova M, Schwarze J, Skypala I, Suppli-Ulrik C, Taborda-Barata L, Todo-Bom A, Torres MJ, Valentin-Rostan M, Tomazic PV, Valero A, Toppila-Salmi S, Tsiligianni I, Untersmayr E, Urrutia-Pereira M, Valiulis A, Valovirta E, Vandenplas O, Ventura MT, Vichyanond P, Wagenmann M, Wallace D, Walusiak-Skorupa J, Wang DY, Waserman S, Wong GW, Yorgancioglu A, Yusuf OM, Zernotti M, Zhang L, Zidarn M, Zuberbier T, Jutel M. ARIA-EAACI care pathways for allergen immunotherapy in respiratory allergy. Clin Transl Allergy 2021; 11:e12014. [PMID: 34136127 PMCID: PMC8190541 DOI: 10.1002/clt2.12014] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 02/08/2021] [Indexed: 11/09/2022] Open
Affiliation(s)
- Jean Bousquet
- Department of Dermatology and Allergy Comprehensive Allergy Center Charité Universitätsmedizin Berlin Humboldt-Universität zu Berlin, and Berlin Institute of Health Berlin Germany.,Allergology University Hospital Montpellier Montpellier France.,MACVIA-France Montpellier France
| | - Oliver Pfaar
- Department of Otorhinolaryngology Head and Neck Surgery Section of Rhinology and Allergy University Hospital Marburg Philipps-Universität Marburg Germany
| | - Ioana Agache
- Allergy and Clinical Immunology Transylvania University Brasov Brasov Romania
| | | | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - G Walter Canonica
- Department of Biomedical Sciences Humanitas University Pieve Emanuele (MI) and Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Milano Italy.,Personalized Medicine, Asthma and Allergy Humanitas Clinical and Research Center IRCCS Rozzano Milano Italy
| | - Tomas Chivato
- School of Medicine University CEU San Pablo Madrid, Spain
| | - Mona Al-Ahmad
- Department of Allergy and Microbiology Faculty of Medicine Al-Rashed Allergy Center Kuwait University Kuwait City Kuwait.,Department of Allergy Al-Rashed Allergy Center Kuwait City Kuwait
| | | | - Ignacio J Ansotegui
- Department of Allergy and Immunology Hospital Quironsalud Bizkaia Erandio, Spain
| | - Claus Bachert
- ENT Department Upper Airways Research Laboratory Ghent University Hospital Ghent Belgium.,International Airway Research Center First Affiliated Hospital Guangzou Sun Yat-sen University Guangzhou China.,Division of ENT Diseases Department of ENT Diseases CLINTEC Karolinska Institutet Karolinska University Hospital Stockholm Sweden
| | - Abdullah Baharuddin
- Department of Otorhinolaryngology-Head and Neck Surgery School of Medical Sciences Universiti Sains Malaysia Kubang Kerian Kelantan Malaysia
| | - Karl-Christian Bergmann
- Department of Dermatology and Allergy Comprehensive Allergy Center Charité Universitätsmedizin Berlin Humboldt-Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| | - Carsten Bindslev-Jensen
- Department of Dermatology and Allergy Centre Odense University Hospital Odense Denmark.,Division of ENT Diseases Department of ENT Diseases CLINTEC Karolinska Institutet Karolinska University Hospital Stockholm Sweden.,Research Center for Anaphylaxis (ORCA) Odense Denmark
| | - Leif Bjermer
- Department of Respiratory Medicine and Allergology University Hospital Lund Sweden
| | - Matteo Bonini
- Department of Cardiovascular and Thoracic Sciences Fondazione Policlinico Universitario A Gemelli IRCCS Università Cattolica del Sacro Cuore Rome Italy.,National Heart and Lung Institute Royal Brompton Hospital & Imperial College London UK
| | - Sinthia Bosnic-Anticevich
- Woolcock Institute of Medical Research University of Sydney Australia.,Woolcock Emphysema Centre and Sydney Local Health District Glebe New South Wales Australia
| | | | - Helen A Brough
- Paediatric Allergy Department of Asthma, Allergy and Respiratory Science Guys' Hospital King's College London London UK
| | - Luisa Brussino
- Department of Medical Sciences Allergy and Clinical Immunology Unit University of Torino & Mauriziano Hospital Torino Italy
| | | | - Luis Caraballo
- Institute for Immunological Research University of Cartagena Cartagena Colombia.,Foundation for the Development of Medical and Biological Sciences (Fundemeb) Cartagena Colombia
| | - Victoria Cardona
- Allergy Section Department of Internal Medicine Hospital Vall d'Hebron & ARADyAL Research Network Barcelona, Spain
| | - Pedro Carreiro-Martins
- Serviço de Imunoalergologia Hospital de Dona Estefânia Centro Hospitalar de Lisboa Central Lisbon Portugal.,NOVA Medical School CEDOC Comprehensive Health Research Center (CHRC) Lisboa Portugal
| | - Tomas Casale
- Division of Allergy/immunology University of South Florida Tampa Fla USA
| | - Lorenzo Cecchi
- SOS Allergology and Clinical Immunology USL Toscana Centro Prato Italy
| | - Alfonso M Cepeda Sarabia
- Allergy and Immunology Laboratory Metropolitan University Simon Bolivar University Barranquilla Colombia.,SLaai, Sociedad Latinoamericana de Allergia Asma e Immunologia Branquilla Colombia
| | - Ekaterine Chkhartishvili
- David Tatishvili Medical Center David Tvildiani Medical University-AIETI Medical School Tbilisi Georgia
| | - Derek K Chu
- Departments of Medicine and Health Research Methods McMaster University Hamilton ON Canada
| | - Ieva Cirule
- Latvain Association of Allergists University Children Hospital Riga Latvia
| | - Alvaro A Cruz
- Fundação ProAR Federal University of Bahia and GARD/WHO Planning Group Salvador Brazil
| | | | - Stefano Del Giacco
- Department of Medical Sciences and Public Health and Unit of Allergy and Clinical Immunology University Hospital "Duilio Casula" University of Cagliari Cagliari Italy
| | - Pascal Demoly
- Department of Pulmonology Division of Allergy Hôpital Arnaud de Villeneuve University Hospital of Montpellier France.,Equipe EPAR - IPLESP Sorbonne Université Paris France
| | - Philippe Devillier
- Unité de Recherche en Pharmacologie Respiratoire Pôle des Maladies des Voies Respiratoires, Hôpital Foch Université Paris Saclay Suresnes France
| | - Dejan Dokic
- Medical Faculty University Clinic of Pulmology and Allergy Skopje Republic of Macedonia
| | | | - Motohiro Ebisawa
- Clinical Reserch Center for Allergy and Rheumatology NHO Sagamihara National Hospital Sagamihara Japan
| | - Yehia El-Gamal
- Pediatric Allergy and Immunology Unit Children's Hospital Ain Shams University Cairo Egypt
| | - Regina Emuzyte
- Faculty of Medicine Clinic of Children's Diseases Vilnius University Vilnius Lithuania
| | - Amiran Gamkrelidze
- National Center for Disease Control and Public Health of Georgia Tbilisi Georgia
| | - Jean Luc Fauquert
- CHU Clermont-Ferrand Unité d'Allergologie de l'Enfant Pole pédiatrique Hopital Estaing Clermont-Ferrand France
| | - Alessandro Fiocchi
- Division of Allergy The Bambino Gesu Children's Hospital IRCCS Rome Italy
| | - Wytske J Fokkens
- Department of Otorhinolaryngology Academic Medical Centers Amsterdam The Netherland.,EUFOREA Brussels Belgium
| | - Joao A Fonseca
- Faculdade de Medicina CINTESIS, Center for Health Technology and Services Research Universidade do Porto Porto Portugal.,Allergy Unit CUF Porto Portugal
| | | | - Radoslaw Gawlik
- Department of Internal Medicine, Allergology and Clinical Immunology Silesian University of Medicine Katowice Poland
| | - Asli Gelincik
- Division of Allergy and Immunology Dışkapı Yıldırım Beyazıt Training and Research Hospital Ankara Turkey
| | - Bilun Gemicioglu
- Department of Pulmonary Diseases Cerrahpasa Faculty of Medicine Istanbul University-Cerrahpasa Istanbul Turkey
| | - Jose E Gereda
- Allergy and Immunology Division Clinica Ricardo Palma Lima Peru
| | - Roy Gerth van Wijk
- Department of Internal Medicine Section of Allergology Erasmus MC Rotterdam the Netherlands
| | | | - Maia Gotua
- Center of Allergy and Immunology Georgian Association of Allergology and Clinical Immunology Tbilisi Georgia
| | - Ineta Grisle
- Latvian Association of Allergists Center of Tuberculosis and Lung Diseases Riga Latvia
| | | | - Tari Haahtela
- Skin and Allergy Hospital Helsinki University Hospital Helsinki Finland
| | - Susanne Halken
- Hans Christian Andersen Children's Hospital Odense University Hospital Odense Denmark
| | - Enrico Heffler
- Department of Biomedical Sciences Humanitas University Pieve Emanuele (MI) and Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Milano Italy
| | | | - Elham Hossny
- Pediatric Allergy and Immunology Unit Children's Hospital Ain Shams University Cairo Egypt
| | - Martin Hrubiško
- Department of Clinical Immunology and Allergy Oncology Institute of St Elisabeth Bratislava Slovakia
| | - Carla Irani
- Department of Internal Medicine and Infectious Diseases St Joseph University Hotel Dieu de France Hospital Beirut Lebanon
| | | | - Zhanat Ispayeva
- Department of Allergology and Clinical Immunology of the Kazakh National Medical University Kazakhstan Association of Allergology and Clinical Immunology Kazakhstan
| | - Kaja Julge
- Allergy Center of Childrens's Clinic of Tartu University Hospital Tartu Estonia
| | - Igor Kaidashev
- Ukrainina Medical Stomatological Academy Poltava Ukraine
| | - Omer Kalayci
- Pediatric Allergy and Asthma Unit Hacettepe University School of Medicine Ankara Turkey
| | - Musa Khaitov
- National Research Center Institute of Immunology Federal Medicobiological Agency Laboratory of Molecular Immunology Russia
| | - Ludger Klimek
- Department of Otolaryngology Head and Neck Surgery Universitätsmedizin Mainz Mainz Germany.,Center for Rhinology and Allergology Wiesbaden Germany
| | - Edward Knol
- Departments of Immunology and Dermatology/Allergology University Medical Center Utrecht The Netherlands
| | - Marek L Kowalski
- Department of Immunology and Allergy Healthy Ageing Research Center Medical University of Lodz Poland
| | - Helga Kraxner
- Department of Otorhinolaryngology Head and Neck Surgery Semmelweis University Budapest Hungary
| | - Inger Kull
- Department of Clinical Science and Education Södersjukhuset Karolinska Institutet Stockholm Sweden.,Sach´s Children and Youth Hospital Södersjukhuset Stockholm Sweden
| | - Piotr Kuna
- Division of Internal Medicine, Asthma and Allergy Barlicki University Hospital Medical University of Lodz Poland
| | - Violeta Kvedariene
- Department of Pathology Faculty of Medicine Institute of Biomedical Sciences Vilnius University Vilnius Lithuania.,Faculty of Medicine Institute of Clinical Medicine Clinic of Chest Diseases and Allergology Vilnius University Vilnius Lithuania
| | - Vicky Kritikos
- Quality Use of Respiratory Medicines Group Woolcock Institute of Medical Research University of Sydney Sydney NSW Australia.,Department of Respiratory and Sleep Medicine Royal Prince Alfred Hospital Sydney Australia
| | - Antti Lauerma
- Department of Dermatology and Allergology University of Helsinki and Helsinki University Helsinki Finland
| | - Susanne Lau
- Department of Pediatric Pneumology and Immunology Charité Universitätsmedizin Berlin Germany
| | | | - Michael Levin
- Division of Paediatric Allergology University of Cape Town Cape Town South Africa
| | | | - Karin C Lodrup Carlsen
- Department of Paediatrics Oslo University Hospital Oslo Norway.,Faculty of Medicine Institute of Clinical Medicine University of Oslo Oslo Norway
| | - Carlo Lombardi
- Departmental Unit of Allergology & Respiratory Diseases Fondazione Poliambulanza Brescia Italy
| | - Olga M Lourenço
- Faculty of Health Sciences and CICS - UBI Health Sciences Research Centre University of Beira Interior Covilhã Portugal
| | - Bassam Mahboub
- Department of Pulmonary Medicine Rashid Hospital Dubai UAE
| | | | - Patrick Manning
- Department of Medicine (RCSI) Bon Secours Hospital Dublin Ireland
| | - Gailen D Marshall
- The University of Mississippi Medical Center Division of Clinical Immunology and Allergy Laboratory of Behavioral Immunology Research Jackson Mississippi USA
| | - Erik Melén
- Sachs' Children and Youth Hospital Södersjukhuset Stockholm Sweden.,Sach´s Children and Youth Hospital Södersjukhuset Stockholm Sweden
| | - Eli O Meltzer
- Allergy Allergy and Asthma Medical Group and Research Center San Diego California USA
| | | | - Branislava Milenkovic
- Faculty of Medicine Clinic for Pulmonary Diseases Clinical Center of Serbia University of Belgrade Belgrade Serbia.,Serbian Association for Asthma and COPD Belgrade Serbia
| | - Mostafa Moin
- Immunology and Asthma and Allergy Research Institute Tehran University of Medical Sciences Tehran Iran
| | - Stephen Montefort
- Faculty of Medicine and Surgery Mater Dei Hospital Malta University of Medicine La Valette Malta
| | | | - Charlotte G Mortz
- Department of Dermatology and Allergy Centre Odense University Hospital Odense Denmark
| | - Ralph Mösges
- CRI-Clinical Research International-Ltd Hamburg Germany
| | - Joaquim Mullol
- ENT Department Rhinology Unit & Smell Clinic Hospital Clínic Barcelona Spain.,Clinical & Experimental Respiratory Immunoallergy IDIBAPS CIBERES University of Barcelona Spain
| | - Leyla Namazova Baranova
- Scientific Centre of Children's Health Russian National Research Medical University Moscow Russia
| | - Hugo Neffen
- Center of Allergy, Immunology and Respiratory Diseases Santa Fe Argentina
| | - Kristof Nekam
- Hospital of the Hospitaller Brothers in Buda Budapest Hungary
| | - Marek Niedoszytko
- Department of Allergology Medical University of Gdańsk Gdańsk Poland
| | - Mikaëla Odemyr
- EFA European Federation of Allergy and Airways Diseases Patients' Associations Brussels Belgium
| | - Robyn E O'Hehir
- Department of Allergy, Immunology and Respiratory Medicine Central Clinical School Monash University Victoria Australia.,Alfred Health, Melbourne Victoria Australia
| | - Markus Ollert
- Department of Infection and Immunity Luxembourg Institute of Health Esch-sur-Alzette Luxembourg.,Department of Dermatology and Allergy Centre Odense Research Center for Anaphylaxis (ORCA) Odense University Hospital Odense Denmark
| | - Liam O'Mahony
- Departments of Medicine and Microbiology APC Microbiome Ireland University College Cork Cork Ireland
| | - Ken Ohta
- National Hospital Organization Tokyo National Hospital Tokyo Japan
| | - Yoshitaka Okamoto
- Department of Otorhinolaryngology Chiba University Hospital Chiba Japan
| | - Kimi Okubo
- Department of Otolaryngology Nippon Medical School Tokyo Japan
| | - Giovanni B Pajno
- Department of Pediatrics Allergy Unit University of Messina Messina Italy
| | - Oscar Palomares
- Department of Biochemistry and Molecular Biology School of Chemistry Complutense University of Madrid Madrid, Spain
| | - Susanna Palkonen
- Department of Immunology and Allergology Faculty of Medicine and Faculty Hospital in Pilsen Charles University in Prague Pilsen Czech Republic
| | - Petr Panzner
- Department of Immunology and Allergology Faculty of Medicine and Faculty Hospital in Pilsen Charles University in Prague Pilsen Czech Republic
| | - Nikolaos G Papadopoulos
- Division of Infection Immunity & Respiratory Medicine Royal Manchester Children's Hospital University of Manchester Manchester UK
| | - Hae-Sim Park
- Department of Allergy and Clinical Immunology Ajou University School of Medicine Suwon South Korea
| | - Giovanni Passalacqua
- Allergy and Respiratory Diseases Ospedale Policlino San Martino -University of Genoa Italy
| | - Vincenzo Patella
- Department of Medicine Division of Allergy and Clinical Immunology Agency of Health ASL Salerno "Santa Maria della Speranza" Hospital Battipaglia Salerno Italy
| | - Ruby Pawankar
- Department of Pediatrics Nippon Medical School Tokyo Japan
| | - Nhân Pham-Thi
- Ecole Polytechnique Palaiseau IRBA (Institut de Recherche bio-Médicale des Armées) Bretigny France
| | - Davor Plavec
- School of Medicine Children's Hospital Srebrnjak, Zagreb University J.J. Strossmayer Osijek Croatia
| | | | - Marysia Recto
- Department of Pediatrics Section of Allergy and Immunology UP-PGH Manila Philipinnes
| | - Frederico S Regateiro
- Allergy and Clinical Immunology Unit Centro Hospitalar e Universitário de Coimbra Coimbra Coimbra Portugal.,Faculty of Medicine Institute of Immunology University of Coimbra Coimbra Portugal.,Faculty of Medicine ICBR - Coimbra Institute for Clinical and Biomedical Research CIBB University of Coimbra Coimbra Portugal
| | - Carmen Riggioni
- Pediatric Allergy and Clinical Immunology Department Hospital Sant Joan de Déu Barcelona Spain.,Institut de Recerca Sant Joan de Déu Barcelona Spain
| | - Graham Roberts
- Salford Royal NHS Foundation Trust NHS England North Salford UK
| | | | | | - Menachem Rottem
- Division of Allergy Asthma and Clinical Immunology Emek Medical Center Afula Israel.,Rappaport Faculty of Medicine Technion-Israel Institute of Technology Haifa Israël
| | - Philip W Rouadi
- Department of Otolaryngology-Head and Neck Surgery Eye and Ear University Hospital Beirut Lebanon
| | - Dermot Ryan
- Usher Institute Medical School University of Edinburgh Edinburgh UK
| | - Boleslaw Samolinski
- Department of Prevention of Environmental Hazards Allergology and Immunology Medical University of Warsaw Warsaw Poland
| | - Mario Sanchez-Borges
- Allergy and Clinical Immunology Department Centro Medico-Docente La Trinidad Caracas Venezuela
| | - Faradiba S Serpa
- Asthma Reference Center - Escola Superior de Ciencias Santa Casa de Misericórdia of Vitória-Espírito Santo Vitoria Brazil
| | - Joaquin Sastre
- Faculty of Medicine Fundacion Jimenez Diaz, CIBERES Autonoma University of Madrid Spain
| | | | - Mohamed H Shamji
- Immunomodulation and Tolerance Group Imperial College London London UK.,Allergy and Clinical Immunology Imperial College London London UK
| | | | - Holger J Schünemann
- Departments of Medicine and Health Research Methods McMaster University Hamilton ON Canada
| | - Aziz Sheikh
- The Usher Institute of Population Health Sciences and Informatics The University of Edinburgh Edinburgh UK
| | | | - Juan Carlos Sisul
- Sociedad Paraguaya de Alergia Asma e Inmunologıa Clinica Sisul, Allergy & Asthma Asuncion Paraguay
| | | | - Dirceu Solé
- Department of Pediatrics Division of Allergy, Clinical Immunology and Rheumatology Federal University of São Paulo São Paulo Brazil
| | - Talant Sooronbaev
- Kyrgyzstan National Centre of Cardiology and Internal Medicine Euro-Asian Respiratory Society Bishkek Kyrgyzstan
| | - Manuel Soto-Martinez
- Department of Pediatrics Division of Respiratory Medicine Hospital Nacional de Niños Universidad de Costa Rica San Jose Costa Rica
| | | | - Milan Sova
- Department of Respiratory Medicine University Hospital Olomouc Czech Republic
| | - Jürgen Schwarze
- Centre for Inflammation Research Child Life and Health The University of Edinburgh Edinburgh UK
| | - Isabel Skypala
- Royal Brompton and Harefield NHS Foundation Trust London UK
| | - Charlotte Suppli-Ulrik
- Department of Respiratory Medicine Copenhagen University Hospital Hvidovre Copenhagen Denmark.,Institute of Cinical Medicine University of Copenhagen Copenhagen Denmark
| | - Luis Taborda-Barata
- Department of Immunoallergology Faculty of Health Sciences Cova da Beira Covilhã Portugal.,University Hospital Centre Covilhã Portugal
| | - Ana Todo-Bom
- Imunoalergologia Centro Hospitalar Universitário de Coimbra Coimbra Portugal.,Faculty of Medicine University of Coimbra Coimbra Portugal
| | - Maria J Torres
- Allergy Unit Málaga Regional University Hospital-IBIMA Málaga Spain
| | | | - Peter-Valentin Tomazic
- Department of General ORL, H&NS ENT-University Hospital Graz Medical University of Graz Graz Austria
| | - Antonio Valero
- Pneumology and Allergy Department CIBERES Clinical & Experimental Respiratory Immunoallergy, IDIBAPS University of Barcelona Barcelona Spain
| | | | - Ioanna Tsiligianni
- Department of Social Medicine Health Planning Unit Faculty of Medicine University of Crete Crete Greece.,International Primary Care Respiratory Group IPCRG Aberdeen Scotland
| | - Eva Untersmayr
- Institute of Pathophysiology and Allergy Research Center of Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria
| | | | - Arunas Valiulis
- Faculty of Medicine Vilnius University Institute of Clinical Medicine & Institute of Health Sciences Vilnius Lithuania.,European Academy of Paediatrics (EAP/UEMS-SP) Brussels Belgium
| | - Erkka Valovirta
- Department of Lung Diseases and Clinical Immunology University of Turku Turku Finland.,Terveystalo Allergy Clinic Turku Finland
| | - Olivier Vandenplas
- Department of Chest Medicine Centre Hospitalier Universitaire UCL Namur Université Catholique de Louvain Yvoir Belgium
| | - Maria Teresa Ventura
- Unit of Geriatric Immunoallergology University of Bari Medical School Bari Italy
| | - Pakit Vichyanond
- Division of Allergy and Immunology Department of Pediatrics Faculty of Medicine Siriraj Hospital Mahidol University Bangkok Thailand
| | - Martin Wagenmann
- Department of Otorhinolaryngology, HNO-Klinik Universitätsklinikum Düsseldorf Germany
| | - Dana Wallace
- Nova Southeastern University, Fort Lauderdale Florida USA
| | - Jolanta Walusiak-Skorupa
- Department of Occupational Diseases and Environmental Health Nofer Institute of Occupational Medicine Lodz Poland
| | - De Yun Wang
- Department of Otolaryngology Yong Loo Lin School of Medicine National University of Singapore Singapore Singapore
| | - Susan Waserman
- Department of Medicine, Clinical Immunology and Allergy McMaster University Hamilton Ontario Canada
| | - Gary Wk Wong
- Department of Paediatrics Prince of Wales Hospital The Chinese University of Hong Kong Shatin, New Territories Hong Kong China
| | | | | | - Mario Zernotti
- Universidad Católica de Córdoba Universidad Nacional de Villa Maria Argentina
| | - Luo Zhang
- Department of Otolaryngology Head and Neck Surgery Beijing TongRen Hospital Beijing China.,Otolaryngology Beijing Institute of Otolaryngology Beijing China
| | - Mihaela Zidarn
- Respiratory and Allergic Diseases University Clinic Golnik Slovenia
| | - Torsten Zuberbier
- Department of Dermatology and Allergy Comprehensive Allergy Center Charité Universitätsmedizin Berlin Humboldt-Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| | - Marek Jutel
- Department of Clinical Immunology Wrocław Medical University Wroclaw Poland.,ALL-MED Medical Research Institute Wroclaw Poland
| |
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9
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Bousquet J, Anto JM, Czarlewski W, Haahtela T, Fonseca SC, Iaccarino G, Blain H, Vidal A, Sheikh A, Akdis CA, Zuberbier T, Hamzah Abdul Latiff A, Abdullah B, Aberer W, Abusada N, Adcock I, Afani A, Agache I, Aggelidis X, Agustin J, Akdis M, Al‐Ahmad M, Al‐Zahab Bassam A, Alburdan H, Aldrey‐Palacios O, Alvarez Cuesta E, Alwan Salman H, Alzaabi A, Amade S, Ambrocio G, Angles R, Annesi‐Maesano I, Ansotegui IJ, Anto J, Ara Bardajo P, Arasi S, Arshad H, Cristina Artesani M, Asayag E, Avolio F, Azhari K, Bachert C, Bagnasco D, Baiardini I, Bajrović N, Bakakos P, Bakeyala Mongono S, Balotro‐Torres C, Barba S, Barbara C, Barbosa E, Barreto B, Bartra J, Bateman ED, Battur L, Bedbrook A, Bedolla Barajas M, Beghé B, Bekere A, Bel E, Ben Kheder A, Benson M, Berghea EC, Bergmann K, Bernardini R, Bernstein D, Bewick M, Bialek S, Białoszewski A, Bieber T, Billo NE, Bilo MB, Bindslev‐Jensen C, Bjermer L, Bobolea I, Bochenska Marciniak M, Bond C, Boner A, Bonini M, Bonini S, Bosnic‐Anticevich S, Bosse I, Botskariova S, Bouchard J, Boulet L, Bourret R, Bousquet P, Braido F, Briggs A, Brightling CE, Brozek J, Brussino L, Buhl R, Bumbacea R, Buquicchio R, Burguete Cabañas M, Bush A, Busse WW, Buters J, Caballero‐Fonseca F, Calderon MA, Calvo M, Camargos P, Camuzat T, Canevari F, Cano A, Canonica GW, Capriles‐Hulett A, Caraballo L, Cardona V, Carlsen K, Carmon Pirez J, Caro J, Carr W, Carreiro‐Martins P, Carreon‐Asuncion F, Carriazo A, Casale T, Castor M, Castro E, Caviglia A, Cecchi L, Cepeda Sarabia A, Chandrasekharan R, Chang Y, Chato‐Andeza V, Chatzi L, Chatzidaki C, Chavannes NH, Chaves Loureiro C, Chelninska M, Chen Y, Cheng L, Chinthrajah S, Chivato T, Chkhartishvili E, Christoff G, Chrystyn H, Chu DK, Chua A, Chuchalin A, Chung KF, Cicerán A, Cingi C, Ciprandi G, Cirule I, Coelho AC, Compalati E, Constantinidis J, Correia de Sousa J, Costa EM, Costa D, Costa Domínguez MDC, Coste A, Cottini M, Cox L, Crisci C, Crivellaro MA, Cruz AA, Cullen J, Custovic A, Cvetkovski B, Czarlewski W, D'Amato G, Silva J, Dahl R, Dahlen S, Daniilidis V, DarjaziniNahhas L, Darsow U, Davies J, Blay F, De Feo G, De Guia E, los Santos C, De Manuel Keenoy E, De Vries G, Deleanu D, Demoly P, Denburg J, Devillier P, Didier A, Dimic Janjic S, Dimou M, Dinh‐Xuan AT, Djukanovic R, Do Ceu Texeira M, Dokic D, Dominguez Silva MG, Douagui H, Douladiris N, Doulaptsi M, Dray G, Dubakiene R, Dupas E, Durham S, Duse M, Dykewicz M, Ebo D, Edelbaher N, Eiwegger T, Eklund P, El‐Gamal Y, El‐Sayed ZA, El‐Sayed SS, El‐Seify M, Emuzyte R, Enecilla L, Erhola M, Espinoza H, Espinoza Contreras JG, Farrell J, Fernandez L, Fink Wagner A, Fiocchi A, Fokkens WJ, Lenia F, Fonseca JA, Fontaine J, Forastiere F, Fuentes Pèrez JM, Gaerlan–Resureccion E, Gaga M, Gálvez Romero JL, Gamkrelidze A, Garcia A, García Cobas CY, García Cruz MDLLH, Gayraud J, Gelardi M, Gemicioglu B, Gennimata D, Genova S, Gereda J, Gerth van Wijk R, Giuliano A, Gomez M, González Diaz S, Gotua M, Grigoreas C, Grisle I, Gualteiro L, Guidacci M, Guldemond N, Gutter Z, Guzmán A, Halloum R, Halpin D, Hamelmann E, Hammadi S, Harvey R, Heffler E, Heinrich J, Hejjaoui A, Hellquist‐Dahl B, Hernández Velázquez L, Hew M, Hossny E, Howarth P, Hrubiško M, Huerta Villalobos YR, Humbert M, Salina H, Hyland M, Ibrahim M, Ilina N, Illario M, Incorvaia C, Infantino A, Irani C, Ispayeva Z, Ivancevich J, E.J. Jares E, Jarvis D, Jassem E, Jenko K, Jiméneracruz Uscanga RD, Johnston SL, Joos G, Jošt M, Julge K, Jung K, Just J, Jutel M, Kaidashev I, Kalayci O, Kalyoncu F, Kapsali J, Kardas P, Karjalainen J, Kasala CA, Katotomichelakis M, Kavaliukaite L, Kazi BS, Keil T, Keith P, Khaitov M, Khaltaev N, Kim Y, Kirenga B, Kleine‐Tebbe J, Klimek L, Koffi N’Goran B, Kompoti E, Kopač P, Koppelman G, KorenJeverica A, Koskinen S, Košnik M, Kostov KV, Kowalski ML, Kralimarkova T, Kramer Vrščaj K, Kraxner H, Kreft S, Kritikos V, Kudlay D, Kuitunen M, Kull I, Kuna P, Kupczyk M, Kvedariene V, Kyriakakou M, Lalek N, Landi M, Lane S, Larenas‐Linnemann D, Lau S, Laune D, Lavrut J, Le L, Lenzenhuber M, Lessa M, Levin M, Li J, Lieberman P, Liotta G, Lipworth B, Liu X, Lobo R, Lodrup Carlsen KC, Lombardi C, Louis R, Loukidis S, Lourenço O, Luna Pech JA, Madjar B, Maggi E, Magnan A, Mahboub B, Mair A, Mais Y, Maitland van der Zee A, Makela M, Makris M, Malling H, Mandajieva M, Manning P, Manousakis M, Maragoudakis P, Marseglia G, Marshall G, Reza Masjedi M, Máspero JF, Matta Campos JJ, Maurer M, Mavale‐Manuel S, Meço C, Melén E, Melioli G, Melo‐Gomes E, Meltzer EO, Menditto E, Menzies‐Gow A, Merk H, Michel J, Micheli Y, Miculinic N, Midão L, Mihaltan F, Mikos N, Milanese M, Milenkovic B, Mitsias D, Moalla B, Moda G, Mogica Martínez MD, Mohammad Y, Moin M, Molimard M, Momas I, Mommers M, Monaco A, Montefort S, Mora D, Morais‐Almeida M, Mösges R, Mostafa B, Mullol J, Münter L, Muraro A, Murray R, Musarra A, Mustakov T, Naclerio R, Nadeau KC, Nadif R, Nakonechna A, Namazova‐Baranova L, Navarro‐Locsin G, Neffen H, Nekam K, Neou A, Nettis E, Neuberger D, Nicod L, Nicola S, Niederberger‐Leppin V, Niedoszytko M, Nieto A, Novellino E, Nunes E, Nyembue D, O’Hehir R, Odjakova C, Ohta K, Okamoto Y, Okubo K, Oliver B, Onorato GL, Pia Orru M, Ouédraogo S, Ouoba K, Paggiaro PL, Pagkalos A, Pajno G, Pala G, Palaniappan S, Pali‐Schöll I, Palkonen S, Palmer S, Panaitescu Bunu C, Panzner P, Papadopoulos NG, Papanikolaou V, Papi A, Paralchev B, Paraskevopoulos G, Park H, Passalacqua G, Patella V, Pavord I, Pawankar R, Pedersen S, Peleve S, Pellegino S, Pereira A, Pérez T, Perna A, Peroni D, Pfaar O, Pham‐Thi N, Pigearias B, Pin I, Piskou K, Pitsios C, Plavec D, Poethig D, Pohl W, Poplas Susic A, Popov TA, Portejoie F, Potter P, Poulsen L, Prados‐Torres A, Prarros F, Price D, Prokopakis E, Puggioni F, Puig‐Domenech E, Puy R, Rabe K, Raciborski F, Ramos J, Recto MT, Reda SM, Regateiro FS, Reider N, Reitsma S, Repka‐Ramirez S, Ridolo E, Rimmer J, Rivero Yeverino D, Angelo Rizzo J, Robalo‐Cordeiro C, Roberts G, Roche N, Rodríguez González M, Rodríguez Zagal E, Rolla G, Rolland C, Roller‐Wirnsberger R, Roman Rodriguez M, Romano A, Romantowski J, Rombaux P, Romualdez J, Rosado‐Pinto J, Rosario N, Rosenwasser L, Rossi O, Rottem M, Rouadi P, Rovina N, Rozman Sinur I, Ruiz M, Ruiz Segura LT, Ryan D, Sagara H, Sakai D, Sakurai D, Saleh W, Salimaki J, Samitas K, Samolinski B, Sánchez Coronel MG, Sanchez‐Borges M, Sanchez‐Lopez J, Sarafoleanu C, Sarquis Serpa F, Sastre‐Dominguez J, Savi E, Sawaf B, Scadding GK, Scheire S, Schmid‐Grendelmeier P, Schuhl JF, Schunemann H, Schvalbová M, Schwarze J, Scichilone N, Senna G, Sepúlveda C, Serrano E, Shields M, Shishkov V, Siafakas N, Simeonov A, FER Simons E, Carlos Sisul J, Sitkauskiene B, Skrindo I, SokličKošak T, Solé D, Sooronbaev T, Soto‐Martinez M, Soto‐Quiros M, Sousa Pinto B, Sova M, Soyka M, Specjalski K, Spranger O, Stamataki S, Stefanaki L, Stellato C, Stelmach R, Strandberg T, Stute P, Subramaniam A, Suppli Ulrik C, Sutherland M, Sylvestre S, Syrigou A, Taborda Barata L, Takovska N, Tan R, Tan F, Tan V, Ping Tang I, Taniguchi M, Tannert L, Tantilipikorn P, Tattersall J, Tesi F, Thijs C, Thomas M, To T, Todo‐Bom A, Togias A, Tomazic P, Tomic‐Spiric V, Toppila‐Salmi S, Toskala E, Triggiani M, Triller N, Triller K, Tsiligianni I, Uberti M, Ulmeanu R, Urbancic J, Urrutia Pereira M, Vachova M, Valdés F, Valenta R, Valentin Rostan M, Valero A, Valiulis A, Vallianatou M, Valovirta E, Van Eerd M, Van Ganse E, Hage M, Vandenplas O, Vasankari T, Vassileva D, Velasco Munoz C, Ventura MT, Vera‐Munoz C, Vicheva D, Vichyanond P, Vidgren P, Viegi G, Vogelmeier C, Von Hertzen L, Vontetsianos T, Vourdas D, Tran Thien Quan V, Wagenmann M, Walker S, Wallace D, Wang DY, Waserman S, Wickman M, Williams S, Williams D, Wilson N, Wong G, Woo K, Wright J, Wroczynski P, Xepapadaki P, Yakovliev P, Yamaguchi M, Yan K, Yeow Yap Y, Yawn B, Yiallouros P, Yorgancioglu A, Yoshihara S, Young I, Yusuf OB, Zaidi A, Zaitoun F, Zar H, Zedda M, Zernotti ME, Zhang L, Zhong N, Zidarn M, Zubrinich C. Cabbage and fermented vegetables: From death rate heterogeneity in countries to candidates for mitigation strategies of severe COVID-19. Allergy 2021; 76:735-750. [PMID: 32762135 PMCID: PMC7436771 DOI: 10.1111/all.14549] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 07/31/2020] [Accepted: 08/04/2020] [Indexed: 12/20/2022]
Abstract
Large differences in COVID‐19 death rates exist between countries and between regions of the same country. Some very low death rate countries such as Eastern Asia, Central Europe, or the Balkans have a common feature of eating large quantities of fermented foods. Although biases exist when examining ecological studies, fermented vegetables or cabbage have been associated with low death rates in European countries. SARS‐CoV‐2 binds to its receptor, the angiotensin‐converting enzyme 2 (ACE2). As a result of SARS‐CoV‐2 binding, ACE2 downregulation enhances the angiotensin II receptor type 1 (AT1R) axis associated with oxidative stress. This leads to insulin resistance as well as lung and endothelial damage, two severe outcomes of COVID‐19. The nuclear factor (erythroid‐derived 2)‐like 2 (Nrf2) is the most potent antioxidant in humans and can block in particular the AT1R axis. Cabbage contains precursors of sulforaphane, the most active natural activator of Nrf2. Fermented vegetables contain many lactobacilli, which are also potent Nrf2 activators. Three examples are: kimchi in Korea, westernized foods, and the slum paradox. It is proposed that fermented cabbage is a proof‐of‐concept of dietary manipulations that may enhance Nrf2‐associated antioxidant effects, helpful in mitigating COVID‐19 severity.
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Affiliation(s)
- Jean Bousquet
- Charité Universitätsmedizin BerlinHumboldt‐Universität zu Berlin Berlin Germany
- Department of Dermatology and Allergy Berlin Institute of HealthComprehensive Allergy Center Berlin Germany
- MACVIA‐France and CHU Montpellier France
| | - Josep M. Anto
- Centre for Research in Environmental Epidemiology (CREAL) ISGlobAL Barcelona Spain
- IMIM (Hospital del Mar Research Institute) Barcelona Spain
- Universitat Pompeu Fabra (UPF) Barcelona Spain
- CIBER Epidemiología y Salud Pública (CIBERESP) Barcelona Spain
| | | | - Tari Haahtela
- Skin and Allergy Hospital Helsinki University Hospital University of Helsinki Finland
| | - Susana C. Fonseca
- Faculty of Sciences GreenUPorto ‐ Sustainable Agrifood Production Research Centre DGAOTUniversity of Porto Porto Portugal
| | - Guido Iaccarino
- Department of Advanced Biomedical Sciences Federico II University Napoli Italy
| | - Hubert Blain
- Department of Geriatrics Montpellier University hospital and MUSE Montpellier France
| | - Alain Vidal
- World Business Council for Sustainable Development (WBCSD) Geneva Switzerland
- AgroParisTech ‐ Paris Institute of Technology for Life, Food and Environmental Sciences Paris France
| | - Aziz Sheikh
- Usher Institute University of Edinburgh Scotland, UK
| | - Cezmi A. Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Torsten Zuberbier
- Charité Universitätsmedizin BerlinHumboldt‐Universität zu Berlin Berlin Germany
- Department of Dermatology and Allergy Berlin Institute of HealthComprehensive Allergy Center Berlin Germany
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Bousquet J, Anto JM, Bachert C, Haahtela T, Zuberbier T, Czarlewski W, Bedbrook A, Bosnic-Anticevich S, Walter Canonica G, Cardona V, Costa E, Cruz AA, Erhola M, Fokkens WJ, Fonseca JA, Illario M, Ivancevich JC, Jutel M, Klimek L, Kuna P, Kvedariene V, Le L, Larenas-Linnemann DE, Laune D, Lourenço OM, Melén E, Mullol J, Niedoszytko M, Odemyr M, Okamoto Y, Papadopoulos NG, Patella V, Pfaar O, Pham-Thi N, Rolland C, Samolinski B, Sheikh A, Sofiev M, Suppli Ulrik C, Todo-Bom A, Tomazic PV, Toppila-Salmi S, Tsiligianni I, Valiulis A, Valovirta E, Ventura MT, Walker S, Williams S, Yorgancioglu A, Agache I, Akdis CA, Almeida R, Ansotegui IJ, Annesi-Maesano I, Arnavielhe S, Basagaña X, D Bateman E, Bédard A, Bedolla-Barajas M, Becker S, Bennoor KS, Benveniste S, Bergmann KC, Bewick M, Bialek S, E Billo N, Bindslev-Jensen C, Bjermer L, Blain H, Bonini M, Bonniaud P, Bosse I, Bouchard J, Boulet LP, Bourret R, Boussery K, Braido F, Briedis V, Briggs A, Brightling CE, Brozek J, Brusselle G, Brussino L, Buhl R, Buonaiuto R, Calderon MA, Camargos P, Camuzat T, Caraballo L, Carriazo AM, Carr W, Cartier C, Casale T, Cecchi L, Cepeda Sarabia AM, H Chavannes N, Chkhartishvili E, Chu DK, Cingi C, Correia de Sousa J, Costa DJ, Courbis AL, Custovic A, Cvetkosvki B, D'Amato G, da Silva J, Dantas C, Dokic D, Dauvilliers Y, De Feo G, De Vries G, Devillier P, Di Capua S, Dray G, Dubakiene R, Durham SR, Dykewicz M, Ebisawa M, Gaga M, El-Gamal Y, Heffler E, Emuzyte R, Farrell J, Fauquert JL, Fiocchi A, Fink-Wagner A, Fontaine JF, Fuentes Perez JM, Gemicioğlu B, Gamkrelidze A, Garcia-Aymerich J, Gevaert P, Gomez RM, González Diaz S, Gotua M, Guldemond NA, Guzmán MA, Hajjam J, Huerta Villalobos YR, Humbert M, Iaccarino G, Ierodiakonou D, Iinuma T, Jassem E, Joos G, Jung KS, Kaidashev I, Kalayci O, Kardas P, Keil T, Khaitov M, Khaltaev N, Kleine-Tebbe J, Kouznetsov R, Kowalski ML, Kritikos V, Kull I, La Grutta S, Leonardini L, Ljungberg H, Lieberman P, Lipworth B, Lodrup Carlsen KC, Lopes-Pereira C, Loureiro CC, Louis R, Mair A, Mahboub B, Makris M, Malva J, Manning P, Marshall GD, Masjedi MR, Maspero JF, Carreiro-Martins P, Makela M, Mathieu-Dupas E, Maurer M, De Manuel Keenoy E, Melo-Gomes E, Meltzer EO, Menditto E, Mercier J, Micheli Y, Miculinic N, Mihaltan F, Milenkovic B, Mitsias DI, Moda G, Mogica-Martinez MD, Mohammad Y, Montefort S, Monti R, Morais-Almeida M, Mösges R, Münter L, Muraro A, Murray R, Naclerio R, Napoli L, Namazova-Baranova L, Neffen H, Nekam K, Neou A, Nordlund B, Novellino E, Nyembue D, O'Hehir R, Ohta K, Okubo K, Onorato GL, Orlando V, Ouedraogo S, Palamarchuk J, Pali-Schöll I, Panzner P, Park HS, Passalacqua G, Pépin JL, Paulino E, Pawankar R, Phillips J, Picard R, Pinnock H, Plavec D, Popov TA, Portejoie F, Price D, Prokopakis EP, Psarros F, Pugin B, Puggioni F, Quinones-Delgado P, Raciborski F, Rajabian-Söderlund R, Regateiro FS, Reitsma S, Rivero-Yeverino D, Roberts G, Roche N, Rodriguez-Zagal E, Rolland C, Roller-Wirnsberger RE, Rosario N, Romano A, Rottem M, Ryan D, Salimäki J, Sanchez-Borges MM, Sastre J, Scadding GK, Scheire S, Schmid-Grendelmeier P, Schünemann HJ, Sarquis Serpa F, Shamji M, Sisul JC, Sofiev M, Solé D, Somekh D, Sooronbaev T, Sova M, Spertini F, Spranger O, Stellato C, Stelmach R, Thibaudon M, To T, Toumi M, Usmani O, Valero AA, Valenta R, Valentin-Rostan M, Pereira MU, van der Kleij R, Van Eerd M, Vandenplas O, Vasankari T, Vaz Carneiro A, Vezzani G, Viart F, Viegi G, Wallace D, Wagenmann M, Wang DY, Waserman S, Wickman M, Williams DM, Wong G, Wroczynski P, Yiallouros PK, Yusuf OM, Zar HJ, Zeng S, Zernotti ME, Zhang L, Shan Zhong N, Zidarn M. ARIA digital anamorphosis: Digital transformation of health and care in airway diseases from research to practice. Allergy 2020; 76:168-190. [PMID: 32512619 DOI: 10.1111/all.14422] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 05/04/2020] [Accepted: 05/19/2020] [Indexed: 12/12/2022]
Abstract
Digital anamorphosis is used to define a distorted image of health and care that may be viewed correctly using digital tools and strategies. MASK digital anamorphosis represents the process used by MASK to develop the digital transformation of health and care in rhinitis. It strengthens the ARIA change management strategy in the prevention and management of airway disease. The MASK strategy is based on validated digital tools. Using the MASK digital tool and the CARAT online enhanced clinical framework, solutions for practical steps of digital enhancement of care are proposed.
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Affiliation(s)
- Jean Bousquet
- MACVIA-France and CHU, Montpellier, France.,INSERM U 1168, VIMA: Ageing and Chronic Diseases Epidemiological and Public Health Approaches, Villejuif, Université Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny le Bretonneux, France, and Charité, Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Comprehensive Allergy Center, Department of Dermatology and Allergy, Berlin, Germany
| | - Josep M Anto
- ISGlobAL, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,IMIM (Hospital del Mar Research Institute), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Claus Bachert
- Upper Airways Research Laboratory, ENT Department, Ghent University Hospital, Ghent, Belgium and Sun Yat-sen University, International Airway Research Center, First Affiliated Hospital Guangzou, China, and Division of ENT Diseases, CLINTEC, Karolinska Institutet, Stockholm and Department of ENT Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Tari Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland
| | - Torsten Zuberbier
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Uniersität zu Berlin and Berlin Institute of Health, Comprehensive Allergy-Centre, Department of Dermatology and Allergy, Member of GA2LEN, Berlin, Germany
| | | | | | - Sinthia Bosnic-Anticevich
- Woolcock Institute of Medical Research, University of Sydney and Woolcock Emphysema Centre and Sydney Local Health District, Glebe, NSW, Australia
| | - G Walter Canonica
- Personalized Medicine Clinic Asthma & Allergy, Humanitas Clinical and Research Center IRCCS, Rozzano and Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
| | - Victoria Cardona
- Allergy Section, Department of Internal Medicine, Hospital Vall d'Hebron & ARADyAL research network, Barcelona, Spain
| | - Elisio Costa
- UCIBIO, REQUINTE, Faculty of Pharmacy and Competence Center on Active and Healthy Ageing of University of Porto (Porto4Ageing), Porto, Portugal
| | - Alvaro A Cruz
- ProAR-Nucleo de Excelencia em Asma, Federal University of Bahia, Brasil and WHO GARD Planning Group, Brazil
| | - Marina Erhola
- National Insitute for Health and Welfare, Helsinki, Finland
| | - Wytske J Fokkens
- Department of Otorhinolaryngology, Academic Medical Centres, AMC, Amsterdam, the Netherlands, and Euforea, Brussels, Belgium
| | - Joao A Fonseca
- CINTESIS, Center for Research in Health Technology and Information Systems, Faculdade de Medicina da Universidade do Porto; and Medida, Lda Porto, Portugal
| | - Maddalena Illario
- Division for Health Innovation, Campania Region and Federico II University Hospital Naples (R&D and DISMET), Naples, Italy
| | | | - Marek Jutel
- Department of Clinical Immunology, Wrocław Medical University and ALL-MED Medical Research Institute, Warsaw, Poland
| | - Ludger Klimek
- Center for Rhinology and Allergology, Wiesbaden, Germany
| | - Piotr Kuna
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Poland
| | - Violeta Kvedariene
- Institute of Biomedical Sciences, Department of Pathology, Faculty of Medicine, Vilnius University and Institute of Clinical Medicine, Clinic of Chest diseases and Allergology, Faculty of Medicine, Vilnius, Lithuania
| | - Ltt Le
- University of Medicine and Pharmacy, Hochiminh City, Vietnam
| | - Désirée E Larenas-Linnemann
- Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, México City, Mexico
| | | | - Olga M Lourenço
- Faculty of Health Sciences and CICS-UBI, Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
| | - Erik Melén
- Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm and Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Joaquim Mullol
- Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic; Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, University of Barcelona, Spain
| | - Marek Niedoszytko
- Department of Allergology, Medical University of Gdańsk, Gdańsk, Poland
| | - Mikaëla Odemyr
- EFA European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium
| | - Yoshitaka Okamoto
- Dept of Otorhinolaryngology, Chiba University Hospital, Chiba, Japan
| | - Nikos G Papadopoulos
- Division of Infection, Immunity & Respiratory Medicine, Royal Manchester Children's Hospital, University of Manchester, Manchester, UK.,Allergy Department, 2nd Pediatric Clinic, Athens General Children's Hospital "P&A Kyriakou", University of Athens, Athens, Greece
| | - Vincenzo Patella
- Division of Allergy and Clinical Immunology, Department of Medicine, Agency of Health ASL Salerno, "Santa Maria della Speranza" Hospital, Salerno, Italy
| | - Oliver Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany
| | - Nhân Pham-Thi
- Ecole polytechnique, Palaiseau, IRBA (Institut de Recherche bio-Médicale des Armées, Bretigny), France
| | | | - Boleslaw Samolinski
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - Aziz Sheikh
- The Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
| | - Mikhail Sofiev
- Finnish Meteorological Institute (FMI), Helsinki, Finland
| | - Charlotte Suppli Ulrik
- Department of Respiratory Medicine, Hvidovre Hospital & University of Copenhagen, Copenhagen, Denmark
| | - Ana Todo-Bom
- Allergy and Clinical Immunology Unit, Institute of Immunology, Faculty of Medicine, University of Coimbra, ICBR - Coimbra Institute for Clinical and Biomedical Research, CIBB, Coimbra, Portugal
| | | | - Sanna Toppila-Salmi
- Skin and Allergy Hospital, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland
| | - Ioanna Tsiligianni
- Health Planning Unit, Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece and International Primary Care Respiratory Group IPCRG, Aberdeen, Scotland
| | - Arunas Valiulis
- Vilnius University Faculty of Medicine, Institute of Clinical Medicine & Institute of Health Sciences, Vilnius, Lithuania
| | - Erkka Valovirta
- Department of Lung Diseases and Clinical Immunology, University of Turku and Terveystalo Allergy Clinic, Turku, Finland
| | - Maria-Teresa Ventura
- University of Bari Medical School, Unit of Geriatric Immunoallergology, Bari, Italy
| | | | - Sian Williams
- International Primary Care Respiratory Group IPCRG, Aberdeen, Scotland
| | - Arzu Yorgancioglu
- Department of Pulmonary Diseases, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Ioana Agache
- Faculty of Medicine, Transylvania University, Brasov, Romania
| | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Rute Almeida
- CINTESIS, Center for Research in Health Technology and Information Systems, Faculdade de Medicina da Universidade do Porto; and Medida, Lda Porto, Portugal
| | - Ignacio J Ansotegui
- Department of Allergy and Immunology, Hospital Quirón Bizkaia, Erandio, Spain
| | - Isabella Annesi-Maesano
- Epidemiology of Allergic and Respiratory Diseases, Department Institute Pierre Louis of Epidemiology and Public Health, INSERM and Sorbonne Universités, Medical School Saint Antoine, Paris, France
| | | | - Xavier Basagaña
- ISGlobAL, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,IMIM (Hospital del Mar Research Institute), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Eric D Bateman
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Annabelle Bédard
- ISGlobAL, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,IMIM (Hospital del Mar Research Institute), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | | | - Sven Becker
- Department of Otolaryngology, Head and Neck Surgery, University of Mainz, Mainz, Germany
| | - Kazi S Bennoor
- Dept of Respiratory Medicine, National Institute of Diseases of the Chest and Hospital, Dhaka, Bangladesh
| | - Samuel Benveniste
- National Center of Expertise in Cognitive Stimulation (CEN STIMCO), Broca Hospital, Paris, France.,Mines ParisTech CRI-PSL Research University, Fontainebleau, France
| | - Karl C Bergmann
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Uniersität zu Berlin and Berlin Institute of Health, Comprehensive Allergy-Centre, Department of Dermatology and Allergy, Member of GA2LEN, Berlin, Germany
| | | | - Slawomir Bialek
- Department of Biochemistry and Clinical Chemistry, Faculty of Pharmacy with the Division of Laboratory Medicine, Warsaw Medical University, Warsaw, Poland
| | | | - Carsten Bindslev-Jensen
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense Research Center for Anaphylaxis (ORCA), Odense, Denmark
| | - Leif Bjermer
- Department of Respiratory Medicine and Allergology, University Hospital, Lund, Sweden
| | - Hubert Blain
- Department of Geriatrics, Montpellier University hospital, Montpellier, France.,EA 2991, Euromov, University Montpellier, Montpellier, France
| | - Matteo Bonini
- UOC Pneumologia, Istituto di Medicina Interna, F Policlinico Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy, and National Heart and Lung Institute, Royal Brompton Hospital & Imperial College London, London, UK
| | | | | | | | | | | | - Koen Boussery
- Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - Fluvio Braido
- University of Genoa, Department of Internal Medicine (DiMI) and IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Vitalis Briedis
- Department of Clinical Pharmacy of Lithuanian, University of Health, Kaunas, Lithuania
| | - Andrew Briggs
- Health Economics and Health Technology Assessment, Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Christopher E Brightling
- Institute of Lung Health, Respiratory Biomedical Unit, University Hospitals of Leicester NHS Trust, Leicestershire, UK; Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
| | - Jan Brozek
- Department of Health Research Methods, Evidence and Impact, Division of Immunology and Allergy, McMaster University, Hamilton, ON, Canada
| | - Guy Brusselle
- Dept of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Luisa Brussino
- Department of Medical Sciences, Allergy and Clinical Immunology Unit, University of Torino & Mauriziano Hospital, Torino, Italy
| | - Roland Buhl
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | | | - Moises A Calderon
- Imperial College London-National Heart and Lung Institute, London, UK
| | - Paulo Camargos
- Department of Pediatrics, Medical School, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Thierry Camuzat
- Assitant Director General, Montpellier, Région Occitanie, Montpellier, France
| | - Luis Caraballo
- Institute for Immunological Research, University of Cartagena, Campus de Zaragocilla, Edificio Biblioteca Primer Piso, Cartagena, Colombia, and Foundation for the Development of Medical and Biological Sciences (Fundemeb), Cartagena, Colombia
| | | | - Warner Carr
- Allergy and Asthma Associates of Southern California, Mission Viejo, CA, USA
| | | | - Thomas Casale
- Division of Allergy/Immunology, University of South Florida, Tampa, FL, USA
| | - Lorenzo Cecchi
- SOS Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy
| | - Alfonso M Cepeda Sarabia
- Allergy and Immunology Laboratory, Metropolitan University, Simon Bolivar University, Barranquilla, Colombia and SLaai, Sociedad Latinoamericana de Allergia, Asma e Immunologia, Branquilla, Colombia
| | - Niels H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Ekaterine Chkhartishvili
- Chachava Clinic, David Tvildiani Medical University-AIETI Medical School, Grigol Robakidze University, Tbilisi, Georgia
| | - Derek K Chu
- Department of Health Research Methods, Evidence and Impact, Division of Immunology and Allergy, McMaster University, Hamilton, ON, Canada
| | - Cemal Cingi
- ENT Department, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Jaime Correia de Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Guimaraes, Portugal
| | | | | | - Adnan Custovic
- Centre for Respiratory Medicine and Allergy, Institute of Inflammation and Repair, University of Manchester and University Hospital of South Manchester, Manchester, UK
| | - Biljana Cvetkosvki
- Woolcock Institute of Medical Research, University of Sydney and Woolcock Emphysema Centre and Sydney Local Health District, Glebe, NSW, Australia
| | - Gennaro D'Amato
- Division of Respiratory and Allergic Diseases, Department of Respiratory Diseases, High Specialty Hospital ACardarelli, Napoli, Italy
| | - Jane da Silva
- Department of Internal Medicine and Allergy Clinic of Professor Polydoro Ernani de São, Thiago University Hospital, Federal University of Santa Catarina (UFSC), Florianopolis-SC, Brazil
| | - Carina Dantas
- Cáritas Diocesana de Coimbra, Coimbra, Portugal, Ageing@Coimbra EIP-AHA Reference Site, Coimbra, Portugal
| | - Dejan Dokic
- Medical Faculty Skopje, University Clinic of Pulmology and Allergy, Skopje, Republic of Macedonia
| | - Yves Dauvilliers
- Sleep Unit, Department of Neurology, Hôpital Gui-de-Chauliac Montpellier, Inserm U1061, Montpellier, France
| | - Giulia De Feo
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | | | - Philippe Devillier
- UPRES EA220, Pôle des Maladies des Voies Respiratoires, Hôpital Foch, Université Paris-Saclay, Suresnes, France
| | | | - Gerard Dray
- IMT Mines Ales, Université Montpellier, Montpellier, France
| | - Ruta Dubakiene
- Clinic of Infectious, Chest Diseases, Dermatology and Allergology, Vilnius University, Vilnius, Lithuania
| | - Stephen R Durham
- Allergy and Clinical Immunology Section, National Heart and Lung Institute, Imperial College London, London, UK
| | - Mark Dykewicz
- Section of Allergy and Immunology, Saint Louis University School of Medicine, Saint Louis, MO, USA
| | - Motohiro Ebisawa
- Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Japan
| | - Mina Gaga
- ERS President 2017-2018, Athens Chest Hospital, 7th Resp Med Dept and Asthma Center, Athens, Greece
| | - Yehia El-Gamal
- Pediatric Allergy and Immunology Unit, Children's hospital, Ain Shams University, Cairo, Egypt
| | - Enrico Heffler
- Personalized Medicine Clinic Asthma & Allergy, Humanitas Clinical and Research Center IRCCS, Rozzano and Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
| | - Regina Emuzyte
- Clinic of Children's Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - John Farrell
- Department of Health, Social Services and Public Safety, Northern Ireland Belfast, UK
| | - Jean-Luc Fauquert
- CHU Clermont-Ferrand, Unité d'allergologie de l'enfant, pôle pédiatrique, Hôpital Estaing, Clermont-Ferrand, France
| | - Alessandro Fiocchi
- Division of Allergy, Department of Pediatric Medicine-The Bambino Gesù Children's Research Hospital Holy See, Rome, Italy
| | | | | | - José M Fuentes Perez
- Hospital General Regional 1 "Dr Carlos Mc Gregor Sanchez Navarro" IMSS, Mexico City, Mexico
| | - Bilun Gemicioğlu
- Department of Pulmonary Diseases, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, Turkey
| | - Amiran Gamkrelidze
- Gamkrelidze National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia
| | | | - Philippe Gevaert
- Upper Airways Research Laboratory, ENT Department, Ghent University Hospital, Ghent, Belgium and Sun Yat-sen University, International Airway Research Center, First Affiliated Hospital Guangzou, China, and Division of ENT Diseases, CLINTEC, Karolinska Institutet, Stockholm and Department of ENT Diseases, Karolinska University Hospital, Stockholm, Sweden
| | | | | | - Maia Gotua
- Center of Allergy and Immunology, Georgian Association of Allergology and Clinical Immunology, Tbilisi, Georgia
| | - Nick A Guldemond
- Institute of Health Policy and Management iBMG, Erasmus University, Rotterdam, The Netherlands
| | - Maria-Antonieta Guzmán
- Immunology and Allergy Division, Clinical Hospital, University of Chile, Santiago, Chile
| | - Jawad Hajjam
- Centich: Centre d'Expertise National des Technologies de l'Information et de la communication pour l'autonomie, Groupe VyV, Conseil Régional des Pays de la Loire, Centre d'expertise PartenariatEuropéen d'Innovation pour un vieillissement actif et en bonne santé, Nantes, France
| | | | - Marc Humbert
- Université Paris-Sud; Service de Pneumologie, Hôpital Bicêtre; Inserm UMR_S999, Le Kremlin Bicêtre, France
| | - Guido Iaccarino
- Department of Advanced Biomedical Sciences, Federico II University, Napoli, Italy
| | - Despo Ierodiakonou
- Department of Social Medicine, Faculty of Medicine, University of Crete, and International Primary Care Respiratory Group, Crete, Greece
| | - Tomohisa Iinuma
- Dept of Otorhinolaryngology, Chiba University Hospital, Chiba, Japan
| | - Ewa Jassem
- Department of Allergology, Medical University of Gdańsk, Gdansk, Poland
| | - Guy Joos
- Dept of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Ki-Suck Jung
- Hallym University College of Medicine, Hallym University Sacred Heart Hospital, Gyeonggi-do, South Korea
| | - Igor Kaidashev
- Ukrainina Medical Stomatological Academy, Poltava, Ukraine
| | - Omer Kalayci
- Pediatric Allergy and Asthma Unit, Hacettepe University School of Medicine, Ankara, Turkey
| | - Przemyslaw Kardas
- First Department of Family Medicine, Medical University of Lodz, Poland
| | - Thomas Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, and Institute for Clinical Epidemiology and Biometry, University of Wuerzburg, and Institute of Health Resort Medicine and Health Promotion, Bavarian Health and Food Safety Authority, Bad Kissingen, Germany
| | - Musa Khaitov
- National Research Center, Institute of Immunology, Federal Medicobiological Agency, Laboratory of Molecular immunology, Moscow, Russian Federation
| | | | | | | | - Marek L Kowalski
- Department of Immunology and Allergy, Healthy Ageing Research Center, Medical University of Lodz, Lodz, Poland
| | - Vicky Kritikos
- Woolcock Institute of Medical Research, University of Sydney and Woolcock Emphysema Centre and Sydney Local Health District, Glebe, NSW, Australia
| | - Inger Kull
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, and Sach's Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Stefania La Grutta
- Institute for Research and Biomedical Innovation (IRIB), National Research Council (CNR), Palermo, Italy
| | - Lisa Leonardini
- Veneto Region, Mattone Internazionale Program, Venise, Italy
| | - Henrik Ljungberg
- Lung-Allergy Department at Astrid Lindgren Children's Hospital, Karolinska University Hospital, & Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Philip Lieberman
- Departments of Internal Medicine and Pediatrics (Divisions of Allergy and Immunology), University of Tennessee College of Medicine, Germantown, TN, USA
| | - Brian Lipworth
- Scottish Centre for Respiratory Research, Cardiovascular & Diabetes Medicine, Medical Research Institute, Ninewells Hospital, University of Dundee, Dundee, UK
| | - Karin C Lodrup Carlsen
- Oslo University Hospital, Department of Paediatrics, Oslo, and University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway
| | | | - Claudia C Loureiro
- Pneumology Department, Hospitais da Universidade de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Renaud Louis
- Department of Pulmonary Medicine, CHU Sart-Tilman, and GIGA I3 Research Group, Liege, Belgium
| | - Alpana Mair
- DG for Health and Social Care, Scottish Government, Edinburgh, UK
| | - Bassam Mahboub
- Department of Pulmonary Medicine, Rashid Hospital, Dubai, UAE
| | - Michaël Makris
- Allergy Unit "D Kalogeromitros", 2nd Department of Dermatology and Venereology, National & Kapodistrian University of Athens, "Attikon" University Hospital, Chaidari, Greece
| | - Joao Malva
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra; Coimbra, and Ageing@Coimbra EIP-AHA Reference Site, Coimbra, Portugal
| | - Patrick Manning
- Department of Medicine (RCSI), Bon Secours Hospital, Glasnevin, Dublin, Ireland
| | - Gailen D Marshall
- Division of Clinical Immunology and Allergy, Laboratory of Behavioral Immunology Research, The University of Mississippi Medical Center, Jackson, MS, USA
| | - Mohamed R Masjedi
- Tobacco Control Research Centre; Iranian Anti Tobacco Association, Tehran, Iran
| | - Jorge F Maspero
- Argentine Association of Allergy and Clinical Immunology, Buenos Aires, Argentina
| | - Pedro Carreiro-Martins
- Serviço de Immunologia, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, Lisbon, Portugal and Nova Medical School/Comprehensive Health Research Center (CHRC), Universidade Nova de Lisboa, Lisboa, Portugal
| | - Mika Makela
- Skin and Allergy Hospital, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland
| | | | - Marcus Maurer
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Uniersität zu Berlin and Berlin Institute of Health, Comprehensive Allergy-Centre, Department of Dermatology and Allergy, Member of GA2LEN, Berlin, Germany
| | | | - Elisabete Melo-Gomes
- PNDR, Portuguese National Programme for Respiratory Diseases, Faculdade de Medicina de Lisboa, Lisbon, Portugal
| | - Eli O Meltzer
- Allergy and Asthma Medical Group and Research Center, San Diego, CA, USA
| | | | - Jacques Mercier
- Department of Physiology, CHRU, University Montpellier, Vice President for Research, PhyMedExp, INSERM U1046, CNRS UMR 9214, Montpellier, France
| | | | | | - Florin Mihaltan
- National Institute of Pneumology M Nasta, Bucharest, Romania
| | - Branislava Milenkovic
- Clinic for Pulmonary Diseases, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Serbian Association for Asthma and COPD, Belgrade, Serbia
| | - Dimitirios I Mitsias
- Allergy Department, 2nd Pediatric Clinic, Athens General Children's Hospital "P&A Kyriakou", University of Athens, Athens, Greece
| | | | | | - Yousser Mohammad
- National Center for Research in Chronic Respiratory Diseases, Tishreen University School of Medicine, Latakia, and Syrian Private University-Damascus, Damascus, Syria
| | - Steve Montefort
- Lead Respiratory Physician Mater Dei Hospital Malta, Academic Head of Department and Professor of Medicine, University of Malta, Deputy Dean Faculty of Medicine and Surgery, University of Medicine, La Valette, Malta
| | - Ricardo Monti
- Department of Medical Sciences, Allergy and Clinical Immunology Unit, University of Torino & Mauriziano Hospital, Torino, Italy
| | | | - Ralph Mösges
- CRI-Clinical Research International-Ltd, Hamburg, Germany
| | - Lars Münter
- Danish Committee for Health Education, Copenhagen East, Denmark
| | - Antonella Muraro
- Food Allergy Referral Centre Veneto Region, Department of Women and Child Health, Padua General University Hospital, Padua, Italy
| | - Ruth Murray
- Research Fellow, OPC, Cambridge, UK and Director Medscript, Paraparaumu, New Zealand
| | | | - Luigi Napoli
- Director, Consortium of Pharmacies and Services COSAFER, Salerno, Italy
| | - Leyla Namazova-Baranova
- Scientific Centre of Children's Health under the PoH, Russian National Research Medical University named Pirogov, Moscow, Russia
| | - Hugo Neffen
- Director of Center of Allergy, Immunology and Respiratory Diseases, Center for Allergy and Immunology, Santa Fe, Argentina
| | - Kristoff Nekam
- Hospital of the Hospitaller Brothers in Buda, Budapest, Hungary
| | - Angelo Neou
- Die Hautambulanz and Rothhaar study center, Berlin, Germany
| | - Björn Nordlund
- Lung-Allergy Department at Astrid Lindgren Children's Hospital, Karolinska University Hospital, & Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Ettore Novellino
- Director of Department of Pharmacy of University of Naples Federico II, Naples, Italy
| | | | - Robyn O'Hehir
- Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Central Clinical School, Monash University, Melbourne, Vic., Australia; Department of Immunology, Monash University, Melbourne, Vic., Australia
| | - Ken Ohta
- Allergy Department, 2nd Pediatric Clinic, Athens General Children's Hospital "P&A Kyriakou", University of Athens, Athens, Greece
| | - Kimi Okubo
- Department of Otolaryngology, Nippon Medical School, Tokyo, Japan
| | | | - Valentina Orlando
- Director of Department of Pharmacy of University of Naples Federico II, Naples, Italy
| | - Solange Ouedraogo
- Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle, Ouagadougou, Burkina Faso
| | | | - Isabella Pali-Schöll
- Department of Comparative Medicine, Messerli Research Institute of the University of Veterinary Medicine and Medical University, Vienna, Austria
| | - Peter Panzner
- Department of Immunology and Allergology, Faculty of Medicine in Pilsen, Charles University in Prague, Pilsen, Czech Republic
| | - Hae-Sim Park
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, South Korea
| | - Gianni Passalacqua
- Allergy and Respiratory Diseases, Ospedale Policlino San Martino-University of Genoa, Genoa, Italy
| | - Jean-Louis Pépin
- Université Grenoble Alpes, Laboratoire HP2, Grenoble, INSERM, U1042 and CHU de Grenoble, Grenoble, France
| | | | - Ruby Pawankar
- Department of Pediatrics, Nippon Medical School, Tokyo, Japan
| | - Jim Phillips
- Centre for Empowering Patients and Communities, Faulkland, UK
| | - Robert Picard
- Conseil Général de l'Economie Ministère de l'Economie, de l'Industrie et du Numérique, Paris, France
| | - Hilary Pinnock
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - Davor Plavec
- Children's Hospital Srebrnjak, Zagreb, School of Medicine, University JJ Strossmayer, Osijek, Croatia
| | - Todor A Popov
- University Hospital "Sv Ivan Rilski", Sofia, Bulgaria
| | | | - David Price
- Observational and Pragmatic Research Institute Singapore, Singapore City, Singapore
| | - Emmanuel P Prokopakis
- Department of Otorhinolaryngology, University of Crete School of Medicine, Heraklion, Greece
| | - Fotis Psarros
- Allergy Department, Athens Naval Hospital, Athens, Greece
| | - Benoit Pugin
- European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Brussels, Belgium
| | - Francesca Puggioni
- Personalized Medicine Clinic Asthma & Allergy, Humanitas Clinical and Research Center IRCCS, Rozzano and Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
| | - Pablo Quinones-Delgado
- Agency for Social Services and Dependency, Regional Government for Equality, Social Policies and Conciliation of Andalucia, Seville, Spain
| | - Filip Raciborski
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | | | - Frederico S Regateiro
- Allergy and Clinical Immunology Unit, Institute of Immunology, Faculty of Medicine, University of Coimbra, ICBR - Coimbra Institute for Clinical and Biomedical Research, CIBB, Coimbra, Portugal
| | - Sietze Reitsma
- Department of Otorhinolaryngology, Academic Medical Centres, AMC, Amsterdam, the Netherlands, and Euforea, Brussels, Belgium
| | | | - Graham Roberts
- David Hide Centre, St Mary's Hospital, Isle of Wight and University of Southampton, Southampton, UK
| | - Nicolas Roche
- Pneumologie et Soins Intensifs Respiratoires, Centre Hôpital Cochin, Hôpitaux Universitaires Paris, Paris, France
| | | | | | | | - Nelson Rosario
- Hospital de Clinicas, University of Parana, Parana, Brazil
| | - Antonino Romano
- Allergy Unit, Presidio Columbus, Rome, Catholic University of Sacred Heart, Rome and IRCCS Oasi Maria SS, Troina, Italy
| | - Menachem Rottem
- Division of Allergy Asthma and Clinical Immunology, Emek Medical Center, Afula, Israel
| | - Dermot Ryan
- Honorary Clinical Research Fellow, Allergy and Respiratory Research Group, The University of Edinburgh, Edinburgh, UK
| | | | - Mario M Sanchez-Borges
- Allergy and Clinical Immunology Department, Centro Médico-Docente la, Trinidad and Clínica El Avila, Caracas, Venezuela
| | - Joaquin Sastre
- Faculty of Medicine, Autnonous University of Madrid, Madrid, Spain
| | | | - Sophie Scheire
- Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | | | - Holger J Schünemann
- Department of Health Research Methods, Evidence and Impact, Division of Immunology and Allergy, McMaster University, Hamilton, ON, Canada
| | - Faradiba Sarquis Serpa
- Asthma Reference Center, School of Medicine of Santa Casa de Misericordia of Vitoria-Esperito Santo, Vitoria, Brazil
| | - Mohamed Shamji
- Immunomodulation and Tolerance Group, Imperial College London, and Allergy and Clinical Immunology, Imperial College London, London, UK
| | | | - Mikhail Sofiev
- Finnish Meteorological Institute (FMI), Helsinki, Finland
| | - Dirceu Solé
- Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of São Paulo, Sao Paulo, Brazil
| | - David Somekh
- European Health Futures Forum (EHFF), Dromahair, UK
| | - Talant Sooronbaev
- Kyrgyzstan National Centre of Cardiology and Internal Medicine, Euro-Asian Respiratory Society, Bishkek, Kyrgyzstan
| | - Milan Sova
- Department of Respiratory Medicine, University Hospital Olomouc, Olomouc, Czech Republic
| | - François Spertini
- Service Immunologie et Allergie, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Otto Spranger
- Global Allergy and Airways Patient Platform GAAPP, Vienna, Austria
| | - Cristiana Stellato
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | - Rafael Stelmach
- Pulmonary Division, Heart Institute (InCor), Hospital da Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Michel Thibaudon
- RNSA (Réseau National de Surveillance Aérobiologique), Brussieu, France
| | - Teresa To
- Sidkkids Hospitala and Institute of Health Policy, Management and Evaluation, Toronto, Canada
| | - Mondher Toumi
- Public Health, Aix-marseille University, Marseille, France
| | - Omar Usmani
- National Heart and Lung Institute (NHLI), Imperial College London & Royal Brompton Hospital, Airways Disease Section, London, UK
| | - Antonio A Valero
- Pneumology and Allergy Department CIBERES and Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Rudolph Valenta
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.,NRC Institute of Immunology FMBA of Russia, Moscow, Russia and Laboratory of Immunopathology, Department of Clinical Immunology and Allergy, Sechenov First Moscow State Medical University, Moscow, Russia
| | | | | | - Rianne van der Kleij
- Department of Public Health & Primary Care, Leiden University Medical Center (LUMC), Leiden, The Netherlands, Erasmus MC, Department of Obstetrics and Gynaecology, University Medical Center, Rotterdam, The Netherlands
| | | | - Olivier Vandenplas
- Department of Chest Medicine, Centre Hospitalier Universitaire UCL Namur, Université Catholique de Louvain, Yvoir, Belgium
| | - Tuula Vasankari
- FILHA, Finnish Lung Association, Helsinki, and Turku University, Turku, Finland
| | - Antonio Vaz Carneiro
- Instituto de Medicina Preventiva e Saude Publica, Instituto de Saude Ambiental, Centro de Estudos de Medicina Baseada na Evidência, Cochrane, Portugal
| | - Giorgio Vezzani
- Pulmonary Unit, Department of Medical Specialties, Arcispedale SMaria Nuova/IRCCS, AUSL di Reggio Emilia, Reggio Emilia, Italy
| | | | - Giovanni Viegi
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa (Italy), Via Trieste 41, 56126, Pisa, Italy; and CNR Institute of Biomedicine and Molecular Immunology "A Monroy", Palermo, Italy
| | - Dana Wallace
- Nova Southeastern University, Fort Lauderdale, FL, USA
| | - Martin Wagenmann
- Department of Otorhinolaryngology, HNO-Klinik, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - De Yun Wang
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore City, Singapore
| | - Susan Waserman
- Department of Medicine, Clinical Immunology and Allergy, McMaster University, Hamilton, ON, Canada
| | - Magnus Wickman
- Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden
| | - Dennis M Williams
- Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA
| | - Gary Wong
- Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Piotr Wroczynski
- Department of Physical Pharmacy and Bioanalysis, Faculty of Pharmacy with the Laboratory Medicine Division, Medical University of Warsaw, Warsaw, Poland
| | - Panayiotis K Yiallouros
- Cyprus International Institute for Environmental & Public Health in Association with Harvard School of Public Health, Cyprus University of Technology, Limassol, Cyprus; Department of Pediatrics, Hospital "Archbishop Makarios III", Nicosia, Cyprus
| | | | - Heather J Zar
- Department of Paediatrics and Child Health, Red Cross Children's Hospital, and MRC Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
| | | | | | - Luo Zhang
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital and Beijing Institute of Otolaryngology, Beijing, China
| | - Nan Shan Zhong
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Mihaela Zidarn
- University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia
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Dykewicz MS, Wallace DV, Amrol DJ, Baroody FM, Bernstein JA, Craig TJ, Dinakar C, Ellis AK, Finegold I, Golden DBK, Greenhawt MJ, Hagan JB, Horner CC, Khan DA, Lang DM, Larenas-Linnemann DES, Lieberman JA, Meltzer EO, Oppenheimer JJ, Rank MA, Shaker MS, Shaw JL, Steven GC, Stukus DR, Wang J, Dykewicz MS, Wallace DV, Dinakar C, Ellis AK, Golden DBK, Greenhawt MJ, Horner CC, Khan DA, Lang DM, Lieberman JA, Oppenheimer JJ, Rank MA, Shaker MS, Stukus DR, Wang J, Dykewicz MS, Wallace DV, Amrol DJ, Baroody FM, Bernstein JA, Craig TJ, Finegold I, Hagan JB, Larenas-Linnemann DES, Meltzer EO, Shaw JL, Steven GC. Rhinitis 2020: A practice parameter update. J Allergy Clin Immunol 2020; 146:721-767. [PMID: 32707227 DOI: 10.1016/j.jaci.2020.07.007] [Citation(s) in RCA: 110] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 06/22/2020] [Accepted: 07/01/2020] [Indexed: 12/12/2022]
Abstract
This comprehensive practice parameter for allergic rhinitis (AR) and nonallergic rhinitis (NAR) provides updated guidance on diagnosis, assessment, selection of monotherapy and combination pharmacologic options, and allergen immunotherapy for AR. Newer information about local AR is reviewed. Cough is emphasized as a common symptom in both AR and NAR. Food allergy testing is not recommended in the routine evaluation of rhinitis. Intranasal corticosteroids (INCS) remain the preferred monotherapy for persistent AR, but additional studies support the additive benefit of combination treatment with INCS and intranasal antihistamines in both AR and NAR. Either intranasal antihistamines or INCS may be offered as first-line monotherapy for NAR. Montelukast should only be used for AR if there has been an inadequate response or intolerance to alternative therapies. Depot parenteral corticosteroids are not recommended for treatment of AR due to potential risks. While intranasal decongestants generally should be limited to short-term use to prevent rebound congestion, in limited circumstances, patients receiving regimens that include an INCS may be offered, in addition, an intranasal decongestant for up to 4 weeks. Neither acupuncture nor herbal products have adequate studies to support their use for AR. Oral decongestants should be avoided during the first trimester of pregnancy. Recommendations for use of subcutaneous and sublingual tablet allergen immunotherapy in AR are provided. Algorithms based on a combination of evidence and expert opinion are provided to guide in the selection of pharmacologic options for intermittent and persistent AR and NAR.
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Affiliation(s)
- Mark S Dykewicz
- Section of Allergy and Immunology, Division of Infectious Diseases, Allergy and Immunology, Department of Internal Medicine, School of Medicine, Saint Louis University, St Louis, Mo.
| | - Dana V Wallace
- Department of Medicine, Nova Southeastern Allopathic Medical School, Fort Lauderdale, Fla
| | - David J Amrol
- Department of Internal Medicine, School of Medicine, University of South Carolina, Columbia, SC
| | - Fuad M Baroody
- Department of Otolaryngology-Head and Neck Surgery, Pritzker School of Medicine, University of Chicago, Chicago, Ill
| | - Jonathan A Bernstein
- Allergy Section, Division of Immunology, Department of Internal Medicine, College of Medicine, University of Cincinnati, Cincinnati, Ohio
| | - Timothy J Craig
- Departments of Medicine and Pediatrics, Penn State University, Hershey, Pa
| | - Chitra Dinakar
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, School of Medicine, Stanford University, Stanford, Calif
| | - Anne K Ellis
- Division of Allergy and Immunology, Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Ira Finegold
- Division of Allergy and Immunology, Department of Medicine, Mount Sinai West, New York, NY
| | - David B K Golden
- Division of Allergy and Clinical Immunology, Department of Medicine, School of Medicine, John Hopkins University, Baltimore, Md
| | - Matthew J Greenhawt
- Section of Allergy and Immunology, Department of Pediatrics, Children's Hospital Colorado, School of Medicine, University of Colorado, Aurora, Colo
| | - John B Hagan
- Division of Allergic Diseases, Mayo Clinic, Rochester, Minn
| | - Caroline C Horner
- Division of Allergy, Immunology and Pulmonary Medicine, Department of Pediatrics, School of Medicine, Washington University, St Louis, Mo
| | - David A Khan
- Division of Allergy and Immunology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Tex
| | - David M Lang
- Department of Allergy and Clinical Immunology, Respiratory Institute, Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, Cleveland, Ohio
| | | | - Jay A Lieberman
- Division of Pulmonology Allergy and Immunology, Department of Pediatrics, The University of Tennessee Health Science Center, Memphis, Tenn
| | - Eli O Meltzer
- Division of Allergy and Immunology, Department of Pediatrics, School of Medicine, University of California, San Diego, Calif; Allergy and Asthma Medical Group and Research Center, San Diego, Calif
| | - John J Oppenheimer
- Division of Pulmonary & Critical Care Medicine and Allergic & Immunologic Diseases, Department of Internal Medicine, University of Medicine and Dentistry of New Jersey-Rutgers New Jersey Medical School, New Brunswick, NJ; Pulmonary and Allergy Associates, Morristown, NJ
| | - Matthew A Rank
- Division of Allergy, Asthma, and Clinical Immunology, Mayo Clinic in Arizona, Scottsdale, Ariz
| | - Marcus S Shaker
- Department of Pediatrics, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | | | | | - David R Stukus
- Division of Allergy and Immunology, Nationwide Children's Hospital, Columbus, Ohio; Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, Ohio
| | - Julie Wang
- Division of Allergy and Immunology, Department of Pediatrics, The Elliot and Roslyn Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai, New York, NY
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Meltzer EO, Bachert C, Mayer MJ, Kopietz F, Koltun A, Maus J, D'Addio AD. Deposition characteristics of a novel intranasal formulation of azelastine hydrochloride plus fluticasone propionate in an anatomic model of the human nasal cavity. Allergy Asthma Proc 2020; 41:265-270. [PMID: 32393418 DOI: 10.2500/aap.2020.41.200028] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background: Intranasal antihistamines and steroids should be delivered in a volume and with a technique that allow for optimal drug retention within the entire nasal cavity, maximize local absorption by the nasal mucosa, and, subsequently, increase the potential for the most desirable local availability and therapeutic effect. Objective: This in vitro evaluation simulated nasal medication deposition and evaluated the extent of runoff. MP-AzeFlu, a novel intranasal formulation of azelastine hydrochloride (AZE) plus fluticasone propionate (FP), was compared with sequential sprays of available commercial products with the individual medication components. Methods: A model of a normal adult human nasal cavity was used to visualize deposition of nasal spray products. A single spray of MP-AzeFlu (0.137 mL [137 μg of AZE/50 μg of FP]) or single sequential sprays of AZE nasal spray (0.137 mL [137 μg]) followed by brand name or generic FP nasal spray (0.100 mL [50 μg]) were manually actuated into the model. The interior was coated with a water-sensitive dye that changes to magenta when exposed to aqueous-based formulations. A slight vacuum was applied during spray delivery to simulate sniffing. The results were photographed by using anterior and lateral views. Results: Three replicates of MP-AzeFlu showed no dripping from the front of the nostril or backflow from the nasal cavity. However, three replicates of AZE nasal spray, followed by a brand name or generic FP nasal spray, showed significant dripping from the front of the nostril and backflow from the nasal cavity. Conclusion: A single spray of MP-AzeFlu resulted in no runoff compared with sequential dosing of the two other therapeutic products. Product runoff is likely due to the volume exceeding the capacity of the nasal cavity model. Furthermore, the common clinical dosing regimen of two sprays per nostril of each of the individual components would promote even greater increased undesirable flooding and leakage.
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Affiliation(s)
- Eli O. Meltzer
- From the Department of Pediatrics, Division of Allergy and Immunology, University of California, San Diego, School of Medicine California
| | - Claus Bachert
- ENT Department, Ghent University Hospital, Ghent, Belgium
| | | | - Ferdinand Kopietz
- Medical Affairs, Meda Pharma GmbH & Co. KG (a Mylan Company), Bad Homburg, Germany
| | - Arkady Koltun
- Global Medical Affairs, Mylan Inc., Canonsburg, Pennsylvania; and
| | - Joachim Maus
- Medical Affairs, Meda Pharma GmbH & Co. KG (a Mylan Company), Bad Homburg, Germany
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Bédard A, Antó JM, Fonseca JA, Arnavielhe S, Bachert C, Bedbrook A, Bindslev‐Jensen C, Bosnic‐Anticevich S, Cardona V, Cruz AA, Fokkens WJ, Garcia‐Aymerich J, Hellings PW, Ivancevich JC, Klimek L, Kuna P, Kvedariene V, Larenas‐Linnemann D, Melén E, Monti R, Mösges R, Mullol J, Papadopoulos NG, Pham‐Thi N, Samolinski B, Tomazic PV, Toppila‐Salmi S, Ventura MT, Yorgancioglu A, Bousquet J, Pfaar O, Basagaña X, Aberer W, Agache I, Akdis CA, Akdis M, Aliberti MR, Almeida R, Amat F, Angles R, Annesi‐Maesano I, Ansotegui IJ, Anto JM, Arnavielle S, Asayag E, Asarnoj A, Arshad H, Avolio F, Bacci E, Baiardini I, Barbara C, Barbagallo M, Baroni I, Barreto BA, Bateman ED, Bedolla‐Barajas M, Bewick M, Beghé B, Bel EH, Bergmann KC, Bennoor KS, Benson M, Bertorello L, Białoszewski AZ, Bieber T, Bialek S, Bjermer L, Blain H, Blasi F, Blua A, Bochenska Marciniak M, Bogus‐Buczynska I, Boner AL, Bonini M, Bonini S, Bosse I, Bouchard J, Boulet LP, Bourret R, Bousquet PJ, Braido F, Briedis V, Brightling CE, Brozek J, Bucca C, Buhl R, Buonaiuto R, Panaitescu C, Burguete Cabañas MT, Burte E, Bush A, Caballero‐Fonseca F, Caillaud D, Caimmi D, Calderon MA, Camargos PAM, Camuzat T, Canfora G, Canonica GW, Carlsen KH, Carreiro‐Martins P, Carriazo AM, Carr W, Cartier C, Casale T, Castellano G, Cecchi L, Cepeda AM, Chavannes NH, Chen Y, Chiron R, Chivato T, Chkhartishvili E, Chuchalin AG, Chung KF, Ciaravolo MM, Ciceran A, Cingi C, Ciprandi G, Carvalho Coehlo AC, Colas L, Colgan E, Coll J, Conforti D, Constantinidis J, Correia de Sousa J, Cortés‐Grimaldo RM, Corti F, Costa E, Costa‐Dominguez MC, Courbis AL, Cox L, Crescenzo M, Custovic A, Czarlewski W, Dahlen SE, D'Amato G, Dario C, da Silva J, Dauvilliers Y, Darsow U, De Blay F, De Carlo G, Dedeu T, de Fátima Emerson M, De Feo G, De Vries G, De Martino B, Motta Rubini NP, Deleanu D, Denburg JA, Devillier P, Di Capua Ercolano S, Di Carluccio N, Didier A, Dokic D, Dominguez‐Silva MG, Douagui H, Dray G, Dubakiene R, Durham SR, Du Toit G, Dykewicz MS, El‐Gamal Y, Eklund P, Eller E, Emuzyte R, Farrell J, Farsi A, Ferreira de Mello J, Ferrero J, Fink‐Wagner A, Fiocchi A, Fontaine JF, Forti S, Fuentes‐Perez JM, Gálvez‐Romero JL, Gamkrelidze A, García‐Cobas CY, Garcia‐Cruz MH, Gemicioğlu B, Genova S, Christoff G, Gereda JE, Gerth van Wijk R, Gomez RM, Gómez‐Vera J, González Diaz S, Gotua M, Grisle I, Guidacci M, Guldemond NA, Gutter Z, Guzmán MA, Haahtela T, Hajjam J, Hernández L, Hourihane JO, Huerta‐Villalobos YR, Humbert M, Iaccarino G, Illario M, Ispayeva Z, Jares EJ, Jassem E, Johnston SL, Joos G, Jung KS, Just J, Jutel M, Kaidashev I, Kalayci O, Kalyoncu AF, Karjalainen J, Kardas P, Keil T, Keith PK, Khaitov M, Khaltaev N, Kleine‐Tebbe J, Kowalski ML, Kuitunen M, Kull I, Kupczyk M, Krzych‐Fałta E, Lacwik P, Laune D, Lauri D, Lavrut J, Le LTT, Lessa M, Levato G, Li J, Lieberman P, Lipiec A, Lipworth B, Lodrup Carlsen KC, Louis R, Lourenço O, Luna‐Pech JA, Magnan A, Mahboub B, Maier D, Mair A, Majer I, Malva J, Mandajieva E, Manning P, De Manuel Keenoy E, Marshall GD, Masjedi MR, Maspero JF, Mathieu‐Dupas E, Matta Campos JJ, Matos AL, Maurer M, Mavale‐Manuel S, Mayora O, Meco C, Medina‐Avalos MA, Melo‐Gomes E, Meltzer EO, Menditto E, Mercier J, Miculinic N, Mihaltan F, Milenkovic B, Moda G, Mogica‐Martinez MD, Mohammad Y, Momas I, Montefort S, Mora Bogado D, Morais‐Almeida M, Morato‐Castro FF, Mota‐Pinto A, Moura Santo P, Münter L, Muraro A, Murray R, Naclerio R, Nadif R, Nalin M, Napoli L, Namazova‐Baranova L, Neffen H, Niedeberger V, Nekam K, Neou A, Nieto A, Nogueira‐Silva L, Nogues M, Novellino E, Nyembue TD, O'Hehir RE, Odzhakova C, Ohta K, Okamoto Y, Okubo K, Onorato GL, Ortega Cisneros M, Ouedraogo S, Pali‐Schöll I, Palkonen S, Panzner P, Park HS, Papi A, Passalacqua G, Paulino E, Pawankar R, Pedersen S, Pépin JL, Pereira AM, Persico M, Phillips J, Picard R, Pigearias B, Pin I, Pitsios C, Plavec D, Pohl W, Popov TA, Portejoie F, Potter P, Pozzi AC, Price D, Prokopakis EP, Puy R, Pugin B, Pulido Ross RE, Przemecka M, Rabe KF, Raciborski F, Rajabian‐Soderlund R, Reitsma S, Ribeirinho I, Rimmer J, Rivero‐Yeverino D, Rizzo JA, Rizzo MC, Robalo‐Cordeiro C, Rodenas F, Rodo X, Rodriguez Gonzalez M, Rodriguez‐Mañas L, Rolland C, Rodrigues Valle S, Roman Rodriguez M, Romano A, Rodriguez‐Zagal E, Rolla G, Roller‐Wirnsberger RE, Romano M, Rosado‐Pinto J, Rosario N, Rottem M, Ryan D, Sagara H, Salimäki J, Sanchez‐Borges M, Sastre‐Dominguez J, Scadding GK, Schunemann HJ, Scichilone N, Schmid‐Grendelmeier P, Sarquis Serpa F, Shamai S, Sheikh A, Sierra M, Simons FER, Siroux V, Sisul JC, Skrindo I, Solé D, Somekh D, Sondermann M, Sooronbaev T, Sova M, Sorensen M, Sorlini M, Spranger O, Stellato C, Stelmach R, Stukas R, Sunyer J, Strozek J, Szylling A, Tebyriçá JN, Thibaudon M, To T, Todo‐Bom A, Trama U, Triggiani M, Suppli Ulrik C, Urrutia‐Pereira M, Valenta R, Valero A, Valiulis A, Valovirta E, van Eerd M, van Ganse E, van Hage M, Vandenplas O, Vezzani G, Vasankari T, Vatrella A, Verissimo MT, Viart F, Viegi G, Vicheva D, Vontetsianos T, Wagenmann M, Walker S, Wallace D, Wang DY, Waserman S, Werfel T, Westman M, Wickman M, Williams DM, Williams S, Wilson N, Wright J, Wroczynski P, Yakovliev P, Yawn BP, Yiallouros PK, Yusuf OM, Zar HJ, Zhang L, Zhong N, Zernotti ME, Zhanat I, Zidarn M, Zuberbier T, Zubrinich C, Zurkuhlen A. Correlation between work impairment, scores of rhinitis severity and asthma using the MASK-air ® App. Allergy 2020; 75:1672-1688. [PMID: 31995656 DOI: 10.1111/all.14204] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 11/23/2019] [Accepted: 12/05/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND In allergic rhinitis, a relevant outcome providing information on the effectiveness of interventions is needed. In MASK-air (Mobile Airways Sentinel Network), a visual analogue scale (VAS) for work is used as a relevant outcome. This study aimed to assess the performance of the work VAS work by comparing VAS work with other VAS measurements and symptom-medication scores obtained concurrently. METHODS All consecutive MASK-air users in 23 countries from 1 June 2016 to 31 October 2018 were included (14 189 users; 205 904 days). Geolocalized users self-assessed daily symptom control using the touchscreen functionality on their smart phone to click on VAS scores (ranging from 0 to 100) for overall symptoms (global), nose, eyes, asthma and work. Two symptom-medication scores were used: the modified EAACI CSMS score and the MASK control score for rhinitis. To assess data quality, the intra-individual response variability (IRV) index was calculated. RESULTS A strong correlation was observed between VAS work and other VAS. The highest levels for correlation with VAS work and variance explained in VAS work were found with VAS global, followed by VAS nose, eye and asthma. In comparison with VAS global, the mCSMS and MASK control score showed a lower correlation with VAS work. Results are unlikely to be explained by a low quality of data arising from repeated VAS measures. CONCLUSIONS VAS work correlates with other outcomes (VAS global, nose, eye and asthma) but less well with a symptom-medication score. VAS work should be considered as a potentially useful AR outcome in intervention studies.
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Buhl R, FitzGerald JM, Meltzer EO, de la Hoz A, Sigmund R, Kerstjens HAM, Bleecker ER. Efficacy of once-daily tiotropium Respimat in adults with asthma at GINA Steps 2-5. Pulm Pharmacol Ther 2019; 60:101881. [PMID: 31874283 DOI: 10.1016/j.pupt.2019.101881] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 12/20/2019] [Indexed: 01/07/2023]
Abstract
Tiotropium Respimat is an efficacious add-on to maintenance treatment in patients with symptomatic asthma. Currently, the Global Initiative for Asthma (GINA) strategy recommends tiotropium for patients at Steps 4-5. To assess the clinical benefits of tiotropium Respimat across asthma severities, GINA Steps 2-5, a post hoc analysis of five double-blind trials (12-48-weeks; patients aged 18-75 years) investigated the effect of tiotropium Respimat, 5 μg or 2.5 μg, versus placebo, on peak forced expiratory volume in 1 s (FEV1) within 3 h post-dose (FEV1(0-3h)) response, and Asthma Control Questionnaire-7 (ACQ-7) responder rate. GINA step grouping was based on patients' background treatment regimen. Baseline characteristics of patients (N = 2926) were balanced between treatments. Tiotropium Respimat showed consistent improvements in lung function across GINA steps; placebo-corrected peak FEV1(0-3h) improvements after tiotropium Respimat 5 μg and 2.5 μg were: Step 2 (Week 8), 135 mL (95% confidence interval: 84, 187) and 155 mL (103, 206); Step 3 (Week 24), 187 mL (139, 235) and 235 mL (187, 283); Step 4 (Week 24), 111 mL (63, 159) and 181 mL (35, 326); Step 5 (Week 24; 5 μg only), 164 mL (5, 323). Asthma control improved with tiotropium Respimat versus placebo, showing statistical significance (nominal P value) with tiotropium Respimat 5 μg at Step 4 (odds ratio 1.36 [1.03, 1.78]). Safety profiles were similar between treatments. In conclusion, tiotropium Respimat add-on therapy improves lung function, and may improve asthma control, in adults across disease severities.
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Affiliation(s)
- Roland Buhl
- Johannes Gutenberg University Mainz, Mainz, Germany.
| | | | - Eli O Meltzer
- University of California, San Diego, La Jolla, CA, USA.
| | - Alberto de la Hoz
- Boehringer Ingelheim International GmbH, Ingelheim Am Rhein, Germany.
| | - Ralf Sigmund
- Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany.
| | - Huib A M Kerstjens
- University of Groningen, University Medical Center Groningen, And Groningen Research Institute for Asthma and COPD GRAIC, Groningen, the Netherlands.
| | - Eugene R Bleecker
- Genomics and Precision Medicine, University of Arizona College of Medicine, Tucson, AZ, USA.
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15
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Bousquet JJ, Schünemann HJ, Togias A, Erhola M, Hellings PW, Zuberbier T, Agache I, Ansotegui IJ, Anto JM, Bachert C, Becker S, Bedolla-Barajas M, Bewick M, Bosnic-Anticevich S, Bosse I, Boulet LP, Bourrez JM, Brusselle G, Chavannes N, Costa E, Cruz AA, Czarlewski W, Fokkens WJ, Fonseca JA, Gaga M, Haahtela T, Illario M, Klimek L, Kuna P, Kvedariene V, Le LTT, Larenas-Linnemann D, Laune D, Lourenço OM, Menditto E, Mullol J, Okamoto Y, Papadopoulos N, Pham-Thi N, Picard R, Pinnock H, Roche N, Roller-Wirnsberger RE, Rolland C, Samolinski B, Sheikh A, Toppila-Salmi S, Tsiligianni I, Valiulis A, Valovirta E, Vasankari T, Ventura MT, Walker S, Williams S, Akdis CA, Annesi-Maesano I, Arnavielhe S, Basagana X, Bateman E, Bedbrook A, Bennoor KS, Benveniste S, Bergmann KC, Bialek S, Billo N, Bindslev-Jensen C, Bjermer L, Blain H, Bonini M, Bonniaud P, Bouchard J, Briedis V, Brightling CE, Brozek J, Buhl R, Buonaiuto R, Canonica GW, Cardona V, Carriazo AM, Carr W, Cartier C, Casale T, Cecchi L, Cepeda Sarabia AM, Chkhartishvili E, Chu DK, Cingi C, Colgan E, de Sousa JC, Courbis AL, Custovic A, Cvetkosvki B, D’Amato G, da Silva J, Dantas C, Dokic D, Dauvilliers Y, Dedeu A, De Feo G, Devillier P, Di Capua S, Dykewickz M, Dubakiene R, Ebisawa M, El-Gamal Y, Eller E, Emuzyte R, Farrell J, Fink-Wagner A, Fiocchi A, Fontaine JF, Gemicioğlu B, Schmid-Grendelmeir P, Gamkrelidze A, Garcia-Aymerich J, Gomez M, González Diaz S, Gotua M, Guldemond NA, Guzmán MA, Hajjam J, O’B Hourihane J, Humbert M, Iaccarino G, Ierodiakonou D, Illario M, Ivancevich JC, Joos G, Jung KS, Jutel M, Kaidashev I, Kalayci O, Kardas P, Keil T, Khaitov M, Khaltaev N, Kleine-Tebbe J, Kowalski ML, Kritikos V, Kull I, Leonardini L, Lieberman P, Lipworth B, Lodrup Carlsen KC, Loureiro CC, Louis R, Mair A, Marien G, Mahboub B, Malva J, Manning P, De Manuel Keenoy E, Marshall GD, Masjedi MR, Maspero JF, Mathieu-Dupas E, Matricardi PM, Melén E, Melo-Gomes E, Meltzer EO, Menditto E, Mercier J, Miculinic N, Mihaltan F, Milenkovic B, Moda G, Mogica-Martinez MD, Mohammad Y, Montefort S, Monti R, Morais-Almeida M, Mösges R, Münter L, Muraro A, Murray R, Naclerio R, Napoli L, Namazova-Baranova L, Neffen H, Nekam K, Neou A, Novellino E, Nyembue D, O’Hehir R, Ohta K, Okubo K, Onorato G, Ouedraogo S, Pali-Schöll I, Palkonen S, Panzner P, Park HS, Pépin JL, Pereira AM, Pfaar O, Paulino E, Phillips J, Picard R, Plavec D, Popov TA, Portejoie F, Price D, Prokopakis EP, Pugin B, Raciborski F, Rajabian-Söderlund R, Reitsma S, Rodo X, Romano A, Rosario N, Rottem M, Ryan D, Salimäki J, Sanchez-Borges MM, Sisul JC, Solé D, Somekh D, Sooronbaev T, Sova M, Spranger O, Stellato C, Stelmach R, Suppli Ulrik C, Thibaudon M, To T, Todo-Bom A, Tomazic PV, Valero AA, Valenta R, Valentin-Rostan M, van der Kleij R, Vandenplas O, Vezzani G, Viart F, Viegi G, Wallace D, Wagenmann M, Wang DY, Waserman S, Wickman M, Williams DM, Wong G, Wroczynski P, Yiallouros PK, Yorgancioglu A, Yusuf OM, Zar HJ, Zeng S, Zernotti M, Zhang L, Zhong NS, Zidarn M. Next-generation ARIA care pathways for rhinitis and asthma: a model for multimorbid chronic diseases. Clin Transl Allergy 2019; 9:44. [PMID: 31516692 PMCID: PMC6734297 DOI: 10.1186/s13601-019-0279-2] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 07/29/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND In all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system into integrated care with organizational health literacy. MAIN BODY As an example for chronic disease care, MASK (Mobile Airways Sentinel NetworK), a new project of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, and POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EIT Health), in collaboration with professional and patient organizations in the field of allergy and airway diseases, are proposing real-life ICPs centred around the patient with rhinitis, and using mHealth to monitor environmental exposure. Three aspects of care pathways are being developed: (i) Patient participation, health literacy and self-care through technology-assisted "patient activation", (ii) Implementation of care pathways by pharmacists and (iii) Next-generation guidelines assessing the recommendations of GRADE guidelines in rhinitis and asthma using real-world evidence (RWE) obtained through mobile technology. The EU and global political agendas are of great importance in supporting the digital transformation of health and care, and MASK has been recognized by DG Santé as a Good Practice in the field of digitally-enabled, integrated, person-centred care. CONCLUSION In 20 years, ARIA has considerably evolved from the first multimorbidity guideline in respiratory diseases to the digital transformation of health and care with a strong political involvement.
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Affiliation(s)
- J. Jean Bousquet
- MACVIA-France, Fondation Partenariale FMC VIA-LR, CHU, 34295 Montpellier Cedex 5, France
- INSERM U 1168, VIMA: Ageing and Chronic Diseases Epidemiological and Public Health Approaches, Villejuif Université Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny Le Bretonneux, France
- European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Brussels, Belgium
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Uniersität zu Berlin, Berlin, Germany
| | - Holger J. Schünemann
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON Canada
| | - Alkis Togias
- Division of Allergy, Immunology, and Transplantation (DAIT), National Institute of Allergy and Infectious Diseases, NIH, Bethesda, USA
| | - Marina Erhola
- National Institute for Health and Welfare, Helsinki, Finland
| | - Peter W. Hellings
- European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Brussels, Belgium
- Dept of Otorhinolaryngology, Univ Hospitals Leuven, Louvain, Belgium
- Academic Medical Center, Univ of Amsterdam, Amsterdam, The Netherlands
| | - Torsten Zuberbier
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Uniersität zu Berlin, Berlin, Germany
- Department of Dermatology and Allergy Member of GA2LEN, Comprehensive Allergy-Centre, Berlin Institute of Health, Berlin, Germany
| | - Ioana Agache
- Faculty of Medicine, Transylvania University, Brasov, Romania
| | - Ignacio J. Ansotegui
- Department of Allergy and Immunology, Hospital Quirónsalud Bizkaia, Erandio, Spain
| | - Josep M. Anto
- ISGlobAL, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- IMIM (Hospital del Mar Research Institute), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Claus Bachert
- Upper Airways Research Laboratory, ENT Dept, Ghent University Hospital, Ghent, Belgium
| | - Sven Becker
- Dept of Otolaryngology, Head and Neck Surgery, University of Mainz, Mainz, Germany
| | | | | | - Sinthia Bosnic-Anticevich
- Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia
- Woolcock Emphysema Centre, Sydney, Australia
- Sydney Local Health District, Glebe, NSW Australia
| | | | - Louis P. Boulet
- Quebec Heart and Lung Institute, Laval University, Quebec City, QC Canada
| | | | - Guy Brusselle
- Dept of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Niels Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Elisio Costa
- UCIBIO, REQUINTE, Faculty of Pharmacy and Competence Center on Active and Healthy Ageing of University of Porto (Porto4Ageing), Porto, Portugal
| | - Alvaro A. Cruz
- ProAR–Nucleo de Excelencia em Asma, Federal University of Bahia, Bahia, Brazil
- WHO GARD Planning Group, Salvador, Brazil
| | | | - Wytske J. Fokkens
- European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Brussels, Belgium
- Department of Otorhinolaryngology, Amsterdam University Medical Centres, AMC, Amsterdam, The Netherlands
| | - Joao A. Fonseca
- CINTESIS, Center for Research in Health Technology and Information Systems, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
- Medida, Lda Porto, Portugal
| | - Mina Gaga
- ERS President 2017-2018, Athens Chest Hospital, 7th Resp Med Dept and Asthma Center, Athens, Greece
| | - Tari Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Maddalena Illario
- Division for Health Innovation, Campania Region and Federico II University Hospital Naples (R &D and DISMET), Naples, Italy
| | - Ludger Klimek
- Center for Rhinology and Allergology, Wiesbaden, Germany
| | - Piotr Kuna
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Łódź, Poland
| | | | - L. T. T. Le
- University of Medicine and Pharmacy, Hochiminh City, Vietnam
| | - Desiree Larenas-Linnemann
- Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, México City, Mexico
| | | | - Olga M. Lourenço
- Faculty of Health Sciences and CICS–UBI, Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
| | | | - Joaquin Mullol
- Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic, Barcelona, Spain
- Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, University of Barcelona, Barcelona, Spain
| | - Yashitaka Okamoto
- Dept of Otorhinolaryngology, Chiba University Hospital, Chiba, Japan
| | - Nikos Papadopoulos
- Division of Infection, Immunity & Respiratory Medicine, Royal Manchester Children’s Hospital, University of Manchester, Manchester, UK
- Allergy Department, 2nd Pediatric Clinic, Athens General Children’s Hospital “P&A Kyriakou”, University of Athens, Athens, Greece
| | - Nhân Pham-Thi
- Allergy Department, Pasteur Institute, Paris, France
| | - Robert Picard
- Conseil Général de l’Economie Ministère de l’Economie, de l’Industrie et du Numérique, Paris, France
| | - Hilary Pinnock
- The Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
| | - Nicolas Roche
- Pneumologie et Soins Intensifs Respiratoires, Hôpitaux Universitaires Paris, Centre Hôpital Cochin, Paris, France
| | | | | | - Boleslaw Samolinski
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - Aziz Sheikh
- The Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
| | - Sanna Toppila-Salmi
- Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Ioanna Tsiligianni
- Health Planning Unit, Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece
- International Primary Care Respiratory Group IPCRG, Aberdeen, Scotland UK
| | - Arunas Valiulis
- Institute of Clinical Medicine & Institute of Health Sciences, Vilnius University Faculty of Medicine, Vilnius, Lithuania
| | - Erkka Valovirta
- Department of Lung Diseases and Clinical Immunology, University of Turku and Terveystalo Allergy Clinic, Turku, Finland
| | | | - Maria-Teresa Ventura
- Unit of Geriatric Immunoallergology, University of Bari Medical School, Bari, Italy
| | | | - Sian Williams
- Department of Lung Diseases and Clinical Immunology, University of Turku and Terveystalo Allergy Clinic, Turku, Finland
| | - Cezmi A. Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Isabella Annesi-Maesano
- Epidemiology of Allergic and Respiratory Diseases, Department Institute Pierre Louis of Epidemiology and Public Health, INSERM and Sorbonne Université, Medical School Saint Antoine, Paris, France
| | | | - Xavier Basagana
- ISGlobAL, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- IMIM (Hospital del Mar Research Institute), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Eric Bateman
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Anna Bedbrook
- MACVIA-France, Fondation Partenariale FMC VIA-LR, CHU, 34295 Montpellier Cedex 5, France
| | - K. S. Bennoor
- Dept of Respiratory Medicine, National Institute of Diseases of the Chest and Hospital, Dhaka, Bangladesh
| | - Samuel Benveniste
- National Center of Expertise in Cognitive Stimulation (CEN STIMCO), Broca Hospital, Paris, France
| | - Karl C. Bergmann
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Uniersität zu Berlin, Berlin, Germany
- Department of Dermatology and Allergy Member of GA2LEN, Comprehensive Allergy-Centre, Berlin Institute of Health, Berlin, Germany
| | - Slawomir Bialek
- Department of Biochemistry and Clinical Chemistry, Faculty of Pharmacy with the Division of Laboratory Medicine, Warsaw Medical University, Warsaw, Poland
| | - Nils Billo
- Global Alliance against Chronic Respiratory Diseases (WHO GARD), Joensuu, Finland
| | - Carsten Bindslev-Jensen
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense Research Center for Anaphylaxis (ORCA), Odense, Denmark
- Termofischer Scientific, Uppsala, Sweden
| | - Leif Bjermer
- Department of Respiratory Medicine and Allergology, University Hospital, Lund, Sweden
| | - Hubert Blain
- Department of Geriatrics, Montpellier University hospital, Montpellier, France
- EA 2991 Euromov, University Montpellier, Montpellier, France
| | - Mateo Bonini
- UOC Pneumologia, Istituto di Medicina Interna, F Policlinico Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
- National Heart and Lung Institute, Royal Brompton Hospital & Imperial College, London, UK
| | | | - Jacques Bouchard
- Clinical Medicine, Laval’s University, Quebec City, Canada
- Medicine Department, Hôpital de la Malbaie, Quebec city, QC Canada
| | - Vitalis Briedis
- Department of Clinical Pharmacy of Lithuanian, University of Health, Kaunas, Lithuania
| | - Christofer E. Brightling
- Institute of Lung Health, Respiratory Biomedical Unit, University Hospitals of Leicester NHS Trust, Leicestershire, UK
- Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
| | - Jan Brozek
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON Canada
| | - Roland Buhl
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | | | - Giorgo W. Canonica
- Personalized Medicine Clinic Asthma & Allergy, Humanitas University, Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Victoria Cardona
- Allergy Section, Department of Internal Medicine, Hospital Vall d’Hebron & ARADyAL Research Network, Barcelona, Spain
| | | | - Warner Carr
- Allergy and Asthma Associates of Southern California, Mission Viejo, CA USA
| | | | - Thomas Casale
- Division of Allergy/Immunology, University of South Florida, Tampa, FL USA
| | - Lorenzo Cecchi
- SOS Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy
| | - Alfonso M. Cepeda Sarabia
- Allergy and Immunology Laboratory, Metropolitan University, Simon Bolivar University, Barranquilla, Colombia
- SLaai, Sociedad Latinoamericana de Allergia, Asma e Immunologia, Barranquilla, Colombia
| | - Eka Chkhartishvili
- Chachava Clinic, David Tvildiani Medical University-AIETI Medical School, Grigol Robakidze University, Tbilisi, Georgia
| | - Derek K. Chu
- European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Brussels, Belgium
| | - Cemal Cingi
- Medical Faculty, ENT Department, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Elaine Colgan
- Department of Health, Social Services and Public Safety, Belfast, Northern Ireland UK
| | - Jaime Correia de Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- PT Government Associate Laboratory, ICVS/3B’s, Braga/Guimarães, Portugal
| | | | - Adnan Custovic
- Centre for Respiratory Medicine and Allergy, Institute of Inflammation and Repair, University of Manchester and University Hospital of South Manchester, Manchester, UK
| | - Biljana Cvetkosvki
- Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia
- Woolcock Emphysema Centre, Sydney, Australia
- Sydney Local Health District, Glebe, NSW Australia
| | - Gennaro D’Amato
- Division of Respiratory and Allergic Diseases, Department of Respiratory Diseases, High Specialty Hospital A.Cardarelli, Naples, Italy
| | - Jane da Silva
- Allergy Service, University Hospital of Federal University of Santa Catarina (HU-UFSC), Florianópolis, Brazil
| | - Carina Dantas
- Cáritas Diocesana de Coimbra, Coimbra, Portugal
- Ageing@Coimbra EIP-AHA Reference Site, Coimbra, Portugal
| | - Dejand Dokic
- Medical Faculty Skopje, University Clinic of Pulmonology and Allergy, Skopje, Republic of Macedonia
| | - Yves Dauvilliers
- Sleep Unit, Department of Neurology, Hôpital Gui-de-Chauliac Montpellier, Inserm U1061, Montpellier, France
| | - Antoni Dedeu
- AQuAS, Barcelna, Spain
- EUREGHA, European Regional and Local Health Association, Brussels, Belgium
| | - Giulia De Feo
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Salerno, Italy
| | - Philippe Devillier
- UPRES EA220, Pôle des Maladies des Voies Respiratoires, Hôpital Foch, Université Paris-Saclay, Suresnes, France
| | | | - Marc Dykewickz
- Section of Allergy and Immunology, Saint Louis University School of Medicine, Saint Louis, MO USA
| | - Ruta Dubakiene
- Clinic of Infectious, Chest Diseases, Dermatology and Allergology, Vilnius University, Vilnius, Lithuania
| | - Motohiro Ebisawa
- Clinical Reserch Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Japan
| | - Yaya El-Gamal
- Pediatric Allergy and Immunology Unit, Children’s hospital, Ain Shams University, Cairo, Egypt
| | - Esben Eller
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense Research Center for Anaphylaxis (ORCA), Odense, Denmark
- Termofischer Scientific, Uppsala, Sweden
| | - Regina Emuzyte
- Clinic of Children’s Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - John Farrell
- PT Government Associate Laboratory, ICVS/3B’s, Braga/Guimarães, Portugal
| | | | - Alessandro Fiocchi
- Division of Allergy, Department of Pediatric Medicine, The Bambino Gesù Children’s Research Hospital Holy See, Rome, Italy
| | | | - Bilun Gemicioğlu
- Department of Pulmonary Diseases, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istambul, Turkey
| | | | - Amiran Gamkrelidze
- National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia
| | | | - Maximiliano Gomez
- Allergy & Asthma Unit, Hospital San Bernardo Salta, Salta, Argentina
| | | | - Maia Gotua
- Center of Allergy and Immunology, Georgian Association of Allergology and Clinical Immunology, Tbilisi, Georgia
| | - Nick A. Guldemond
- Institute of Health Policy and Management iBMG, Erasmus University, Rotterdam, The Netherlands
| | - Maria-Antonieta Guzmán
- Immunology and Allergy Division, Clinical Hospital, University of Chile, Santiago, Chile
| | - Jawad Hajjam
- Centich: Centre d’Expertise National des Technologies de l’Information et de la Communication pour l’Autonomie, Gérontopôle Autonomie Longévité des Pays de la Loire, Conseil Régional des Pays de la Loire, Centre d’Expertise Partenariat Européen d’Innovation pour un Vieillissement Actif et en Bonne Santé, Nantes, France
| | - John O’B Hourihane
- Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - Marc Humbert
- Université Paris-Sud; Service de Pneumologie, Hôpital Bicêtre, Inserm UMR_S999, Le Kremlin Bicêtre, France
| | - Guido Iaccarino
- Department of Medicine and Surgery, University of Salerno, Baronissi, Italy
| | - Despo Ierodiakonou
- Health Planning Unit, Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece
- Department of Lung Diseases and Clinical Immunology, University of Turku and Terveystalo Allergy Clinic, Turku, Finland
| | | | - Juan C. Ivancevich
- Servicio de Alergia e Immunologia, Clinica Santa Isabel, Buenos Aires, Argentina
| | - Guy Joos
- Quebec Heart and Lung Institute, Laval University, Quebec City, QC Canada
| | - Ki-Suck Jung
- Hallym University College of Medicine, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do South Korea
| | - Marek Jutel
- Department of Clinical Immunology, Wrocław Medical University, Wrocław, Poland
| | - Igor Kaidashev
- Ukrainian Medical Stomatological Academy, Poltava, Ukraine
| | - Omer Kalayci
- Pediatric Allergy and Asthma Unit, Hacettepe University School of Medicine, Ankara, Turkey
| | - Przemyslaw Kardas
- First Department of Family Medicine, Medical University of Lodz, Łódź, Poland
| | - Thomas Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Institute for Clinical Epidemiology and Biometry, University of Wuerzburg, Würzburg, Germany
| | - Mussa Khaitov
- National Research Center, Institute of Immunology, Federal Medicobiological Agency, Laboratory of Molecular Immunology, Moscow, Russian Federation
| | | | | | - Marek L. Kowalski
- Department of Immunology and Allergy, Healthy Ageing Research Center, Medical University of Lodz, Łódź, Poland
| | - Vicky Kritikos
- Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia
- Woolcock Emphysema Centre, Sydney, Australia
- Sydney Local Health District, Glebe, NSW Australia
| | - Inger Kull
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
- Sach’s Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | | | - Philip Lieberman
- Departments of Internal Medicine and Pediatrics (Divisions of Allergy and Immunology), University of Tennessee College of Medicine, Germantown, TN USA
| | - Brian Lipworth
- Scottish Centre for Respiratory Research, Cardiovascular & Diabetes Medicine, Medical Research Institute, Ninewells Hospital, University of Dundee, Dundee, UK
| | - Karin C. Lodrup Carlsen
- Department of Paediatrics, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Claudia C. Loureiro
- Imunoalergologia, Centro Hospitalar Universitário de Coimbra and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Renaud Louis
- Department of Pulmonary Medicine, CHU Sart-Tilman, and GIGA I3 Research Group, Liege, Belgium
| | - Alpana Mair
- DG for Health and Social Care, Scottish Government, Edinburgh, UK
| | - Gert Marien
- European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Brussels, Belgium
| | - Bassam Mahboub
- Department of Pulmonary Medicine, Rashid Hospital, Dubai, UAE
| | - Joao Malva
- Ageing@Coimbra EIP-AHA Reference Site, Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Patrick Manning
- Department of Medicine (RCSI), Bon Secours Hospital, Glasnevin, Dublin, Ireland
| | - Esteban De Manuel Keenoy
- Kronikgune, International Centre of Excellence in Chronicity Research Barakaldo, Barakaldo, Bizkaia Spain
| | - Gailen D. Marshall
- Division of Clinical Immunology and Allergy, Laboratory of Behavioral Immunology Research, The University of Mississippi Medical Center, Jackson, MS USA
| | - Mohamed R. Masjedi
- Tobacco Control Research Centre, Iranian Anti Tobacco Association, Tehran, Iran
| | - Jorge F. Maspero
- Argentine Association of Allergy and Clinical Immunology, Buenos Aires, Argentina
| | | | - Poalo M. Matricardi
- Department of Pediatric Pneumology and Immunology, AG Molecular Allergology and Immunomodulation, Charité Medical University, Berlin, Germany
| | - Eric Melén
- Sach’s Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Elisabete Melo-Gomes
- PNDR, Portuguese National Programme for Respiratory Diseases, Faculdade de Medicina de Lisboa, Lisbon, Portugal
| | - Eli O. Meltzer
- Allergy and Asthma Medical Group and Research Center, San Diego, CA USA
| | | | - Jacques Mercier
- Department of Physiology, CHRU, University Montpellier, Vice President for Research, PhyMedExp, INSERM U1046, CNRS, UMR 9214, Montpellier, France
| | | | - Florin Mihaltan
- National Institute of Pneumology M Nasta, Bucharest, Romania
| | - Branislava Milenkovic
- Clinic for Pulmonary Diseases, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Serbian Association for Asthma and COPD, Belgrade, Serbia
| | | | | | - Yousser Mohammad
- National Center for Research in Chronic Respiratory Diseases, Tishreen University School of Medicine, Latakia, Syria
- Syrian Private University, Damascus, Syria
| | - Steve Montefort
- Faculty of Medicine and Surgery, University of Medicine, La Valette, Malta
| | - Ricardo Monti
- Department of Medical Sciences, Allergy and Clinical Immunology Unit, University of Torino & Mauriziano Hospital, Turin, Italy
| | | | - Ralf Mösges
- Institute of Medical Statistics, and Computational Biology, Medical Faculty, University of Cologne, Cologne, Germany
- CRI-Clinical Research International-Ltd, Hamburg, Germany
| | - Lars Münter
- Danish Commitee for Health Education, Copenhagen East, Denmark
| | - Antonella Muraro
- Food Allergy Referral Centre Veneto Region, Department of Women and Child Health, Padua General University Hospital, Padua, Italy
| | - Ruth Murray
- MedScript Ltd, Paraparomu, New Zealand
- OPC, Cambridge, UK
| | | | - Luigi Napoli
- Consortium of Pharmacies and Services COSAFER, Salerno, Italy
| | - Leila Namazova-Baranova
- Scientific Centre of Children’s Health under the Russian Academy of Medical Sciences, Moscow, Russia
| | - Hugo Neffen
- Center of Allergy, Immunology and Respiratory Diseases, Santa Fe, Argentina
- Center for Allergy and Immunology, Santa Fe, Argentina
| | - Kristoff Nekam
- Hospital of the Hospitaller Brothers in Buda, Budapest, Hungary
| | - Angelo Neou
- Die Hautambulanz and Rothhaar Study Center, Berlin, Germany
| | - Enrico Novellino
- Department of Pharmacy, University of Naples Federico II, Naples, Italy
| | | | - Robin O’Hehir
- Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Central Clinical School, Monash University, Melbourne, VIC Australia
| | - Ken Ohta
- National Hospital Organization, Tokyo National Hospital, Tokyo, Japan
| | - Kimi Okubo
- Dept of Otolaryngology, Nippon Medical School, Tokyo, Japan
| | - Gabrielle Onorato
- MACVIA-France, Fondation Partenariale FMC VIA-LR, CHU, 34295 Montpellier Cedex 5, France
| | - Solange Ouedraogo
- Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle, Ouagadougou, Burkina Faso
| | - Isabella Pali-Schöll
- Dept of Comparative Medicine, Messerli Research Institute of the University of Veterinary Medicine and Medical University, Vienna, Austria
| | - Susanna Palkonen
- EFA European Federation of Allergy and Airways Diseases Patients’ Associations, Brussels, Belgium
| | - Peter Panzner
- Department of Immunology and Allergology, Faculty of Medicine and Faculty Hospital in Pilsen, Charles University in Prague, Pilsen, Czech Republic
| | - Hae-Sim Park
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, South Korea
| | - Jean-Louis Pépin
- Laboratoire HP2, Université Grenoble Alpes, Grenoble, France
- INSERM, U1042 and CHU de Grenoble, Grenoble, France
| | - Ana-Maria Pereira
- Allergy Unit, CUF-Porto Hospital and Institute, Porto, Portugal
- Center for Research in Health Technologies and Information Systems, CINTESIS, Universidade do Porto, Porto, Portugal
| | - Oliver Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany
| | | | - Jim Phillips
- Centre for Empowering Patients and Communities, Faulkland, Somerset, UK
| | - Robert Picard
- Conseil Général de l’Economie Ministère de l’Economie, de l’Industrie et du Numérique, Paris, France
| | - Davor Plavec
- Children’s Hospital Srebrnjak, Zagreb, Croatia
- School of Medicine, University J.J. Strossmayer, Osijek, Croatia
| | - Ted A. Popov
- University Hospital ‘Sv Ivan Rilski’, Sofia, Bulgaria
| | - Fabienne Portejoie
- MACVIA-France, Fondation Partenariale FMC VIA-LR, CHU, 34295 Montpellier Cedex 5, France
| | - David Price
- Academic Centre of Primary Care, University of Aberdeen, Aberdeen, Scotland UK
- Research in Real-Life, Cambridge, UK
| | - Emmanuel P. Prokopakis
- Department of Otorhinolaryngology, University of Crete School of Medicine, Heraklion, Greece
| | - Benoit Pugin
- European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Brussels, Belgium
| | - Filip Raciborski
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | | | - Sietze Reitsma
- European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Brussels, Belgium
- Department of Otorhinolaryngology, Amsterdam University Medical Centres, AMC, Amsterdam, The Netherlands
| | - Xavier Rodo
- ISGlobAL, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
| | - Antonino Romano
- Allergy Unit, Presidio Columbus, Catholic University of Sacred Heart, Rome, Italy
- IRCCS Oasi Maria SS, Troina, Italy
| | - Nelson Rosario
- Hospital de Clinicas, University of Parana, Paraná, Brazil
| | - Menahenm Rottem
- Division of Allergy Asthma and Clinical Immunology, Emek Medical Center, Afula, Israel
| | - Dermot Ryan
- Allergy and Respiratory Research Group, The University of Edinburgh, Edinburgh, UK
| | | | - Mario M. Sanchez-Borges
- Allergy and Clinical Immunology Department, Centro Médico-Docente la, Trinidad and Clínica El Avila, Caracas, Venezuela
| | - Juan-Carlos Sisul
- Sociedad Paraguaya de Alergia Asma e Inmunologia, Asunción, Paraguay
| | - Dirceu Solé
- Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil
| | - David Somekh
- European Health Futures Forum (EHFF), Dromahair, UK
| | - Talant Sooronbaev
- Kyrgyzstan National Centre of Cardiology and Internal Medicine, Euro-Asian Respiratory Society, Bishkek, Kyrgyzstan
| | - Milan Sova
- Department of Respiratory Medicine, University Hospital Olomouc, Olomouc, Czech Republic
| | - Otto Spranger
- Global Allergy and Asthma Platform GAAPP, Vienna, Austria
| | - Cristina Stellato
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Salerno, Italy
| | - Rafael Stelmach
- Pulmonary Division, Heart Institute (InCor), Hospital da Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Charlotte Suppli Ulrik
- Department of Respiratory Medicine, Hvidovre Hospital & University of Copenhagen, Copenhagen, Denmark
| | - Michel Thibaudon
- RNSA (Réseau National de Surveillance Aérobiologique), Brussieu, France
| | - Teresa To
- Sidkkids Hospitala and Institute of Health Policy, Management and Evaluation, Toronto, Canada
| | - Ana Todo-Bom
- Imunoalergologia, Centro Hospitalar Universitário de Coimbra and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | | | - Antonio A. Valero
- Pneumology and Allergy Department CIBERES and Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Rudolph Valenta
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
- NRC Institute of Immunology FMBA of Russia, Moscow, Russia
- Laboratory of Immunopathology, Department of Clinical Immunology and Allergy, Sechenov First Moscow State Medical University, Moscow, Russia
| | | | - Rianne van der Kleij
- Department of Public Health & Primary Care, Leiden University Medical Center (LUMC), Leiden, The Netherlands
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Olivier Vandenplas
- Department of Chest Medicine, Centre Hospitalier Universitaire UCL Namur, Université Catholique de Louvain, Yvoir, Belgium
| | - Giorgio Vezzani
- Pulmonary Unit, Department of Medical Specialties, Arcispedale SMaria Nuova/IRCCS, AUSL di Reggio Emilia, Reggio Emilia, Italy
| | | | - Giovanni Viegi
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa, Italy
- CNR Institute of Biomedicine and Molecular Immunology “A Monroy”, Palermo, Italy
| | - Dana Wallace
- Nova Southeastern University, Fort Lauderdale, FL USA
| | - Martin Wagenmann
- Dept of Otorhinolaryngology, HNO-Klinik, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - De Y. Wang
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Susan Waserman
- Department of Medicine, Clinical Immunology and Allergy, McMaster University, Hamilton, ON Canada
| | - Magnus Wickman
- Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden
| | - Dennis M. Williams
- Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC USA
| | - Gary Wong
- Maladies Infectieuses et immunitaires, CHUL, Quebec City, QC Canada
| | - Piotr Wroczynski
- Department of Biochemistry and Clinical Chemistry, Faculty of Pharmacy with the Division of Laboratory Medicine, Warsaw Medical University, Warsaw, Poland
| | - Panayiotis K. Yiallouros
- Cyprus International Institute for Environmental & Public Health in Association with Harvard School of Public Health, Cyprus University of Technology, Limassol, Cyprus
- Department of Pediatrics, Hospital “Archbishop Makarios III”, Nicosia, Cyprus
| | - Arzu Yorgancioglu
- Department of Pulmonary Diseases, Celal Bayar University, Faculty of Medicine, Manisa, Turkey
| | | | - Heahter J. Zar
- Department of Paediatrics and Child Health, Red Cross Children’s Hospital, Cape Town, South Africa
- MRC Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
| | | | | | - Luo Zhang
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital and Beijing Institute of Otolaryngology, Beijing, China
| | - Nan S. Zhong
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Mihaela Zidarn
- University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia
| | - the ARIA Study Group
- MACVIA-France, Fondation Partenariale FMC VIA-LR, CHU, 34295 Montpellier Cedex 5, France
- INSERM U 1168, VIMA: Ageing and Chronic Diseases Epidemiological and Public Health Approaches, Villejuif Université Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny Le Bretonneux, France
- European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Brussels, Belgium
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Uniersität zu Berlin, Berlin, Germany
- Department of Dermatology and Allergy Member of GA2LEN, Comprehensive Allergy-Centre, Berlin Institute of Health, Berlin, Germany
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON Canada
- Division of Allergy, Immunology, and Transplantation (DAIT), National Institute of Allergy and Infectious Diseases, NIH, Bethesda, USA
- National Institute for Health and Welfare, Helsinki, Finland
- Dept of Otorhinolaryngology, Univ Hospitals Leuven, Louvain, Belgium
- Academic Medical Center, Univ of Amsterdam, Amsterdam, The Netherlands
- Faculty of Medicine, Transylvania University, Brasov, Romania
- Department of Allergy and Immunology, Hospital Quirónsalud Bizkaia, Erandio, Spain
- ISGlobAL, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- IMIM (Hospital del Mar Research Institute), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- Upper Airways Research Laboratory, ENT Dept, Ghent University Hospital, Ghent, Belgium
- Dept of Otolaryngology, Head and Neck Surgery, University of Mainz, Mainz, Germany
- Hospital Civil de Guadalajara Dr Juan I Menchaca, Guadalarara, Mexico
- iQ4U Consultants Ltd, London, UK
- Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia
- Woolcock Emphysema Centre, Sydney, Australia
- Sydney Local Health District, Glebe, NSW Australia
- La Rochelle, France
- Quebec Heart and Lung Institute, Laval University, Quebec City, QC Canada
- EIT Health France, Paris, France
- Dept of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
- UCIBIO, REQUINTE, Faculty of Pharmacy and Competence Center on Active and Healthy Ageing of University of Porto (Porto4Ageing), Porto, Portugal
- ProAR–Nucleo de Excelencia em Asma, Federal University of Bahia, Bahia, Brazil
- WHO GARD Planning Group, Salvador, Brazil
- Medical Consulting Czarlewski, Levallois, France
- Department of Otorhinolaryngology, Amsterdam University Medical Centres, AMC, Amsterdam, The Netherlands
- CINTESIS, Center for Research in Health Technology and Information Systems, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
- Medida, Lda Porto, Portugal
- ERS President 2017-2018, Athens Chest Hospital, 7th Resp Med Dept and Asthma Center, Athens, Greece
- Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Division for Health Innovation, Campania Region and Federico II University Hospital Naples (R &D and DISMET), Naples, Italy
- Center for Rhinology and Allergology, Wiesbaden, Germany
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Łódź, Poland
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania
- University of Medicine and Pharmacy, Hochiminh City, Vietnam
- Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, México City, Mexico
- KYomed INNOV, Montpellier, France
- Faculty of Health Sciences and CICS–UBI, Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
- CIRFF, Federico II University, Naples, Italy
- Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic, Barcelona, Spain
- Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, University of Barcelona, Barcelona, Spain
- Dept of Otorhinolaryngology, Chiba University Hospital, Chiba, Japan
- Division of Infection, Immunity & Respiratory Medicine, Royal Manchester Children’s Hospital, University of Manchester, Manchester, UK
- Allergy Department, 2nd Pediatric Clinic, Athens General Children’s Hospital “P&A Kyriakou”, University of Athens, Athens, Greece
- Allergy Department, Pasteur Institute, Paris, France
- Conseil Général de l’Economie Ministère de l’Economie, de l’Industrie et du Numérique, Paris, France
- The Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
- Pneumologie et Soins Intensifs Respiratoires, Hôpitaux Universitaires Paris, Centre Hôpital Cochin, Paris, France
- Department of Internal Medicine, Medical University of Graz, Graz, Austria
- Association Asthme et Allergie, Paris, France
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
- Health Planning Unit, Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece
- International Primary Care Respiratory Group IPCRG, Aberdeen, Scotland UK
- Institute of Clinical Medicine & Institute of Health Sciences, Vilnius University Faculty of Medicine, Vilnius, Lithuania
- Department of Lung Diseases and Clinical Immunology, University of Turku and Terveystalo Allergy Clinic, Turku, Finland
- FILHA, Finnish Lung Association, Helsinki, Finland
- Unit of Geriatric Immunoallergology, University of Bari Medical School, Bari, Italy
- Asthma UK, Mansell Street, London, UK
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
- Epidemiology of Allergic and Respiratory Diseases, Department Institute Pierre Louis of Epidemiology and Public Health, INSERM and Sorbonne Université, Medical School Saint Antoine, Paris, France
- Department of Medicine, University of Cape Town, Cape Town, South Africa
- Dept of Respiratory Medicine, National Institute of Diseases of the Chest and Hospital, Dhaka, Bangladesh
- National Center of Expertise in Cognitive Stimulation (CEN STIMCO), Broca Hospital, Paris, France
- Department of Biochemistry and Clinical Chemistry, Faculty of Pharmacy with the Division of Laboratory Medicine, Warsaw Medical University, Warsaw, Poland
- Global Alliance against Chronic Respiratory Diseases (WHO GARD), Joensuu, Finland
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense Research Center for Anaphylaxis (ORCA), Odense, Denmark
- Termofischer Scientific, Uppsala, Sweden
- Department of Respiratory Medicine and Allergology, University Hospital, Lund, Sweden
- Department of Geriatrics, Montpellier University hospital, Montpellier, France
- EA 2991 Euromov, University Montpellier, Montpellier, France
- UOC Pneumologia, Istituto di Medicina Interna, F Policlinico Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
- National Heart and Lung Institute, Royal Brompton Hospital & Imperial College, London, UK
- CHU, Dijon, France
- Clinical Medicine, Laval’s University, Quebec City, Canada
- Medicine Department, Hôpital de la Malbaie, Quebec city, QC Canada
- Department of Clinical Pharmacy of Lithuanian, University of Health, Kaunas, Lithuania
- Institute of Lung Health, Respiratory Biomedical Unit, University Hospitals of Leicester NHS Trust, Leicestershire, UK
- Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Germany
- Municipality Pharmacy, Sarno, Italy
- Personalized Medicine Clinic Asthma & Allergy, Humanitas University, Humanitas Research Hospital, Rozzano, Milan, Italy
- Allergy Section, Department of Internal Medicine, Hospital Vall d’Hebron & ARADyAL Research Network, Barcelona, Spain
- Regional Ministry of Health of Andalusia, Seville, Spain
- Allergy and Asthma Associates of Southern California, Mission Viejo, CA USA
- ASA-Advanced Solutions Accelerator, Clapiers, France
- Division of Allergy/Immunology, University of South Florida, Tampa, FL USA
- SOS Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy
- Allergy and Immunology Laboratory, Metropolitan University, Simon Bolivar University, Barranquilla, Colombia
- SLaai, Sociedad Latinoamericana de Allergia, Asma e Immunologia, Barranquilla, Colombia
- Chachava Clinic, David Tvildiani Medical University-AIETI Medical School, Grigol Robakidze University, Tbilisi, Georgia
- Medical Faculty, ENT Department, Eskisehir Osmangazi University, Eskisehir, Turkey
- Department of Health, Social Services and Public Safety, Belfast, Northern Ireland UK
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- PT Government Associate Laboratory, ICVS/3B’s, Braga/Guimarães, Portugal
- Ecole des Mines, Alès, France
- Centre for Respiratory Medicine and Allergy, Institute of Inflammation and Repair, University of Manchester and University Hospital of South Manchester, Manchester, UK
- Division of Respiratory and Allergic Diseases, Department of Respiratory Diseases, High Specialty Hospital A.Cardarelli, Naples, Italy
- Allergy Service, University Hospital of Federal University of Santa Catarina (HU-UFSC), Florianópolis, Brazil
- Cáritas Diocesana de Coimbra, Coimbra, Portugal
- Ageing@Coimbra EIP-AHA Reference Site, Coimbra, Portugal
- Medical Faculty Skopje, University Clinic of Pulmonology and Allergy, Skopje, Republic of Macedonia
- Sleep Unit, Department of Neurology, Hôpital Gui-de-Chauliac Montpellier, Inserm U1061, Montpellier, France
- AQuAS, Barcelna, Spain
- EUREGHA, European Regional and Local Health Association, Brussels, Belgium
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Salerno, Italy
- UPRES EA220, Pôle des Maladies des Voies Respiratoires, Hôpital Foch, Université Paris-Saclay, Suresnes, France
- Farmacie Dei Golfi Group, Massa Lubrense, Italy
- Section of Allergy and Immunology, Saint Louis University School of Medicine, Saint Louis, MO USA
- Clinic of Infectious, Chest Diseases, Dermatology and Allergology, Vilnius University, Vilnius, Lithuania
- Clinical Reserch Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Japan
- Pediatric Allergy and Immunology Unit, Children’s hospital, Ain Shams University, Cairo, Egypt
- Clinic of Children’s Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
- Global Allergy and Asthma Platform GAAPP, Vienna, Austria
- Division of Allergy, Department of Pediatric Medicine, The Bambino Gesù Children’s Research Hospital Holy See, Rome, Italy
- Reims, France
- Department of Pulmonary Diseases, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istambul, Turkey
- Allergy Unit, Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland
- National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia
- Allergy & Asthma Unit, Hospital San Bernardo Salta, Salta, Argentina
- Universidad Autónoma de Nuevo León, San Nicolás de los Garza, Mexico
- Center of Allergy and Immunology, Georgian Association of Allergology and Clinical Immunology, Tbilisi, Georgia
- Institute of Health Policy and Management iBMG, Erasmus University, Rotterdam, The Netherlands
- Immunology and Allergy Division, Clinical Hospital, University of Chile, Santiago, Chile
- Centich: Centre d’Expertise National des Technologies de l’Information et de la Communication pour l’Autonomie, Gérontopôle Autonomie Longévité des Pays de la Loire, Conseil Régional des Pays de la Loire, Centre d’Expertise Partenariat Européen d’Innovation pour un Vieillissement Actif et en Bonne Santé, Nantes, France
- Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
- Université Paris-Sud; Service de Pneumologie, Hôpital Bicêtre, Inserm UMR_S999, Le Kremlin Bicêtre, France
- Department of Medicine and Surgery, University of Salerno, Baronissi, Italy
- Servicio de Alergia e Immunologia, Clinica Santa Isabel, Buenos Aires, Argentina
- Hallym University College of Medicine, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do South Korea
- Department of Clinical Immunology, Wrocław Medical University, Wrocław, Poland
- Ukrainian Medical Stomatological Academy, Poltava, Ukraine
- Pediatric Allergy and Asthma Unit, Hacettepe University School of Medicine, Ankara, Turkey
- First Department of Family Medicine, Medical University of Lodz, Łódź, Poland
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Institute for Clinical Epidemiology and Biometry, University of Wuerzburg, Würzburg, Germany
- National Research Center, Institute of Immunology, Federal Medicobiological Agency, Laboratory of Molecular Immunology, Moscow, Russian Federation
- GARD Chairman, Geneva, Switzerland
- Allergy & Asthma Center Westend, Berlin, Germany
- Department of Immunology and Allergy, Healthy Ageing Research Center, Medical University of Lodz, Łódź, Poland
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
- Sach’s Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
- Mattone Internazionale Program, Veneto Region, Italy
- Departments of Internal Medicine and Pediatrics (Divisions of Allergy and Immunology), University of Tennessee College of Medicine, Germantown, TN USA
- Scottish Centre for Respiratory Research, Cardiovascular & Diabetes Medicine, Medical Research Institute, Ninewells Hospital, University of Dundee, Dundee, UK
- Department of Paediatrics, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Imunoalergologia, Centro Hospitalar Universitário de Coimbra and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Department of Pulmonary Medicine, CHU Sart-Tilman, and GIGA I3 Research Group, Liege, Belgium
- DG for Health and Social Care, Scottish Government, Edinburgh, UK
- Department of Pulmonary Medicine, Rashid Hospital, Dubai, UAE
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Department of Medicine (RCSI), Bon Secours Hospital, Glasnevin, Dublin, Ireland
- Kronikgune, International Centre of Excellence in Chronicity Research Barakaldo, Barakaldo, Bizkaia Spain
- Division of Clinical Immunology and Allergy, Laboratory of Behavioral Immunology Research, The University of Mississippi Medical Center, Jackson, MS USA
- Tobacco Control Research Centre, Iranian Anti Tobacco Association, Tehran, Iran
- Argentine Association of Allergy and Clinical Immunology, Buenos Aires, Argentina
- Department of Pediatric Pneumology and Immunology, AG Molecular Allergology and Immunomodulation, Charité Medical University, Berlin, Germany
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- PNDR, Portuguese National Programme for Respiratory Diseases, Faculdade de Medicina de Lisboa, Lisbon, Portugal
- Allergy and Asthma Medical Group and Research Center, San Diego, CA USA
- Department of Physiology, CHRU, University Montpellier, Vice President for Research, PhyMedExp, INSERM U1046, CNRS, UMR 9214, Montpellier, France
- Croatian Pulmonary Society, Zagreb, Croatia
- National Institute of Pneumology M Nasta, Bucharest, Romania
- Clinic for Pulmonary Diseases, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Serbian Association for Asthma and COPD, Belgrade, Serbia
- Regione Piemonte, Turin, Italy
- Mexico City, Mexico
- National Center for Research in Chronic Respiratory Diseases, Tishreen University School of Medicine, Latakia, Syria
- Syrian Private University, Damascus, Syria
- Faculty of Medicine and Surgery, University of Medicine, La Valette, Malta
- Department of Medical Sciences, Allergy and Clinical Immunology Unit, University of Torino & Mauriziano Hospital, Turin, Italy
- Allergy Center, CUF Descobertas Hospital, Lisbon, Portugal
- Institute of Medical Statistics, and Computational Biology, Medical Faculty, University of Cologne, Cologne, Germany
- CRI-Clinical Research International-Ltd, Hamburg, Germany
- Danish Commitee for Health Education, Copenhagen East, Denmark
- Food Allergy Referral Centre Veneto Region, Department of Women and Child Health, Padua General University Hospital, Padua, Italy
- MedScript Ltd, Paraparomu, New Zealand
- OPC, Cambridge, UK
- Johns Hopkins School of Medicine, Baltimore, MD USA
- Consortium of Pharmacies and Services COSAFER, Salerno, Italy
- Scientific Centre of Children’s Health under the Russian Academy of Medical Sciences, Moscow, Russia
- Center of Allergy, Immunology and Respiratory Diseases, Santa Fe, Argentina
- Center for Allergy and Immunology, Santa Fe, Argentina
- Hospital of the Hospitaller Brothers in Buda, Budapest, Hungary
- Die Hautambulanz and Rothhaar Study Center, Berlin, Germany
- Department of Pharmacy, University of Naples Federico II, Naples, Italy
- ENT Department, University Hospital of Kinshasa, Kinshasa, Congo
- Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Central Clinical School, Monash University, Melbourne, VIC Australia
- Dept of Otolaryngology, Nippon Medical School, Tokyo, Japan
- Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle, Ouagadougou, Burkina Faso
- Dept of Comparative Medicine, Messerli Research Institute of the University of Veterinary Medicine and Medical University, Vienna, Austria
- EFA European Federation of Allergy and Airways Diseases Patients’ Associations, Brussels, Belgium
- Department of Immunology and Allergology, Faculty of Medicine and Faculty Hospital in Pilsen, Charles University in Prague, Pilsen, Czech Republic
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, South Korea
- Laboratoire HP2, Université Grenoble Alpes, Grenoble, France
- INSERM, U1042 and CHU de Grenoble, Grenoble, France
- Allergy Unit, CUF-Porto Hospital and Institute, Porto, Portugal
- Center for Research in Health Technologies and Information Systems, CINTESIS, Universidade do Porto, Porto, Portugal
- Maladies Infectieuses et immunitaires, CHUL, Quebec City, QC Canada
- Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany
- Farmacias Holon, Lisbon, Portugal
- Centre for Empowering Patients and Communities, Faulkland, Somerset, UK
- Children’s Hospital Srebrnjak, Zagreb, Croatia
- School of Medicine, University J.J. Strossmayer, Osijek, Croatia
- University Hospital ‘Sv Ivan Rilski’, Sofia, Bulgaria
- Academic Centre of Primary Care, University of Aberdeen, Aberdeen, Scotland UK
- Research in Real-Life, Cambridge, UK
- Department of Otorhinolaryngology, University of Crete School of Medicine, Heraklion, Greece
- Department of Nephrology and Endocrinology, Karolinska University Hospital, Stockholm, Sweden
- Allergy Unit, Presidio Columbus, Catholic University of Sacred Heart, Rome, Italy
- IRCCS Oasi Maria SS, Troina, Italy
- Hospital de Clinicas, University of Parana, Paraná, Brazil
- Division of Allergy Asthma and Clinical Immunology, Emek Medical Center, Afula, Israel
- Allergy and Respiratory Research Group, The University of Edinburgh, Edinburgh, UK
- Association of Finnish Pharmacists, Helsinki, Finland
- Allergy and Clinical Immunology Department, Centro Médico-Docente la, Trinidad and Clínica El Avila, Caracas, Venezuela
- Sociedad Paraguaya de Alergia Asma e Inmunologia, Asunción, Paraguay
- Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil
- European Health Futures Forum (EHFF), Dromahair, UK
- Kyrgyzstan National Centre of Cardiology and Internal Medicine, Euro-Asian Respiratory Society, Bishkek, Kyrgyzstan
- Department of Respiratory Medicine, University Hospital Olomouc, Olomouc, Czech Republic
- Pulmonary Division, Heart Institute (InCor), Hospital da Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
- Department of Respiratory Medicine, Hvidovre Hospital & University of Copenhagen, Copenhagen, Denmark
- RNSA (Réseau National de Surveillance Aérobiologique), Brussieu, France
- Sidkkids Hospitala and Institute of Health Policy, Management and Evaluation, Toronto, Canada
- Department of ENT, Medical University of Graz, Graz, Austria
- Pneumology and Allergy Department CIBERES and Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, University of Barcelona, Barcelona, Spain
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
- NRC Institute of Immunology FMBA of Russia, Moscow, Russia
- Laboratory of Immunopathology, Department of Clinical Immunology and Allergy, Sechenov First Moscow State Medical University, Moscow, Russia
- Montevideo, Uruguay
- Department of Public Health & Primary Care, Leiden University Medical Center (LUMC), Leiden, The Netherlands
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Chest Medicine, Centre Hospitalier Universitaire UCL Namur, Université Catholique de Louvain, Yvoir, Belgium
- Pulmonary Unit, Department of Medical Specialties, Arcispedale SMaria Nuova/IRCCS, AUSL di Reggio Emilia, Reggio Emilia, Italy
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa, Italy
- CNR Institute of Biomedicine and Molecular Immunology “A Monroy”, Palermo, Italy
- Nova Southeastern University, Fort Lauderdale, FL USA
- Dept of Otorhinolaryngology, HNO-Klinik, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Medicine, Clinical Immunology and Allergy, McMaster University, Hamilton, ON Canada
- Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden
- Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC USA
- Cyprus International Institute for Environmental & Public Health in Association with Harvard School of Public Health, Cyprus University of Technology, Limassol, Cyprus
- Department of Pediatrics, Hospital “Archbishop Makarios III”, Nicosia, Cyprus
- Department of Pulmonary Diseases, Celal Bayar University, Faculty of Medicine, Manisa, Turkey
- The Allergy and Asthma Institute, Islamabad, Pakistan
- Department of Paediatrics and Child Health, Red Cross Children’s Hospital, Cape Town, South Africa
- MRC Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
- Bull DSAS, Echirolles, France
- Universidad Católica de Córdoba, Córdoba, Argentina
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital and Beijing Institute of Otolaryngology, Beijing, China
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia
- National Hospital Organization, Tokyo National Hospital, Tokyo, Japan
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Halpin DMG, Meltzer EO, Pisternick-Ruf W, Moroni-Zentgraf P, Engel M, Zaremba-Pechmann L, Casale T, FitzGerald JM. Peak expiratory flow as an endpoint for clinical trials in asthma: a comparison with FEV 1. Respir Res 2019; 20:159. [PMID: 31319851 PMCID: PMC6637596 DOI: 10.1186/s12931-019-1119-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 07/01/2019] [Indexed: 11/13/2022] Open
Abstract
Background The primary lung function endpoint in clinical trials in adolescent and adult patients with asthma is usually forced expiratory volume in one second (FEV1). The objective of our analysis was to assess whether peak expiratory flow (PEF) is a suitable alternative primary lung function endpoint. Methods For this assessment, we calculated post hoc the correlation between pre-dose FEV1 and pre-dose PEF measured under supervision in the clinic and, for both lung function parameters, the correlations between supervised clinic and unsupervised home measurements, using the results from the 8 Phase III parallel-group trials of the global clinical development programme with tiotropium Respimat® in patients with asthma aged 12 to 75 years. Results Across all 8 trials included in this analysis, changes in lung function from baseline correlated well between pre-dose FEV1 and pre-dose PEF when both were measured under supervision in the clinic. Correlation between supervised in-clinic and unsupervised home measurements was stronger for pre-dose PEF than for pre-dose FEV1. Conclusions Pre-dose PEF measured at home could be an alternative primary lung function endpoint for trials in adolescent and adult patients with asthma. Using home-measured PEF could facilitate trial conduct and improve the convenience for patients by relocating scheduled assessments from the clinic to the patient’s home. Trial registration Adolescents aged 12 to 17 years: RubaTinA-asthma® (NCT01257230), PensieTinA-asthma® (NCT01277523). Adults aged 18 to 75 years: GraziaTinA-asthma® (NCT01316380), MezzoTinA-asthma® (NCT01172808/NCT01172821), CadenTinA-asthma® (NCT01340209), PrimoTinA-asthma® (NCT00772538/NCT00776984). All from Clinicaltrials.gov (https://clinicaltrials.gov/). Electronic supplementary material The online version of this article (10.1186/s12931-019-1119-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- David M G Halpin
- University of Exeter Medical School, College of Medicine and Health, University of Exeter, Exeter, EX1 2LU, UK.
| | - Eli O Meltzer
- Allergy and Asthma Medical Group and Research Center, University of California, San Diego, CA, USA
| | | | | | - Michael Engel
- Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany
| | | | - Thomas Casale
- Division of Allergy and Immunology, University of South Florida Morsani College of Medicine, Tampa, FL, USA
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Blaiss MS, Steven GC, Bender B, Bukstein DA, Meltzer EO, Winders T. Shared decision making for the allergist. Ann Allergy Asthma Immunol 2018; 122:463-470. [PMID: 30201469 DOI: 10.1016/j.anai.2018.08.019] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 08/21/2018] [Accepted: 08/27/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Shared decision making (SDM) is becoming more commonly appreciated and used in medical practice as a way to empower patients who are facing treatment preference-sensitive conditions, such as allergic rhinitis, atopic dermatitis, food allergy, and persistent asthma. The purpose of this review is to educate the allergy health care provider about how SDM works and provide practical advice and allergist-specific SDM resources. DATA SOURCES PubMed and online patient decision aid resources. STUDY SELECTIONS Studies and reviews relevant to SDM and patient decision aids relevant to the allergy health care provider were selected for discussion. RESULTS There are ethical, practical, economic, and psychological imperatives for the implementation of quality SDM, particularly for chronic diseases. Many benefits and barriers of SDM have been identified and models have been developed to encourage implementation of quality SDM. For the allergy health care provider, SDM for asthma has been shown to improve adherence, outcomes, and patient satisfaction with care. Patient decision aids are useful tools for SDM and have recently been developed for allergen immunotherapy, severe asthma, and atopic dermatitis. CONCLUSION Effective SDM has been shown to improve adherence and lead to better outcomes. SDM should be universally implemented as a key component of patient-centered health care. Allergy health care providers should work with their patients to reach treatment decisions that align with their values and preferences.
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Affiliation(s)
- Michael S Blaiss
- Department of Pediatrics, Medical College of Georgia, Augusta, Georgia.
| | - Gary C Steven
- Allergy, Asthma & Sinus Center, Milwaukee, Wisconsin
| | - Bruce Bender
- National Jewish Health, Denver, and University of Colorado School of Medicine, Aurora, Colorado
| | | | - Eli O Meltzer
- Department of Pediatrics, University of California-San Diego School of Medicine, San Diego, California
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Meltzer EO, Halverson PC, Banov CH, Weiler JM, Woehler TR, Hemsworth GR, Freitag JJ. The Effectiveness of Oral Azelastine in the Management of Perennial Allergic Rhinitis. ACTA ACUST UNITED AC 2018. [DOI: 10.2500/105065894781874142] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Azelastine, a phthalazinone derivative, is a chemically novel antiallergy compound that inhibits inflammatory responses in the upper and lower airway. Previous clinical trials demonstrated the effectiveness of azelastine in the treatment of allergic rhinitis. The objective of this double-blind trial was to further evaluate the efficacy and safety of oral azelastine compared with placebo in patients with perennial allergic rhinitis. A total of 192 patients (between 13 and 60 years of age) who satisfied a minimum symptom score during a single-blind placebo evaluation period were randomized to receive one of three treatments: 2 mg of azelastine b.i.d., 1.34 mg of clemastine fumarate b.i.d., or placebo b.i.d. for a 4-week double-blind treatment period. In the primary efficacy analysis, rhinitis symptoms were analyzed as a Total Symptom Complex severity score (nose blows, runny nose, sneezes, stuffy nose, itchy nose, and itchy eyes/ears/throat). After 2 and 4 weeks of therapy, the azelastine group had greater mean percent improvements than the placebo group in the Total Symptom Complex severity scores. The overall and endpoint improvements for the azelastine group were statistically significant (P ≤ .026) versus placebo. Improvements in individual rhinitis symptoms for the azelastine group were superior to placebo for nose blows, runny nose, sneezes, itchy nose, and itchy eyes/ears/throat. Azelastine was well tolerated. Clemastine was also significantly more effective than placebo and was well tolerated. The results support oral azelastine's safety and effectiveness in the treatment of perennial allergic rhinitis.
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Affiliation(s)
- Eli O. Meltzer
- Allergy & Asthma Medical Group and Research Center, San Diego, CA
| | | | - Charles H. Banov
- Professor of Internal Medicine and Microbiology-Immunology, Medical University of South Carolina, Charleston, SC
| | - John M. Weiler
- Department of Internal Medicine, University of Iowa, Iowa City, IA
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Meltzer EO, Philip G, Weinstein SF, LaForce CF, Malice MP, Dass SB, Santanello NC, Reiss TF. Montelukast Effectively Treats the Nighttime Impact of Seasonal Allergic Rhinitis. ACTA ACUST UNITED AC 2018. [DOI: 10.1177/194589240501900611] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Nighttime problems constitute a significant burden on the quality of life of patients with seasonal allergic rhinitis (SAR). The aim of this study was to evaluate the effectiveness of montelukast on nighttime AR symptoms. Methods In seven multicenter, double-blind, parallel-group trials, nighttime problems were assessed as the nighttime symptoms score (NSS), an average of three individual symptom scores: difficulty going to sleep, nighttime awakening, and nasal congestion on awakening (each rated 0 = none to 3 = severe). Patients (aged 15–82 years) were randomized to receive montelukast, 10 mg (n = 1751), placebo (n = 1557), or the positive control loratadine, 10 mg (n = 1616). Results In a combined analysis, changes from baseline (mean ± SE) in NSS were -0.28 ± 0.01, -0.16 ± 0.01, and —0.24 ± 0.01 for the montelukast, placebo, and loratadine groups, respectively. Difference versus placebo in least-squares mean change from baseline were —0.11 (95% confidence interval, -0.14, -0.08; p ≤ 0.001) for montelukast and -0.09 (-0.12, -0.06; p ≤ 0.001) for loratadine. Strong baseline correlations (R > 0.70; p < 0.001) of NSS and two of its individual symptoms with the sleep domain of the validated Rhinoconjunctivitis Quality of Life Questionnaire support the validity and importance of measuring nighttime morbidity in SAR. Furthermore, a clinically important benefit of montelukast on the nighttime impact of SAR was shown using an analysis anchored on the Patient's Global Evaluation. Conclusion These data underscore the importance of nighttime problems in patients with SAR and the need to treat nighttime symptoms. In these studies, montelukast significantly improved the NSS, a clinically relevant and valid measure in patients with SAR.
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Affiliation(s)
- Eli O. Meltzer
- Allergy and Asthma Medical Group and Research Center, A.P.C., San Diego, California
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Busse W, Janssens M, Eisen G, Us E, Busse CW, Creticos P, Dolovich J, Graft D, Knight A, Grant A, Cross G, Munk Z, Pauli B, Bronsky E, Meltzer EO, Nathan R, Nelson H, Seltzer J. A Multicenter, Double-Blind, Randomized, Placebo-Controlled Trial Comparing the Efficacy and Tolerability of Levocabastine-Oxymetazoline Nasal Spray with Levocabastine and Oxymetazoline Alone in the Symptomatic Treatment of Seasonal Allergic Rhinitis. ACTA ACUST UNITED AC 2018. [DOI: 10.2500/105065896781795076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A total of 1015 patients participated in three 1-week, multicenter, double-blind, randomized, placebo-controlled trials undertaken to assess the therapeutic efficacy and tolerability of twice daily administration of a nasal spray containing a combination of levocabastine (0.5 mg/mL) and oxymetazoline (0.5 mg/mL) (levocabastine-D) versus that of either agent alone in the treatment of ragweed-induced seasonal allergic rhinitis. As these studies shared a common protocol, the data have been pooled. Patient assessments revealed that the mean change in area under the curve (AUC) from baseline over the entire treatment period was significantly greater in patients treated with levocabastine or levocabastine-D than in those receiving placebo for all symptoms evaluated (nasal congestion; P < 0.05 and sneezing, rhinorrhea, nasal itching, ocular symptoms, total key symptoms, total all symptoms; P < 0.001). Corresponding changes in patients treated with oxymetazoline alone did not attain statistical significance. Day-by-day analysis demonstrated that the beneficial effects seen with levocabastine and levocabastine-D were maintained throughout the treatment period for all symptoms except nasal congestion (Days 1 and 2 only); oxymetazoline provided significant relief from nasal congestion only and only on the first day of treatment. Investigator assessments revealed similar trends. Global evaluations of therapeutic efficacy revealed that 44% of levocabastine-treated patients and 52% of patients treated with levocabastine-D considered therapeutic efficacy to be excellent or good compared with 39% of those on oxymetazoline and 26% on placebo (P < 0.01 versus placebo). Adverse experiences were reported by 30% of levocabastine-treated patients, 40% of patients treated with levocabastine-D and oxymetazoline, and 32% of placebo controls, with no statistically significant intergroup differences in incidence or type. In conclusion, twice daily levocabastine nasal spray is effective and well-tolerated for the treatment of ragweed-induced seasonal allergic rhinitis with an adverse effect profile comparable with that of placebo. Addition of oxymetazoline to the topical antihistamine does not appear to provide significant additional clinical benefit compared to that observed with levocabastine alone, and tachyphylaxis to the decongestant effect of the topical vasoconstrictor occurs within days of treatment initiation.
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Affiliation(s)
- William Busse
- University of Wisconsin, Madison Medical School, Beerse, Belgium
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Abstract
Analysis of the nasal cytology provides information regarding the pathophysiology and response to therapy of the airway. This paper reviews the techniques for obtaining and interpreting specimens. The discussion focuses on the epithelial and inflammatory cells and the patterns seen in allergic, infectious and structural nasal disorders.
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Affiliation(s)
- Eli O. Meltzer
- Division of Allergy and Immunology, University of California, San Diego and Allergy and Asthma Medical Group and Research Center, San Diego, CA
| | - Alfredo A. Jalowayski
- Pediatric Respiratory Unit and Rapid Diagnostic Laboratory, Department of Pediatrics, University of California, San Diego, San Diego, CA
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Dockhorn RJ, Paull BR, Meltzer EO, van As A, Weakley S, Woehler TR, Krai KM, Rogenes PR. Once- versus Twice-Daily Fluticasone Propionate Aqueous Nasal Spray for Seasonal Allergic Rhinitis. ACTA ACUST UNITED AC 2018. [DOI: 10.2500/105065893781976519] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A new potent topical corticosteroid, fluticasone propionate aqueous nasal spray, has proved effective when administered twice daily for seasonal allergic rhinitis. The purpose of this study was to compare the efficacy and safety of a once-daily dosage with twice-daily administration of fluticasone propionate. A multicenter, double-blind, randomized, placebo-controlled study was conducted in adults with moderate to severe symptoms of allergic rhinitis during the autumn pollen season. Patients were treated for 4 weeks with fluticasone propionate aqueous nasal spray, 200 μg once daily or 100 μg twice daily or matching placebo. Fluticasone propionate administered once daily in the morning was as effective as the twice-daily dosage regimen, and both regimens were more effective than placebo. Nasal symptoms were improved by the second day of treatment and continued to improve throughout the study. Nasal eosinophils were reduced in more patients treated with either regimen of fluticasone propionate compared with placebo. Adverse events were similar in frequency and nature in all three groups. There was no evidence of hypothalamicpituitary-adrenal axis effects; mean morning plasma cortisol concentrations and response to cosyntropin stimulation remained within normal ranges and were similar across groups. We conclude that fluticasone propionate aqueous nasal spray administered once daily is safe and as effective as a twice-daily dosage regimen for treating seasonal allergic rhinitis.
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Affiliation(s)
| | | | - Eli O. Meltzer
- Allergy and Asthma Medical Group and Research Center, San Diego, CA
| | - Andre van As
- The Asthma and Allergy Research Center, Inc., Albuquerque, NM
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Bousquet J, Meltzer EO, Couroux P, Koltun A, Kopietz F, Munzel U, Kuhl HC, Nguyen DT, Salapatek AM, Price D. Onset of Action of the Fixed Combination Intranasal Azelastine-Fluticasone Propionate in an Allergen Exposure Chamber. J Allergy Clin Immunol Pract 2018; 6:1726-1732.e6. [PMID: 29425904 DOI: 10.1016/j.jaip.2018.01.031] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 01/14/2018] [Accepted: 01/19/2018] [Indexed: 01/05/2023]
Abstract
BACKGROUND A fixed-dose combination of intranasal azelastine hydrochloride and fluticasone propionate (MP-AzeFlu) is the most effective treatment of allergic rhinitis, but its onset of action requires further investigation. OBJECTIVE To compare the onset of action of MP-AzeFlu with the free combination of oral loratadine (LORA) and intranasal fluticasone propionate (INFP). METHODS In this single-center, randomized, placebo-controlled, double-blind, double-dummy, 3-period crossover trial, allergic rhinitis symptoms were induced in asymptomatic patients by ragweed pollen challenge in an allergen environmental exposure chamber. Patients received single-dose MP-AzeFlu, LORA/INFP, or placebo and were monitored for 4 hours. The primary outcome was onset of action measured by total nasal symptom score (TNSS). Secondary measures were total ocular symptom score (TOSS), total score of the 7 nasal and ocular symptoms (T7SS), and the global visual analog scale (VAS). RESULTS The full analysis set included 82 patients, of which 78 completed all treatments. TNSS was significantly reduced versus placebo from 5 minutes for MP-AzeFlu and 150 minutes for LORA/INFP onward (both P < .05) till the end of assessment (0-4 hours). MP-AzeFlu reduced TNSS to a greater extent at each time point from 5 to 90 minutes (P < .05) and over the entire assessment interval (P ≤ .005) versus LORA/INFP or placebo. No statistically significant difference between LORA/INFP and placebo was observed over the assessment interval (P = .182). The onset of action of MP-AzeFlu assessed by TOSS, T7SS, and VAS was 10 minutes, 2 hours earlier than with LORA/INFP. CONCLUSION MP-AzeFlu had a more rapid onset of action (5 minutes) and was more effective than LORA/INFP.
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Affiliation(s)
- Jean Bousquet
- MACVIA-France, Contre les MAladies Chroniques pour un VIeillissement Actif en France European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France; INSERM U 1168, VIMA: Ageing and chronic diseases Epidemiological and public health approaches, Villejuif, Université Versailles St-Quentin-en-Yvelines; Euforea, Brussels, Belgium; Charité, Berlin, Germany.
| | - Eli O Meltzer
- Allergy and Asthma Medical Group and Research Center, San Diego, Calif
| | | | | | | | - Ullrich Munzel
- Meda Pharma GmbH & Co. KG (a Mylan Company), Bad Homurg, Germany
| | | | - Duc Tung Nguyen
- Meda Pharma GmbH & Co. KG (a Mylan Company), Bad Homurg, Germany
| | | | - David Price
- Observational and Pragmatic Research Institute, Singapore; Optimum Patient Care, Cambridge, UK; Academic Centre of Primary Care, University of Aberdeen, Aberdeen, UK
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Bousquet J, Price D, Meltzer EO, Tung Nguyen D, Kuhl HC, Koltun A, Kopietz F, Munzel U. Fixed-Dose Combination Intranasal Azelastine-Fluticasone Propionate Versus Oral Loratadine with Intranasal Fluticasone Propionate: Assessment of Onset of Action in the Treatment of Allergen-Induced Allergic Rhinitis Symptoms. J Allergy Clin Immunol 2018. [DOI: 10.1016/j.jaci.2017.12.952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Buhl R, FitzGerald JM, Meltzer EO, de la Hoz A, Sigmund R, Kerstjens HA, Bleecker ER. Efficacy of Once-Daily Tiotropium Respimat ® on Lung Function and Asthma Control in Adults with Asthma at GINA Steps 2–5. J Allergy Clin Immunol 2018. [DOI: 10.1016/j.jaci.2017.12.667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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26
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Meltzer EO, Berger WE. A review of the efficacy and safety of once-daily tiotropium Respimat 2.5 micrograms in adults and adolescents with asthma. Allergy Asthma Proc 2018; 39:14-26. [PMID: 29279056 DOI: 10.2500/aap.2018.39.4103] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Despite current guidelines, many patients with asthma remain symptomatic, particularly those intolerant of, unresponsive to, or uncontrolled by long-acting beta 2-agonists (LABAs). Tiotropium bromide, delivered through the Respimat soft-mist inhaler in 2 puffs of 1.25 micrograms each, is approved for the long-term, maintenance treatment of asthma in patients aged ≥6 years. OBJECTIVE An overview of the use of once-daily tiotropium Respimat 2.5 micrograms in adults and adolescents with varying degrees of asthma severity. The role of the parasympathetic nervous system in the pathophysiology of asthma, the development of tiotropium for respiratory disease, and the value of the Respimat inhaler are also discussed. METHODS A literature search of all phase II and phase III trials of once-daily tiotropium Respimat 2.5 micrograms. RESULTS Once-daily tiotropium Respimat 2.5 micrograms was studied in five phase III studies: three studies in adults and two in adolescents aged 12-17 years. Tiotropium Respimat 2.5 micrograms demonstrated efficacy in adults and adolescents with mild, moderate, or severe asthma, showing significant improvements in lung function and asthma control in patients with uncontrolled asthma despite inhaled corticosteroids (ICS) or ICS plus LABA use. The adverse event profile of tiotropium was very acceptable, with safety similar to placebo. CONCLUSION Once-daily tiotropium Respimat 2.5 micrograms has positive attributes that include efficacy, a safety profile similar to placebo, once-daily dosing, administration by inhalation, and delivery in the easy-to-use and consistent-dosing Respimat device. However, more data are needed on the effects of tiotropium on clinical outcomes, patients' day-to-day lives, and real-world effectiveness.
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Meltzer EO. Hot Topics in Primary Care: Sublingual Immunotherapy: A Guide for Primary Care. J Fam Pract 2017; 66:S58-S63. [PMID: 28375410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Allergen immunotherapy (AIT), the only potential disease-modifying treatment for allergic disease, has been used for more than a century. Hankin et al showed significant reduction in pharmacy, outpatient, and inpatient resources in the 6 months following vs the 6 months preceding AIT in Medicaid-enrolled children with allergic rhinitis (AR). A 2013 analysis showed sustained cost reduction over 18 months in patients with AR treated with AIT compared with matched control subjects not treated with AIT.
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Affiliation(s)
- Eli O Meltzer
- Clinical Professor of Pediatrics, Division of Allergy and Immunology, University of California, San Diego, CA, USA
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28
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Berger WE, Meltzer EO, Unseld A, Shaikh A, Engel M. Tiotropium Respimat® 2.5 μg Add-on to ICS or ICS+controller medications Improves Lung Function in Adults and Adolescents With Mild, Moderate, or Severe Symptomatic Asthma. J Allergy Clin Immunol 2017. [DOI: 10.1016/j.jaci.2016.12.312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Bousquet J, Hellings PW, Agache I, Bedbrook A, Bachert C, Bergmann KC, Bewick M, Bindslev-Jensen C, Bosnic-Anticevitch S, Bucca C, Caimmi DP, Camargos PAM, Canonica GW, Casale T, Chavannes NH, Cruz AA, De Carlo G, Dahl R, Demoly P, Devillier P, Fonseca J, Fokkens WJ, Guldemond NA, Haahtela T, Illario M, Just J, Keil T, Klimek L, Kuna P, Larenas-Linnemann D, Morais-Almeida M, Mullol J, Murray R, Naclerio R, O'Hehir RE, Papadopoulos NG, Pawankar R, Potter P, Ryan D, Samolinski B, Schunemann HJ, Sheikh A, Simons FER, Stellato C, Todo-Bom A, Tomazic PV, Valiulis A, Valovirta E, Ventura MT, Wickman M, Young I, Yorgancioglu A, Zuberbier T, Aberer W, Akdis CA, Akdis M, Annesi-Maesano I, Ankri J, Ansotegui IJ, Anto JM, Arnavielhe S, Asarnoj A, Arshad H, Avolio F, Baiardini I, Barbara C, Barbagallo M, Bateman ED, Beghé B, Bel EH, Bennoor KS, Benson M, Białoszewski AZ, Bieber T, Bjermer L, Blain H, Blasi F, Boner AL, Bonini M, Bonini S, Bosse I, Bouchard J, Boulet LP, Bourret R, Bousquet PJ, Braido F, Briggs AH, Brightling CE, Brozek J, Buhl R, Bunu C, Burte E, Bush A, Caballero-Fonseca F, Calderon MA, Camuzat T, Cardona V, Carreiro-Martins P, Carriazo AM, Carlsen KH, Carr W, Cepeda Sarabia AM, Cesari M, Chatzi L, Chiron R, Chivato T, Chkhartishvili E, Chuchalin AG, Chung KF, Ciprandi G, de Sousa JC, Cox L, Crooks G, Custovic A, Dahlen SE, Darsow U, Dedeu T, Deleanu D, Denburg JA, De Vries G, Didier A, Dinh-Xuan AT, Dokic D, Douagui H, Dray G, Dubakiene R, Durham SR, Du Toit G, Dykewicz MS, Eklund P, El-Gamal Y, Ellers E, Emuzyte R, Farrell J, Fink Wagner A, Fiocchi A, Fletcher M, Forastiere F, Gaga M, Gamkrelidze A, Gemicioğlu B, Gereda JE, van Wick RG, González Diaz S, Grisle I, Grouse L, Gutter Z, Guzmán MA, Hellquist-Dahl B, Heinrich J, Horak F, Hourihane JOB, Humbert M, Hyland M, Iaccarino G, Jares EJ, Jeandel C, Johnston SL, Joos G, Jonquet O, Jung KS, Jutel M, Kaidashev I, Khaitov M, Kalayci O, Kalyoncu AF, Kardas P, Keith PK, Kerkhof M, Kerstjens HAM, Khaltaev N, Kogevinas M, Kolek V, Koppelman GH, Kowalski ML, Kuitunen M, Kull I, Kvedariene V, Lambrecht B, Lau S, Laune D, Le LTT, Lieberman P, Lipworth B, Li J, Lodrup Carlsen KC, Louis R, Lupinek C, MacNee W, Magar Y, Magnan A, Mahboub B, Maier D, Majer I, Malva J, Manning P, De Manuel Keenoy E, Marshall GD, Masjedi MR, Mathieu-Dupas E, Maurer M, Mavale-Manuel S, Melén E, Melo-Gomes E, Meltzer EO, Mercier J, Merk H, Miculinic N, Mihaltan F, Milenkovic B, Millot-Keurinck J, Mohammad Y, Momas I, Mösges R, Muraro A, Namazova-Baranova L, Nadif R, Neffen H, Nekam K, Nieto A, Niggemann B, Nogueira-Silva L, Nogues M, Nyembue TD, Ohta K, Okamoto Y, Okubo K, Olive-Elias M, Ouedraogo S, Paggiaro P, Pali-Schöll I, Palkonen S, Panzner P, Papi A, Park HS, Passalacqua G, Pedersen S, Pereira AM, Pfaar O, Picard R, Pigearias B, Pin I, Plavec D, Pohl W, Popov TA, Portejoie F, Postma D, Poulsen LK, Price D, Rabe KF, Raciborski F, Roberts G, Robalo-Cordeiro C, Rodenas F, Rodriguez-Mañas L, Rolland C, Roman Rodriguez M, Romano A, Rosado-Pinto J, Rosario N, Rottem M, Sanchez-Borges M, Sastre-Dominguez J, Scadding GK, Scichilone N, Schmid-Grendelmeier P, Serrano E, Shields M, Siroux V, Sisul JC, Skrindo I, Smit HA, Solé D, Sooronbaev T, Spranger O, Stelmach R, Sterk PJ, Strandberg T, Sunyer J, Thijs C, Triggiani M, Valenta R, Valero A, van Eerd M, van Ganse E, van Hague M, Vandenplas O, Varona LL, Vellas B, Vezzani G, Vazankari T, Viegi G, Vontetsianos T, Wagenmann M, Walker S, Wang DY, Wahn U, Werfel T, Whalley B, Williams DM, Williams S, Wilson N, Wright J, Yawn BP, Yiallouros PK, Yusuf OM, Zaidi A, Zar HJ, Zernotti ME, Zhang L, Zhong N, Zidarn M. ARIA 2016: Care pathways implementing emerging technologies for predictive medicine in rhinitis and asthma across the life cycle. Clin Transl Allergy 2016; 6:47. [PMID: 28050247 PMCID: PMC5203711 DOI: 10.1186/s13601-016-0137-4] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 12/05/2016] [Indexed: 12/13/2022] Open
Abstract
The Allergic Rhinitis and its Impact on Asthma (ARIA) initiative commenced during a World Health Organization workshop in 1999. The initial goals were (1) to propose a new allergic rhinitis classification, (2) to promote the concept of multi-morbidity in asthma and rhinitis and (3) to develop guidelines with all stakeholders that could be used globally for all countries and populations. ARIA—disseminated and implemented in over 70 countries globally—is now focusing on the implementation of emerging technologies for individualized and predictive medicine. MASK [MACVIA (Contre les Maladies Chroniques pour un Vieillissement Actif)-ARIA Sentinel NetworK] uses mobile technology to develop care pathways for the management of rhinitis and asthma by a multi-disciplinary group and by patients themselves. An app (Android and iOS) is available in 20 countries and 15 languages. It uses a visual analogue scale to assess symptom control and work productivity as well as a clinical decision support system. It is associated with an inter-operable tablet for physicians and other health care professionals. The scaling up strategy uses the recommendations of the European Innovation Partnership on Active and Healthy Ageing. The aim of the novel ARIA approach is to provide an active and healthy life to rhinitis sufferers, whatever their age, sex or socio-economic status, in order to reduce health and social inequalities incurred by the disease.
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Affiliation(s)
- J Bousquet
- Montpellier University Hospital, Montpellier, France ; MACVIA-France, Contre les MAladies Chroniques pour un VIeillissement Actif en France, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France ; INSERM, U1168, Ageing and Chronic Diseases Epidemiological and Public Health Approaches, 94800 Villejuif, France ; CHRU Arnaud de Villeneuve, 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France
| | - P W Hellings
- Laboratory of Clinical Immunology, Department of Microbiology and Immunology, KU Leuven, Louvain, Belgium
| | - I Agache
- Transylvania University Brasov, Brasov, Romania
| | - A Bedbrook
- MACVIA-France, Contre les MAladies Chroniques pour un VIeillissement Actif en France, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France
| | - C Bachert
- Upper Airways Research Laboratory, ENT Department, Ghent University Hospital, Ghent, Belgium
| | - K C Bergmann
- Allergy-Centre-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany ; Global Allergy and Asthma European Network (GA²LEN), Berlin, Germany
| | - M Bewick
- iQ4U Consultants Ltd, London, UK
| | - C Bindslev-Jensen
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark
| | - S Bosnic-Anticevitch
- Woolcock Institute of Medical Research, University of Sydney and Sydney Local Health District, Glebe, NSW Australia
| | - C Bucca
- University Pneumology Unit-AOU Molinette, Hospital City of Health and Science of Torino, Turin, Italy
| | - D P Caimmi
- Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France
| | - P A M Camargos
- Department of Pediatrics, Medical School, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - G W Canonica
- Asthma and Allergy Clinic, Humanitas University, Rozzano, Milan, Italy
| | - T Casale
- Division of Allergy/Immunology, University of South Florida, Tampa, FL USA
| | - N H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - A A Cruz
- ProAR - Nucleo de Excelencia em Asma, Federal University of Bahia, Salvador, Brazil ; GARD Executive Committee, Salvador, Bahia Brazil
| | - G De Carlo
- EFA European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium
| | - R Dahl
- ProAR - Nucleo de Excelencia em Asma, Federal University of Bahia, Salvador, Brazil
| | - P Demoly
- Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France ; EPAR U707 INSERM, Paris, France ; EPAR UMR-S UPMC, Paris VI, Paris, France
| | - P Devillier
- Laboratoire de Pharmacologie Respiratoire UPRES EA220, Hôpital Foch, Suresnes Université Versailles, Saint-Quentin, France
| | - J Fonseca
- Center for Research in Health Technologies and Information Systems - CINTESIS, Universidade do Porto, Porto, Portugal ; Allergy Unit, Instituto CUF Porto e Hospital CUF Porto, Porto, Portugal ; Health Information and Decision Sciences Department - CIDES, Faculdade de Medicina, Universidade do Porto, Rua Dr. Plácido da Costa, s/n, 4200-450 Porto, Portugal
| | - W J Fokkens
- Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, The Netherlands
| | - N A Guldemond
- Institute of Health Policy and Management IBMG, Erasmus University, Rotterdam, The Netherlands
| | - T Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - M Illario
- Federico II University Hospital Naples (R&D and DISMET), Naples, Italy
| | - J Just
- Allergology Department, Centre de l'Asthme et des Allergies, Hôpital d'Enfants Armand-Trousseau (APHP), Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Equipe EPAR, 75013 Paris, France
| | - T Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany ; Institute for Clinical Epidemiology and Biometry, University of Wuerzburg, Würzburg, Germany
| | - L Klimek
- Center for Rhinology and Allergology, Wiesbaden, Germany
| | - P Kuna
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - D Larenas-Linnemann
- Clínica de Alergia, Asma y Pediatría, Hospital Médica Sur, Mexico City, Mexico
| | - M Morais-Almeida
- Allergy and Clinical Immunology Department, Hospital CUF-Descobertas, Lisbon, Portugal
| | - J Mullol
- ENT Department, Hospital Clinic, Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, Universitat de Barcelona, Barcelona, Catalonia Spain
| | - R Murray
- MedScript Ltd, Dundalk, County Louth, Ireland
| | - R Naclerio
- Section of Otolaryngology-Head and Neck Surgery, The University of Chicago Medical Center and The Pritzker School of Medicine, The University of Chicago, Chicago, IL USA
| | - R E O'Hehir
- Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Central Clinical School, Monash University, Melbourne, VIC Australia ; Department of Immunology, Monash University, Melbourne, VIC Australia
| | - N G Papadopoulos
- Center for Pediatrics and Child Health, Institute of Human Development, Royal Manchester Children's Hospital, University of Manchester, Manchester, UK ; Allergy Department, 2nd Pediatric Clinic, Athens General Children's Hospital "P&A Kyriakou", University of Athens, Athens, Greece
| | - R Pawankar
- Department of Pediatrics, Nippon Medical School, Tokyo, Japan
| | - P Potter
- Allergy Diagnostic and Clinical Research Unit, University of Cape Town Lung Institute, Cape Town, South Africa
| | - D Ryan
- Woodbrook Medical Centre, Loughborough, UK ; Allergy and Respiratory Research Group, The University of Edinburgh, Edinburgh, UK
| | - B Samolinski
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - H J Schunemann
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON Canada
| | - A Sheikh
- Allergy and Respiratory Research Group, Centre for Population Health Sciences, The University of Edinburgh Medical School, Edinburgh, UK
| | - F E R Simons
- Department of Pediatrics and Child Health, Department of Immunology, Faculty of Medicine, University of Manitoba, Winnipeg, MB Canada
| | - C Stellato
- Division of Allergy and Clinical Immunology, University of Salerno, Salerno, Italy
| | - A Todo-Bom
- Centre of Pneumology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - P V Tomazic
- Department of ENT, Medical University of Graz, Graz, Austria
| | - A Valiulis
- Clinic of Children's Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania ; Public Health Institute, Vilnius University, Vilnius, Lithuania ; European Academy of Paediatrics (EAP/UEMS-SP), Brussels, Belgium
| | - E Valovirta
- Department of Lung Diseases and Clinical Allergology, University of Turku, Turku, Finland ; Allergy Clinic, Terveystalo, Turku, Finland
| | - M T Ventura
- Unit of Geriatric Immunoallergology, University of Bari Medical School, Bari, Italy
| | - M Wickman
- Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden ; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - I Young
- Queen's University, Belfast, Northern Ireland, UK
| | - A Yorgancioglu
- Department of Pulmonology, Celal Bayar University, Manisa, Turkey
| | - T Zuberbier
- Allergy-Centre-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany ; Global Allergy and Asthma European Network (GA²LEN), Berlin, Germany
| | - W Aberer
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - C A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - M Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - I Annesi-Maesano
- EPAR U707 INSERM, Paris, France ; EPAR UMR-S UPMC, Paris VI, Paris, France
| | - J Ankri
- INSERM, U1168, Ageing and Chronic Diseases Epidemiological and Public Health Approaches, 94800 Villejuif, France
| | - I J Ansotegui
- Department of Allergy and Immunology, Hospital Quirón Bizkaia, Erandio, Spain
| | - J M Anto
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain ; IMIM (Hospital del Mar Research Institute), Barcelona, Spain ; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain ; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | | | - A Asarnoj
- Clinical Immunology and Allergy Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden ; Department of Pediatric Pulmonology and Allergy, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - H Arshad
- David Hide Asthma and Allergy Research Centre, Isle of Wight, UK
| | | | - I Baiardini
- Asthma and Allergy Clinic, Humanitas University, Rozzano, Milan, Italy
| | - C Barbara
- Faculdade de Medicina de Lisboa, Portuguese National Programme for Respiratory Diseases (PNDR), Lisbon, Portugal
| | - M Barbagallo
- Geriatric Unit, Department of Internal Medicine (DIBIMIS), University of Palermo, Palermo, Italy
| | - E D Bateman
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - B Beghé
- Section of Respiratory Disease, Department of Oncology, Haematology and Respiratory Diseases, University of Modena and Reggio Emilia, Modena, Italy
| | - E H Bel
- Department of Respiratory Medicine, Academic Medical Center (AMC), University of Amsterdam, Amsterdam, The Netherlands
| | - K S Bennoor
- Department of Respiratory Medicine, National Institute of Diseases of the Chest and Hospital, Dhaka, Bangladesh
| | - M Benson
- Centre for Individualized Medicine, Department of Pediatrics, Faculty of Medicine, Linköping University, 58185 Linköping, Sweden
| | - A Z Białoszewski
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - T Bieber
- Department of Dermatology and Allergy, Rheinische Friedrich-Wilhelms-University Bonn, Bonn, Germany
| | - L Bjermer
- Department of Respiratory Medicine and Allergology, University Hospital, Lund, Sweden
| | - H Blain
- Department of Geriatrics, Montpellier University Hospital, Montpellier, France ; EA 2991, Euromov, University Montpellier, Montpellier, France
| | - F Blasi
- Department of Pathophysiology and Transplantation, IRCCS Fondazione Ca'Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - A L Boner
- Pediatric Department, University of Verona Hospital, Verona, Italy
| | - M Bonini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - S Bonini
- Second University of Naples and Institute of Translational Medicine, Italian National Research Council, Naples, Italy
| | | | | | - L P Boulet
- Quebec Heart and Lung Institute, Laval University, Quebec City, QC Canada
| | - R Bourret
- Montpellier University Hospital, Montpellier, France
| | | | - F Braido
- Asthma and Allergy Clinic, Humanitas University, Rozzano, Milan, Italy
| | - A H Briggs
- Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - C E Brightling
- Institute of Lung Health, Respiratory Biomedical Unit, University Hospitals of Leicester NHS Trust, Leicestershire, UK ; Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
| | - J Brozek
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON Canada
| | - R Buhl
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - C Bunu
- University of Medicine and Pharmacy Victor Babes, Timisoara, Romania
| | - E Burte
- INSERM, U1168, Ageing and Chronic Diseases Epidemiological and Public Health Approaches, 94800 Villejuif, France
| | - A Bush
- Royal Brompton Hospital NHS, Imperial College London, London, UK
| | | | - M A Calderon
- Royal Brompton Hospital NHS, Imperial College London, London, UK ; National Heart and Lung Institute, Imperial College London, London, UK
| | - T Camuzat
- Montpellier, Région Languedoc Roussillon France
| | - V Cardona
- S. Allergologia, S. Medicina Interna, Hospital Vall d'Hebron, Barcelona, Spain
| | - P Carreiro-Martins
- CEDOC, Respiratory Research Group, Nova Medical School, Campo dos Martires da Patria, Lisbon, Portugal ; Serviço de Imunoalergologia, Centro Hospitalar de Lisboa Central, EPE, Lisbon, Portugal
| | - A M Carriazo
- Regional Ministry of Health of Andalusia, Seville, Spain
| | - K H Carlsen
- Department of Paediatrics, Oslo University Hospital, Oslo, Norway ; University of Oslo, Oslo, Norway
| | - W Carr
- Allergy and Asthma Associates of Southern California, Mission Viejo, CA USA
| | - A M Cepeda Sarabia
- Allergy and Immunology Laboratory, Metropolitan University, Simon Bolivar University, Barranquilla, Colombia ; SLaai, Sociedad Latinoamericana de Allergia, Asma e Immunologia, Cartagena, Colombia
| | - M Cesari
- Gérontopôle de Toulouse, 31059 Toulouse, France
| | - L Chatzi
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete Greece
| | - R Chiron
- Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France
| | - T Chivato
- School of Medicine, University CEU San Pablo, Madrid, Spain
| | - E Chkhartishvili
- Chachava Clinic, David Tvildiani Medical University-AIETI Medical School, Grigol Robakidze University, Tbilisi, Georgia
| | - A G Chuchalin
- Pulmonolory Research Institute FMBA, Moscow, Russia ; GARD Executive Committee, Moscow, Russia
| | - K F Chung
- National Heart and Lung Institute, Imperial College London, London, UK
| | - G Ciprandi
- Medicine Department, IRCCS-Azienda Ospedaliera Universitaria San Martino, Genoa, Italy
| | - J Correia de Sousa
- ICVS/3B's-PT Government Associate Laboratory, Life and Health Sciences, Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
| | - L Cox
- Department of Medicine, Nova Southeastern University, Davie, FL USA
| | - G Crooks
- EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, Reference Site, Scottish Centre for Telehealth and Telecare, NHS 24, Glasgow, UK
| | - A Custovic
- Department of Pediatric, Imperial College London, London, UK
| | - S E Dahlen
- The Centre for Allergy Research, The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - U Darsow
- Department of Dermatology and Allergy, Technische Universität München, Munich, Germany ; ZAUM-Center for Allergy and Environment, Helmholtz Center Munich, Munich, Germany
| | - T Dedeu
- AQuAS, Barcelona, Spain ; EUREGHA, European Regional and Local Health Association, Brussels, Belgium
| | - D Deleanu
- Allergology and Immunology Discipline, "Luliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - J A Denburg
- Division of Clinical Immunology and Allergy, Department of Medicine, McMaster University, Hamilton, ON Canada
| | | | - A Didier
- Respiratory Diseases Department, Rangueil-Larrey Hospital, Toulouse, France
| | - A T Dinh-Xuan
- Service de Physiologie Respiratoire, Hôpital Cochin, Université Paris-Descartes, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - D Dokic
- University Clinic of Pulmology and Allergy, Medical Faculty, Ss Cyril and Methodius University, Skopje, Republic of Macedonia
| | - H Douagui
- Service de Pneumo-Allergologie, Centre Hospitalo-Universitaire de Béni-Messous, Algers, Algeria
| | - G Dray
- Ecole des Mines, Alès, France
| | - R Dubakiene
- Medical Faculty, Vilnius University, Vilnius, Lithuania
| | - S R Durham
- Allergy and Clinical Immunology Section, National Heart and Lung Institute, Imperial College London, London, UK
| | - G Du Toit
- Guy's and St Thomas' NHS Trust, Kings College London, London, UK
| | - M S Dykewicz
- Section of Allergy and Immunology, Saint Louis University School of Medicine, Saint Louis, MO USA
| | - P Eklund
- Computing Science Department, Umeå University, Umeå, Sweden ; Four Computing Oy, Halikko, Finland
| | - Y El-Gamal
- Pediatric Allergy and Immunology Unit, Ain Shams University, Cairo, Egypt
| | - E Ellers
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark
| | - R Emuzyte
- Clinic of Children's Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania ; Public Health Institute, Vilnius University, Vilnius, Lithuania ; European Academy of Paediatrics (EAP/UEMS-SP), Brussels, Belgium
| | - J Farrell
- Department of Health, Social Services and Public Safety, Belfast, Northern Ireland, UK
| | - A Fink Wagner
- Global Allergy and Asthma Platform GAAPP, Altgasse 8-10, 1130 Vienna, Austria
| | - A Fiocchi
- Division of Allergy, Department of Pediatric Medicine, The Bambino Gesù Children's Research Hospital Holy See, Rome, Italy
| | | | - F Forastiere
- Department of Epidemiology, Regional Health Service Lazio Region, Rome, Italy
| | - M Gaga
- Athens Chest Hospital, Athens, Greece
| | - A Gamkrelidze
- National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia
| | - B Gemicioğlu
- Department of Pulmonary Diseases, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - J E Gereda
- Allergy and Immunology Division, Clinica Ricardo Palma, Lima, Peru
| | - R Gerth van Wick
- Section of Allergology, Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - S González Diaz
- Universidad Autónoma de Nuevo León, San Nicolás de los Garza, Mexico
| | - I Grisle
- Center of Tuberculosis and Lung Diseases, Latvian Association of Allergists, Riga, Latvia
| | - L Grouse
- Faculty of the Department of Neurology, University of Washington School of Medicine, Seattle, WA USA
| | - Z Gutter
- National eHealth Centre, University Hospital Olomouc, Olomouc, Czech Republic
| | - M A Guzmán
- Immunology and Allergy Division Clinical Hospital, University of Chile, Santiago, Chile
| | - B Hellquist-Dahl
- Department of Respiratory Diseases, Odense University Hospital, Odense, Denmark
| | - J Heinrich
- Institute of Epidemiology I, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - F Horak
- Vienna Challenge Chamber, Vienna, Austria
| | - J O' B Hourihane
- Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - M Humbert
- Université Paris-Sud, Le Kremlin Bicêtre, France ; Service de Pneumologie, Hôpital Bicêtre, Le Kremlin Bicêtre, France ; Inserm UMR_S999, Le Kremlin Bicêtre, France
| | - M Hyland
- School of Psychology, Plymouth University, Plymouth, UK
| | - G Iaccarino
- Department of Medicine and Surgery, University of Salerno, Baronissi, Italy
| | - E J Jares
- Libra Foundation, Buenos Aires, Argentina
| | - C Jeandel
- MACVIA-France, Contre les MAladies Chroniques pour un VIeillissement Actif en France, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France ; Department of Geriatrics, Montpellier University Hospital, Montpellier, France
| | - S L Johnston
- Airway Disease Infection Section, National Heart and Lung Institute, Imperial College London, London, UK ; MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK
| | - G Joos
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - O Jonquet
- Medical Commission, Montpellier University Hospital, Montpellier, France
| | - K S Jung
- Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Gyeonggi-do South Korea
| | - M Jutel
- Department of Clinical Immunology, Wrocław Medical University, Wrocław, Poland
| | - I Kaidashev
- Ukrainian Medical Stomatological Academy, Poltava, Ukraine
| | - M Khaitov
- Laboratory of Molecular Immunology, National Research Center, Institute of Immunology, Federal Medicobiological Agency, Moscow, Russia
| | - O Kalayci
- Pediatric Allergy and Asthma Unit, School of Medicine, Hacettepe University, Ankara, Turkey
| | - A F Kalyoncu
- Immunology and Allergy Division, Department of Chest Diseases, School of Medicine, Hacettepe University, Ankara, Turkey
| | - P Kardas
- First Department of Family Medicine, Medical University of Lodz, Lodz, Poland
| | - P K Keith
- Department of Medicine, McMaster University, Health Sciences Centre 3V47, 1280 Main Street West, Hamilton, ON Canada
| | - M Kerkhof
- Department of Pulmonary Diseases, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - H A M Kerstjens
- Department of Pulmonary Diseases, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | - M Kogevinas
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain ; IMIM (Hospital del Mar Research Institute), Barcelona, Spain ; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain ; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - V Kolek
- Department of Respiratory Medicine, Faculty of Medicine and Dentistry, University Hospital Olomouc, Olomouc, Czech Republic
| | - G H Koppelman
- Department of Pediatric Pulmonology and Pediatric Allergology, Beatrix Children's Hospital, GRIAC Research Institute, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - M L Kowalski
- Department of Immunology, Rheumatology and Allergy and HARC, Medical University of Lodz, Lodz, Poland
| | - M Kuitunen
- Children's Hospital, University of Helsinki, Helsinki, Finland
| | - I Kull
- Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden ; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - V Kvedariene
- Clinic of Infectious, Chest Diseases, Dermatology and Allergology, Vilnius University, Vilnius, Lithuania
| | - B Lambrecht
- VIB Inflammation Research Center, Ghent University, Ghent, Belgium
| | - S Lau
- Department for Pediatric Pneumology and Immunology, Charité Medical University, Berlin, Germany
| | | | - L T T Le
- University of Medicine and Pharmacy, Hochiminh City, Vietnam
| | - P Lieberman
- Divisions of Allergy and Immunology, Department of Internal Medicine and Pediatrics, University of Tennessee College of Medicine, Germantown, TN USA
| | - B Lipworth
- Scottish Centre for Respiratory Research, Cardiovascular and Diabetes Medicine, Medical Research Institute, Ninewells Hospital, University of Dundee, Dundee, UK
| | - J Li
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - K C Lodrup Carlsen
- Department of Paediatrics, Oslo University Hospital, Oslo, Norway ; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - R Louis
- Department of Pulmonary Medicine, CHU Sart-Tilman, Liege, Belgium
| | - C Lupinek
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - W MacNee
- The Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Y Magar
- Service de Pneumo-allergologie, Hôpital Saint-Joseph, Paris, France
| | - A Magnan
- Service de Pneumologie, UMR INSERM, UMR1087 and CNR 6291, l'institut du Thorax, University of Nantes, Nantes, France
| | - B Mahboub
- Department of Pulmonary Medicine, Rashid Hospital, Dubai, UAE
| | - D Maier
- Biomax Informatics AG, Munich, Germany
| | - I Majer
- Department of Respiratory Medicine, University of Bratislava, Bratislava, Slovakia
| | - J Malva
- Institute of Biomedical Imaging and Life Sciences (IBILI), Faculty of Medicine, University of Coimbra, Coimbra, Portugal ; Ageing@Coimbra EIP-AHA Reference Site, Coimbra, Portugal
| | - P Manning
- Department of Medicine (RCSI), Bon Secours Hospital, Glasnevin, Dublin, Ireland
| | | | - G D Marshall
- Laboratory of Behavioral Immunology Research, Division of Clinical Immunology and Allergy, The University of Mississippi Medical Center, Jackson, MS USA
| | - M R Masjedi
- Tobacco Control Research Centre, Iranian Anti Tobacco Association, Tehran, Iran
| | | | - M Maurer
- Allergy-Centre-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - S Mavale-Manuel
- Department of Paediatrics, Maputo Central Hospital, Maputo, Mozambique
| | - E Melén
- Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden ; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - E Melo-Gomes
- Faculdade de Medicina de Lisboa, Portuguese National Programme for Respiratory Diseases (PNDR), Lisbon, Portugal
| | - E O Meltzer
- Allergy and Asthma Medical Group and Research Center, San Diego, CA USA
| | - J Mercier
- Department of Physiology, CHRU, PhyMedExp, INSERM U1046, CNRS UMR 9214, University Montpellier, Montpellier, France
| | - H Merk
- Hautklinik - Klinik für Dermatologie & Allergologie, Universitätsklinikum der RWTH Aachen, Aachen, Germany
| | | | - F Mihaltan
- National Institute of Pneumology M. Nasta, Bucharest, Romania
| | - B Milenkovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia ; Serbian Association for Asthma and COPD, Belgrade, Serbia
| | - J Millot-Keurinck
- Caisse d'assurance retraite et de la santé au travail du Languedoc-Roussillon (CARSAT-LR), Montpellier, France
| | - Y Mohammad
- National Center for Research in Chronic Respiratory Diseases, Tishreen University School of Medicine, Latakia, Syria
| | - I Momas
- Department of Public Health and Health Products, EA 4064, Paris Descartes University-Sorbonne Paris Cité, Paris, France ; Paris Municipal Department of Social Action, Childhood, and Health, Paris, France
| | - R Mösges
- Institute of Medical Statistics, Informatics and Epidemiology, Medical Faculty, University of Cologne, Cologne, Germany
| | - A Muraro
- Food Allergy Referral Centre Veneto Region, Department of Women and Child Health, Padua General University Hospital, Padua, Italy
| | - L Namazova-Baranova
- Scientific Centre of Children's Health Under the Russian Academy of Medical Sciences, Moscow, Russia
| | - R Nadif
- INSERM, U1168, Ageing and Chronic Diseases Epidemiological and Public Health Approaches, 94800 Villejuif, France
| | - H Neffen
- Hospital de Niños Orlando Alassia, Santa Fe, Argentina
| | - K Nekam
- Hospital of the Hospitaller Brothers in Buda, Budapest, Hungary
| | - A Nieto
- Neumología y Alergología Infantil, Hospital La Fe, Valencia, Spain
| | - B Niggemann
- Department for Pediatric Pneumology and Immunology, Charité Medical University, Berlin, Germany
| | - L Nogueira-Silva
- Center for Research in Health Technologies and Information Systems - CINTESIS, Universidade do Porto, Porto, Portugal ; Allergy Unit, Instituto CUF Porto e Hospital CUF Porto, Porto, Portugal ; Health Information and Decision Sciences Department - CIDES, Faculdade de Medicina, Universidade do Porto, Rua Dr. Plácido da Costa, s/n, 4200-450 Porto, Portugal ; Department of Internal Medicine, Centro Hospitalar Sao Joao, Porto, Portugal
| | - M Nogues
- MACVIA-France, Contre les MAladies Chroniques pour un VIeillissement Actif en France, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France ; Caisse d'assurance retraite et de la santé au travail du Languedoc-Roussillon (CARSAT-LR), Montpellier, France
| | - T D Nyembue
- ENT Department, University Hospital of Kinshasa, Kinshasa, Congo
| | - K Ohta
- National Hospital Organization, Tokyo National Hospital, Tokyo, Japan
| | - Y Okamoto
- Department of Otorhinolaryngology, Chiba University Hospital, Chiba, Japan
| | - K Okubo
- Department of Otolaryngology, Nippon Medical School, Tokyo, Japan
| | - M Olive-Elias
- Montpellier University Hospital, Montpellier, France ; Institute of Health Policy and Management IBMG, Erasmus University, Rotterdam, The Netherlands ; Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - S Ouedraogo
- Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle, Ouagadougou, Burkina Faso
| | - P Paggiaro
- Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Pisa, Italy
| | - I Pali-Schöll
- Department of Comparative Medicine, Messerli Research Institute of the University of Veterinary Medicine, Medical University, Vienna, Austria
| | - S Palkonen
- EFA European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium
| | - P Panzner
- Department of Immunology and Allergology, Faculty of Medicine and Faculty Hospital in Pilsen, Charles University in Prague, Pilsen, Czech Republic
| | - A Papi
- Respiratory Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - H S Park
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, South Korea
| | - G Passalacqua
- Asthma and Allergy Clinic, Humanitas University, Rozzano, Milan, Italy
| | - S Pedersen
- University of Southern Denmark, Kolding, Denmark
| | - A M Pereira
- Center for Research in Health Technologies and Information Systems - CINTESIS, Universidade do Porto, Porto, Portugal ; Allergy Unit, Instituto CUF Porto e Hospital CUF Porto, Porto, Portugal ; Health Information and Decision Sciences Department - CIDES, Faculdade de Medicina, Universidade do Porto, Rua Dr. Plácido da Costa, s/n, 4200-450 Porto, Portugal ; Allergy Unit, CUF-Porto Hospital and Institute, Porto, Portugal
| | - O Pfaar
- Center for Rhinology and Allergology, Wiesbaden, Germany ; Department of Otorhinolaryngology, Head and Neck Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - R Picard
- Conseil Général de l'Economie, Ministère de l'Economie, de l'Industrie et du Numérique, Paris, France
| | - B Pigearias
- Société de Pneumologie de Langue Française, Espace francophone de Pneumologie, Paris, France
| | - I Pin
- Département de pédiatrie, CHU de Grenoble, Grenoble, France
| | - D Plavec
- Children's Hospital Srebrnjak, Zagreb, Croatia ; School of Medicine, University J.J. Strossmayer, Osijek, Croatia
| | - W Pohl
- Karl Landsteiner Institute for Clinical and Experimental Pneumology, Hietzing Hospital, Vienna, Austria
| | - T A Popov
- Clinic of Allergy and Asthma, Medical University Sofia, Sofia, Bulgaria
| | - F Portejoie
- MACVIA-France, Contre les MAladies Chroniques pour un VIeillissement Actif en France, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France
| | - D Postma
- University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - L K Poulsen
- Laboratory of Medical Allergology, Allergy Clinic, Copenhagen University Hospital at Gentofte, Copenhagen, Denmark
| | - D Price
- Academic Centre of Primary Care, University of Aberdeen, Aberdeen, Scotland, UK ; Research in Real-Life, Cambridge, UK
| | - K F Rabe
- LungenClinic Grosshansdorf, Airway Research Center North, German Center for Lung Research (DZL), Grosshansdorf, Germany ; Department of Medicine, Christian Albrechts University, Airway Research Center North, German Center for Lung Research (DZL), Kiel, Germany
| | - F Raciborski
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - G Roberts
- NHS Foundation Trust, University Hospitals of Southampton, Southampton, UK
| | - C Robalo-Cordeiro
- Centre of Pneumology, Coimbra University Hospital, Coimbra, Portugal
| | - F Rodenas
- Polibienestar Research Institute, University of Valencia, Valencia, Spain
| | | | - C Rolland
- Association Asthme et Allergie, Paris, France
| | - M Roman Rodriguez
- Primary Care Respiratory Research Unit, Institutode Investigación Sanitaria de Palma IdisPa, Palma de Mallorca, Spain
| | - A Romano
- Allergy Unit, Complesso Integrato Columbus, Rome, Italy
| | - J Rosado-Pinto
- Serviço de Imunoalergologia, Hospital da Luz, Lisbon, Portugal
| | - N Rosario
- Hospital de Clinicas, University of Parana, Curitiba, Brazil
| | - M Rottem
- Division of Allergy Asthma and Clinical Immunology, Emek Medical Center, Afula, Israel
| | - M Sanchez-Borges
- Allergy and Clinical Immunology Department, Centro Médico-Docente La Trinidad and Clínica El Avila, Caracas, Venezuela
| | | | - G K Scadding
- The Royal National TNE Hospital, University College London, London, UK
| | | | - P Schmid-Grendelmeier
- Allergy Unit, Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland
| | - E Serrano
- Otolaryngology and Head and Neck Surgery, CHU Rangueil-Larrey, Toulouse, France
| | - M Shields
- Child Health, Queen's University, Belfast, Northern Ireland, UK ; Royal Belfast Hospital for Sick Children, Belfast, Northern Ireland, UK
| | - V Siroux
- INSERM, Université Grenoble Alpes, IAB, U 1209, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Université Joseph Fourier, Grenoble, France
| | - J C Sisul
- Sociedad Paraguaya de Alergia Asma e Inmunologıa, Asunción, Paraguay
| | - I Skrindo
- Department of Paediatrics, Oslo University Hospital, Oslo, Norway ; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - H A Smit
- Julius Center of Health Sciences and Primary Care, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands
| | - D Solé
- Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil
| | - T Sooronbaev
- Kyrgyzstan National Centre of Cardiology and Internal Medicine, Euro-Asian Respiratory Society, Bishkek, Kyrgyzstan
| | - O Spranger
- Global Allergy and Asthma Platform GAAPP, Altgasse 8-10, 1130 Vienna, Austria
| | - R Stelmach
- Pulmonary Division, Heart Institute (InCor), Hospital da Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, Brazil
| | - P J Sterk
- Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - T Strandberg
- European Union Geriatric Medicine Society (EUGMS), Helsinki, Finland
| | - J Sunyer
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain ; IMIM (Hospital del Mar Research Institute), Barcelona, Spain ; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain ; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - C Thijs
- Department of Epidemiology, CAPHRI School of Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - M Triggiani
- Division of Allergy and Clinical Immunology, University of Salerno, Salerno, Italy
| | - R Valenta
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - A Valero
- Pneumology and Allergy Department, Hospital Clínic, Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain
| | | | - E van Ganse
- PELyon, Lyon, France ; HESPER 7425, Health Services and Performance Resarch, Université Claude Bernard Lyon, Villeurbanne, France
| | - M van Hague
- Clinical Immunology and Allergy Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden ; Department of Pediatric Pulmonology and Allergy, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden ; University Hospital, Stockholm, Sweden
| | - O Vandenplas
- Department of Chest Medicine, Centre Hospitalier Universitaire UCL Namur, Université Catholique de Louvain, Yvoir, Belgium
| | - L L Varona
- Philippines Society of Allergy, Asthma and Immunology, Manila, Philippines
| | - B Vellas
- Gérontopôle de Toulouse, 31059 Toulouse, France
| | - G Vezzani
- Pulmonary Unit, Department of Cardiology, Thoracic and Vascular Medicine, Arcispedale S. Maria Nuova/IRCCS, Research Hospital, Reggio Emilia, Italy ; Regional Agency for Health and Social Care, Reggio Emilia, Italy
| | - T Vazankari
- Finnish Lung Association (FILHA), Helsinki, Finland
| | - G Viegi
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa, Italy ; CNR Institute of Biomedicine and Molecular Immunology "A. Monroy", Palermo, Italy
| | | | - M Wagenmann
- Department of Otorhinolaryngology, HNO-Klinik, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - S Walker
- Asthma UK, Mansell Street, London, UK
| | - D Y Wang
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - U Wahn
- Department for Pediatric Pneumology and Immunology, Charité Medical University, Berlin, Germany
| | - T Werfel
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - B Whalley
- School of Psychology, Plymouth University, Plymouth, UK
| | - D M Williams
- Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC USA
| | | | - N Wilson
- Northern Health Alliance, Newcastle, UK
| | - J Wright
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - B P Yawn
- Department of Research, Olmsted Medical Center, Rochester, MN USA
| | | | - O M Yusuf
- The Allergy and Asthma Institute, Lahore, Pakistan
| | - A Zaidi
- Social Sciences, University of Southampton, Southampton, UK
| | - H J Zar
- Department of Paediatrics and Child Health, Red Cross Children's Hospital, University of Cape Town, Cape Town, South Africa ; MRC Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - M E Zernotti
- Universidad Católica de Córdoba, Córdoba, Argentina
| | - L Zhang
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Beijing, China ; Beijing Institute of Otolaryngology, Beijing, China
| | - N Zhong
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - M Zidarn
- University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia
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Meltzer EO, Farrar JR, Sennett C. Findings from an Online Survey Assessing the Burden and Management of Seasonal Allergic Rhinoconjunctivitis in US Patients. J Allergy Clin Immunol Pract 2016; 5:779-789.e6. [PMID: 27914815 DOI: 10.1016/j.jaip.2016.10.010] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Revised: 10/05/2016] [Accepted: 10/14/2016] [Indexed: 01/15/2023]
Abstract
BACKGROUND Seasonal allergic rhinoconjunctivitis (SARC) affects ≥16% of the US population annually. Telephone and in-office surveys have demonstrated negative effects of allergic rhinitis (AR) symptoms on sleep, daily activities, productivity, concentration, and emotions. OBJECTIVE The objective of this study was to assess the patient-perceived burden of SARC in relation to newer treatments, increased access to treatments, and changing management protocols. METHODS An online survey of symptom experience, impact on daily life, and management was conducted in US respondents who suffer (or whose child suffers) from SARC symptoms. RESULTS A total of 1001 surveys were completed: 500 adults (≥18 years old) and 501 children (12-17 years old, documented by their parents). Similar to earlier AR surveys, SARC symptoms negatively affected the patient's (and family's) quality of life, and were most severe in the spring. Before being treated, >50% of respondents reported daily symptoms during their season; 75% to 80% considered their symptoms moderate to severe. Patients saw a variety of health care professionals (including pharmacists) and used over-the-counter and prescription medications for symptoms. Those using prescription medications were generally more satisfied with treatment and less likely to switch or discontinue treatment. Nasal and/or ocular symptoms drove adherence, seeing a health care professional, and reviewing and/or changing treatment. CONCLUSIONS The majority of patients with SARC report moderate-to-severe symptoms that significantly impair their quality of life. However, patients appear to be taking more responsibility for their (child's) condition, and patient expectations for therapy are increasingly being met. Continued efforts will be needed to examine the contribution of better information and/or increased access to and availability of medications to control the disease.
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Affiliation(s)
- Eli O Meltzer
- Division of Immunology and Allergy, Department of Pediatrics, University of California San Diego School of Medicine, and Allergy and Asthma Medical Group and Research Center, San Diego, Calif.
| | | | - Cary Sennett
- Asthma and Allergy Foundation of America, Landover, Md
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Durham SR, Creticos PS, Nelson HS, Li Z, Kaur A, Meltzer EO, Nolte H. Treatment effect of sublingual immunotherapy tablets and pharmacotherapies for seasonal and perennial allergic rhinitis: Pooled analyses. J Allergy Clin Immunol 2016; 138:1081-1088.e4. [PMID: 27527264 DOI: 10.1016/j.jaci.2016.04.061] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 04/18/2016] [Accepted: 04/29/2016] [Indexed: 01/08/2023]
Abstract
BACKGROUND Data comparing the treatment effect of allergy immunotherapy and pharmacotherapy are lacking. OBJECTIVE We sought to indirectly compare the treatment effect of sublingual immunotherapy (SLIT)-tablets with pharmacotherapy for seasonal allergic rhinitis (SAR) and perennial allergic rhinitis (PAR). METHODS Pooled data from randomized, double-blind, placebo-controlled trials for the clinical development programs of selected allergic rhinitis treatments were evaluated. Total nasal symptom scores (TNSSs) relative to placebo were compared. Subjects scored symptoms daily during entire pollen seasons in 6 timothy grass SLIT-tablet trials (n = 3094) and 2 ragweed SLIT-tablet trials (n = 658) and during the last 8 weeks of treatment in 2 house dust mite (HDM) SLIT-tablet trials (n = 1768). Subjects scored symptoms daily in 7 montelukast (10 mg, n = 6799), 9 desloratadine (5 mg, n = 4455), and 8 mometasone furoate nasal spray (MFNS; 200 μg daily, n = 2140) SAR or PAR trials. SLIT-tablet trials allowed rescue medication use, whereas most pharmacotherapy trials did not. A fixed-effect meta-analysis method estimated differences in on-treatment average TNSSs. RESULTS In grass and ragweed SLIT-tablet trials, overall improvement in TNSSs relative to placebo was 16.3% and 17.1%, respectively. In HDM SLIT-tablet trials, TNSS overall improvement relative to placebo was 16.1%. In the montelukast, desloratadine, and MFNS trials, TNSS overall improvement relative to placebo was 5.4%, 8.5%, and 22.2%, respectively, for SAR trials, and 3.7%, 4.8%, and 11.2%, respectively, for PAR trials. CONCLUSIONS Although comparisons were limited by study design heterogeneity and use of rescue medications in SLIT-tablet trials, effects on nasal symptoms with timothy grass and ragweed SLIT-tablets were nearly as great as with MFNS and numerically greater than with montelukast and desloratadine for SAR. HDM SLIT-tablet effects were numerically greater than all pharmacotherapies for PAR. SLIT-tablets offer the additional benefit of long-term efficacy.
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Affiliation(s)
- Stephen R Durham
- Royal Brompton and Harefield Hospitals National Health Service Trust and Imperial College, London, United Kingdom
| | - Peter S Creticos
- Creticos Research Group and Division of Allergy & Clinical Immunology, Johns Hopkins University School of Medicine, Baltimore, Md
| | | | | | | | - Eli O Meltzer
- Allergy & Asthma Medical Group & Research Center, San Diego, Calif
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Bousquet J, Schünemann HJ, Hellings PW, Arnavielhe S, Bachert C, Bedbrook A, Bergmann KC, Bosnic-Anticevich S, Brozek J, Calderon M, Canonica GW, Casale TB, Chavannes NH, Cox L, Chrystyn H, Cruz AA, Dahl R, De Carlo G, Demoly P, Devillier P, Dray G, Fletcher M, Fokkens WJ, Fonseca J, Gonzalez-Diaz SN, Grouse L, Keil T, Kuna P, Larenas-Linnemann D, Lodrup Carlsen KC, Meltzer EO, Mullol J, Muraro A, Naclerio RN, Palkonen S, Papadopoulos NG, Passalacqua G, Price D, Ryan D, Samolinski B, Scadding GK, Sheikh A, Spertini F, Valiulis A, Valovirta E, Walker S, Wickman M, Yorgancioglu A, Haahtela T, Zuberbier T. MACVIA clinical decision algorithm in adolescents and adults with allergic rhinitis. J Allergy Clin Immunol 2016; 138:367-374.e2. [PMID: 27260321 DOI: 10.1016/j.jaci.2016.03.025] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 02/05/2016] [Accepted: 03/15/2016] [Indexed: 10/21/2022]
Abstract
The selection of pharmacotherapy for patients with allergic rhinitis (AR) depends on several factors, including age, prominent symptoms, symptom severity, control of AR, patient preferences, and cost. Allergen exposure and the resulting symptoms vary, and treatment adjustment is required. Clinical decision support systems (CDSSs) might be beneficial for the assessment of disease control. CDSSs should be based on the best evidence and algorithms to aid patients and health care professionals to jointly determine treatment and its step-up or step-down strategy depending on AR control. Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR [fighting chronic diseases for active and healthy ageing]), one of the reference sites of the European Innovation Partnership on Active and Healthy Ageing, has initiated an allergy sentinel network (the MACVIA-ARIA Sentinel Network). A CDSS is currently being developed to optimize AR control. An algorithm developed by consensus is presented in this article. This algorithm should be confirmed by appropriate trials.
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Affiliation(s)
- Jean Bousquet
- University Hospital, Montpellier, France; MACVIA-LR, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France; INSERM, VIMA: Ageing and Chronic Diseases, Epidemiological and Public Health approaches, Paris, and Université Versailles St-Quentin-en-Yvelines, St-Quentin-en-Yvelines, France.
| | - Holger J Schünemann
- Departments of Clinical Epidemiology and Biostatistics and Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Peter W Hellings
- Laboratory of Clinical Immunology, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | | | - Claus Bachert
- Upper Airways Research Laboratory, ENT Department, Ghent University Hospital, Ghent, Belgium
| | - Anna Bedbrook
- MACVIA-LR, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France
| | - Karl-Christian Bergmann
- Allergy-Centre-Charité at the Department of Dermatology, Charité-Universitätsmedizin Berlin, and Secretary General of the Global Allergy and Asthma European Network (GA(2)LEN), Berlin, Germany
| | - Sinthia Bosnic-Anticevich
- Woolcock Institute of Medical Research, University of Sydney and Sydney Local Health District, Glebe, Australia
| | - Jan Brozek
- Departments of Clinical Epidemiology and Biostatistics and Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Moises Calderon
- Imperial College London-National Heart and Lung Institute, Royal Brompton Hospital NHS, London, United Kingdom
| | - G Walter Canonica
- Allergy and Respiratory Diseases Clinic, DIMI, University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy
| | - Thomas B Casale
- Division of Allergy/Immunology, University of South Florida, Tampa, Fla
| | - Niels H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Linda Cox
- Department of Medicine, Nova Southeastern University, Davie, Fla
| | | | - Alvaro A Cruz
- ProAR-Nucleo de Excelencia em Asma, Federal University of Bahia, and GARD Executive Committee, Bahia, Brazil
| | - Ronald Dahl
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark
| | - Giuseppe De Carlo
- EFA European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium
| | - Pascal Demoly
- EPAR U707 INSERM, Paris and EPAR UMR-S UPMC, Paris VI, Paris, France; Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France
| | - Phillipe Devillier
- Laboratoire de Pharmacologie Respiratoire UPRES EA220, Hôpital Foch, Suresnes Université Versailles Saint-Quentin, St-Quentin-en-Yvelines, France
| | | | | | - Wytske J Fokkens
- Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, The Netherlands
| | - Joao Fonseca
- Center for Research in Health Technologies and Information Systems-CINTESIS, Universidade do Porto; the Allergy Unit, Instituto CUF Porto e Hospital CUF Porto; the Health Information and Decision Sciences Department-CIDES, Faculdade de Medicina, Universidade do Porto; Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | | | - Lawrence Grouse
- University of Washington School of Medicine, Faculty of the Department of Neurology, Seattle, Wash
| | - Thomas Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, and the Institute for Clinical Epidemiology and Biometry, University of Wuerzburg, Wuerzburg, Germany
| | - Piotr Kuna
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | | | - Karin C Lodrup Carlsen
- Department of Paediatrics, Oslo University Hospital, Oslo, and the Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Eli O Meltzer
- Allergy and Asthma Medical Group and Research Center, San Diego, Calif
| | - Jaoquim Mullol
- Unitat de Rinologia i Clínica de l'Olfacte, Servei d'ORL, Hospital Clínic, Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain
| | - Antonella Muraro
- Food Allergy Referral Centre Veneto Region, Department of Women and Child Health, Padua General University Hospital, Padua, Italy
| | - Robert N Naclerio
- Section of Otolaryngology-Head and Neck Surgery, University of Chicago Medical Center and Pritzker School of Medicine, University of Chicago, Chicago, Ill
| | - Susanna Palkonen
- EFA European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium
| | - Nikolaos G Papadopoulos
- Center for Pediatrics and Child Health, Institute of Human Development, Royal Manchester Children's Hospital, University of Manchester, and the Allergy Department, 2nd Pediatric Clinic, Athens General Children's Hospital "P&A Kyriakou", University of Athens, Athens, Greece
| | - Giovanni Passalacqua
- Allergy and Respiratory Diseases Clinic, DIMI, University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy
| | - David Price
- Academic Centre of Primary Care, University of Aberdeen, and Research in Real-Life, Cambridge, United Kingdom
| | - Dermot Ryan
- Honorary Clinical Research Fellow, Allergy and Respiratory Research Group, University of Edinburgh, Edinburgh, United Kingdom
| | - Boleslaw Samolinski
- Department of Prevention of Envinronmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - Glenis K Scadding
- Royal National TNE Hospital, University College London, London, United Kingdom
| | - Aziz Sheikh
- Allergy and Respiratory Research Group, Centre for Population Health Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - François Spertini
- Service d'Immunologie et Allergie, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Arunas Valiulis
- Vilnius University Clinic of Children's Diseases, Vilnius, Lithuania
| | - Erkka Valovirta
- Department of Lung Diseases and Clinical Allergology, University of Turku, Turku, Finland
| | | | - Magnus Wickman
- Sachs' Children's Hospital, Stockholm, and the Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Arzu Yorgancioglu
- Department of Pulmonology, Celal Bayar University Manisa, Turkey, and GARD Executive Committee, Manisa, Turkey
| | - Tari Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - Torsten Zuberbier
- Allergy-Centre-Charité at the Department of Dermatology, Charité-Universitätsmedizin Berlin, and Secretary General of the Global Allergy and Asthma European Network (GA(2)LEN), Berlin, Germany
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Berger W, Meltzer EO, Amar N, Fox AT, Just J, Muraro A, Nieto A, Valovirta E, Wickman M, Bousquet J. Efficacy of MP-AzeFlu in children with seasonal allergic rhinitis: Importance of paediatric symptom assessment. Pediatr Allergy Immunol 2016; 27:126-33. [PMID: 26928753 DOI: 10.1111/pai.12540] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/17/2015] [Indexed: 12/21/2022]
Abstract
BACKGROUND This study aimed to assess the efficacy of MP-AzeFlu (a novel intranasal formulation of azelastine hydrochloride and fluticasone propionate in a single spray) in children with seasonal allergic rhinitis (SAR) and explore the importance of child symptom severity assessment in paediatric allergic rhinitis (AR) trials. METHODS A total of 348 children (4-11 years) with moderate/severe SAR were randomized into a double-blind, placebo-controlled, 14-day, parallel-group trial. Efficacy was assessed by changes from baseline in reflective total nasal symptom score (rTNSS), reflective total ocular symptom score (rTOSS) and individual symptom scores over 14 days (children 6-11 years; n = 304), recorded by either children or caregivers. To determine whether a by-proxy effect existed, efficacy outcomes were assessed according to degree of child/caregiver rating. Moreover, total Paediatric Rhinitis Quality of Life Questionnaire (PRQLQ) score was compared between the groups. RESULTS A statistically superior, clinically relevant efficacy signal of MP-AzeFlu versus placebo was apparent for PRQLQ overall score (diff: -0.29, 95% CI -0.55, -0.03; p = 0.027), but not for rTNSS (diff: -0.80; 95% CI: -1.75; 0.15; p = 0.099). However, as the extent of children's self-rating increased, so too did the treatment difference between MP-AzeFlu and placebo; MP-AzeFlu provided significantly better relief than placebo for rTNSS (p = 0.002), rTOSS (p = 0.009) and each individual nasal and ocular symptom assessed (except rhinorrhoea; p = 0.064) when children mostly rated their own symptoms. CONCLUSIONS MP-AzeFlu is an effective treatment for AR in childhood. Caregivers are less able than children to accurately assess response to treatment with available tools. A simple paediatric-specific tool to assess efficacy in AR trials in children is needed.
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Affiliation(s)
- William Berger
- Division of Basic Clinical Immunology, School of Medicine, University of California, Irvine, CA, USA.,Allergy and Asthma Associates, Mission Viejo, CA, USA
| | - Eli O Meltzer
- Allergy and Asthma Medical Group and Research Center, San Diego, CA, USA
| | - Niran Amar
- Allergy & Asthma Research Institute, Waco, TX, USA
| | - Adam T Fox
- King's College London, MRC & Asthma UK centre in Allergic Mechanisms of Asthma, Division of Asthma, Allergy and Lung Biology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Jocelyne Just
- Allergology Department, Centre de l'Asthme et des Allergies, Hôpital d'Enfants Armand-Trousseau (APHP) -APHP, Paris, France.,Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Equipe EPAR, Paris, France
| | - Antonella Muraro
- Department of Mother and Child Health, Padua General University Hospital, Padua, Italy
| | - Antonio Nieto
- Pediatric Allergy and Pneumology Unit, Children's Hospital La Fe, Valencia, Spain
| | - Erkka Valovirta
- Department of Lung Diseases & Clinical Allergology, University of Turku & Terveystalo Allergy Clinic, Turku, Finland
| | - Magnus Wickman
- National Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Pediatrics, Sachs' Children's Hospital, Stockholm, Sweden
| | - Jean Bousquet
- University Hospital, Montpellier, France.,MACVIA-LR, Contre les Maladies Chronique pour un Vieillissement Actif en Languedoc Roussilon, European Innovation Partnership on Active and Healthy Aging Reference Site, Montpellier, France.,INSERM, VIMA: Ageing and chronic diseases. Epidemiological and public health approaches, U1168, Paris, France.,UVSQ UMR-S1168, Universite Versailles St-Quentin-en-Yvelines, Versailles, France
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Sher ER, Gawchik SM, Berger WE, Meltzer EO. Efficacy of MP-Azeflu in the Treatment of Postnasal Drip and Rhinorrhea in Patients with Seasonal Allergic Rhinitis (SAR). J Allergy Clin Immunol 2016. [DOI: 10.1016/j.jaci.2015.12.937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Chervinsky P, Meltzer EO, Busse W, Ohta K, Bardin P, Bredenbröker D, Bateman ED. Roflumilast for asthma: Safety findings from a pooled analysis of ten clinical studies. Pulm Pharmacol Ther 2015; 35 Suppl:S28-34. [PMID: 26612545 DOI: 10.1016/j.pupt.2015.11.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 11/13/2015] [Accepted: 11/17/2015] [Indexed: 12/12/2022]
Abstract
BACKGROUND The safety profile of roflumilast, a phosphodiesterase 4 inhibitor, has been extensively researched in patients with chronic obstructive pulmonary disease (COPD). Adverse events (AEs) including headache, diarrhoea and weight loss have been reported. Much less is known about the safety of roflumilast treatment in patients with bronchial asthma. AIM To evaluate the safety and tolerability of roflumilast using safety data from one open-label and ten pooled placebo-controlled phase II and III clinical studies completed between 1997 and 2005. SUBJECTS AND METHODS The studies were conducted at sites in Europe, North and South America, Africa, Australasia and Asia and study length varied from 4 to 40 weeks. Data for 5169 patients between 12 and 70 years of age, of whom 2851 received roflumilast at doses of 125, 250 and 500 μg, were analyzed. At randomization patients had a forced expiratory flow of 45-100%. RESULTS Headache was the most frequent AE with an incidence rate of 50 and 29.2 per 100 patient-years in the 500 μg roflumilast and placebo groups, respectively. Gastrointestinal AEs were common. Nausea and diarrhoea occurred in 28.7 and 28.3 per 100 patient-years in the 500 μg roflumilast and placebo groups, respectively. The extent of weight loss in roflumilast-treated patients was small. AEs reported in 465 patients in the 4-week open-label follow-up study reflected those of the pooled studies. CONCLUSIONS The severity and incidence of AEs reported from this pooled safety analysis confirm that roflumilast is generally well tolerated by patients with asthma. This reflects the general safety profile reported previously in patients with COPD. All studies were funded by Takeda. Trial registration numbers available on ClinicalTrials.gov: NCT00073177, NCT00076076, NCT00163527.
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Affiliation(s)
- P Chervinsky
- Northeast Medical Research Associates, Dartmouth, MD, USA.
| | - E O Meltzer
- Department of Pediatrics, Division of Allergy and Immunology, University of California, San Diego, CA, USA.
| | - W Busse
- Division of Allergy and Immunology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.
| | - K Ohta
- Department of Respiratory Medicine and Allergology, Tokyo National Hospital, Tokyo, Japan.
| | - P Bardin
- Monash Lung & Sleep, Monash Medical Center and University, Victoria, Australia.
| | - D Bredenbröker
- Takeda Pharmaceuticals International GmbH, Zurich, Switzerland.
| | - E D Bateman
- Division of Pulmonology, Department of Medicine, University of Cape Town, Cape Town, South Africa.
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Meltzer EO, Ratner PH, McGraw T. Phenylephrine hydrochloride modified-release tablets for nasal congestion: a randomized, placebo-controlled trial in allergic rhinitis patients. Ann Allergy Asthma Immunol 2015; 116:66-71. [PMID: 26560899 DOI: 10.1016/j.anai.2015.10.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 10/06/2015] [Accepted: 10/19/2015] [Indexed: 12/21/2022]
Abstract
BACKGROUND Over-the-counter phenylephrine hydrochloride (PEH) is used for relief of nasal congestion caused by allergic rhinitis; however, data to support its efficacy are lacking. The US Food and Drug Administration recommended clinical trials to evaluate the efficacy and safety of PEH in patients with this condition. OBJECTIVE To evaluate the efficacy and safety of PEH 30-mg modified-release (MR) tablets in patients with nasal congestion caused by allergic rhinitis in a multicenter, randomized, double-blinded, placebo-controlled, 2-arm, parallel-group study. METHODS Eligible adults at least 18 years old with documented hypersensitivity to fall pollen allergens were randomized to PEH-MR or placebo every 12 hours for 7 days from August 30 to October 12, 2011. The primary end point was mean change from baseline during the entire treatment period in daily reflective nasal congestion score. Secondary end points included changes in other symptom score assessments, time to maximal effect, duration of effect, and quality of life. Safety assessments included adverse events, serious adverse events, vital signs, physical examination, and electrocardiograms. RESULTS Of 575 patients, 288 received PEH-MR and 287 received placebo. No significant beneficial difference was detected between PEH-MR and placebo for the primary end point (PEH-MR, mean -0.394, SD 0.4880; placebo, mean -0.412, SD 0.5383; P = .2655). Likewise, no significant differences were observed for most secondary end points or quality of life. Overall, 89 of 575 patients (15.5%), equally distributed between the PEH-MR and placebo groups, experienced at least 1 treatment-emergency adverse event. CONCLUSION PEH-MR 30-mg tablets taken orally every 12 hours for 7 days is not more efficacious than placebo in relieving nasal congestion caused by allergic rhinitis. TRIAL REGISTRATION clinicaltrials.gov, identifier NCT01413958, protocol CL2011-06.
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Affiliation(s)
- Eli O Meltzer
- Allergy and Asthma Medical Group and Research Center, San Diego, California
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Meltzer EO, Johnson S. Objective and subjective responses to a mechanical external nasal dilator in healthy children and children with nasal congestion. Allergy Asthma Proc 2015; 36:481-6. [PMID: 26534754 DOI: 10.2500/aap.2015.36.3904] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Nasal congestion is a frequent symptom of allergic rhinitis. Mechanical external nasal dilators (MEND) can be applied to the outside of the nose to provide temporary relief from nasal stuffiness. OBJECTIVE To assess the objective and subjective benefits and tolerability of MEND in healthy children and in children with nasal congestion due to allergic rhinitis. METHODS Two studies were performed, one in healthy children and one in children with nasal congestion. The study of healthy children was a single-center, randomized, crossover study of two pediatric MEND variants, "tan" and "stars." The study of children with nasal congestion was a single-center assessment of the stars MEND. In both studies, nasal patency was measured via peak nasal inspiratory flow in the seated position and in the supine position at baseline and after the pediatric MEND was affixed to the nose. Assessment questions were administered at baseline and after MEND application, while seated and while supine, to evaluate subjective reduction in nasal blockage and tolerability. RESULTS Thirty healthy and 26 children with nasal congestion were assessed. Pediatric MENDs showed a statistically significant improvement in peak nasal inspiratory flow for both healthy children and children with nasal congestion while seated and for healthy children while recumbent. Pediatric MENDs were perceived as decreasing nasal obstruction in both healthy children and children with nasal congestion in both positions, and there were statistically significant improvements in most subjective measures. Pediatric MENDs were well tolerated. CONCLUSIONS Pediatric MENDs provided significant objective increases in nasal patency in healthy children and children with nasal congestion in the seated position and also subjective reduction in nasal airway stuffiness in both seated and supine positions; they were also well tolerated.
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Affiliation(s)
- Eli O. Meltzer
- Asthma and Allergy Medical Group and Research Center, San Diego, California, USA
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Meltzer EO, Pearlman DS, Eckerwall G, Uryniak T, DePietro M, Lampl K. Efficacy and safety of budesonide administered by pressurized metered-dose inhaler in children with asthma. Ann Allergy Asthma Immunol 2015; 115:516-22. [PMID: 26460293 DOI: 10.1016/j.anai.2015.09.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 08/24/2015] [Accepted: 09/11/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Budesonide is approved for delivery using a nebulized solution and dry-powder inhaler, but its use through a pressurized metered-dose inhaler (pMDI) in pediatric patients with asthma has not been determined. OBJECTIVE To examine the efficacy and safety of 160 μg twice daily of budesonide through a pMDI vs placebo in children 6 to younger than 12 years with asthma and a demonstrated need for inhaled corticosteroids. METHODS A 6-week, international, multicenter, double-blinded, parallel-group, phase 2 study randomized 304 pediatric patients (mean age, 9 years; 21.7% <8 years) 1:1 to 160 μg (80 μg × 2 inhalations) twice daily of budesonide through a pMDI or placebo after a 7- to 21-day run-in period. The primary efficacy end point was change from baseline in morning peak expiratory flow (PEF); safety end points included adverse events, vital signs, and discontinuations. RESULTS Budesonide treatment significantly improved morning PEF vs placebo; mean treatment effect (budesonide vs placebo) was 13.6 L/min (P < .0001). Budesonide also showed significant improvements vs placebo for forced expiratory volume in 1 second, evening PEF, forced expiratory flow at 25% to 75% of pulmonary volume, reliever medication use, nighttime awakenings, awakenings with reliever use, and percentage of patients with at least 15- and at least 30-L/min increase in morning PEF from baseline. The numbers of patients experiencing adverse events and discontinuations were smaller in the budesonide than in the placebo group. No serious adverse events were reported. CONCLUSION Budesonide at 160 μg twice daily through a pMDI was generally well tolerated and significantly improved lung function, symptoms, rescue medication use, and nighttime awakenings vs placebo in children 6 to younger than 12 years with asthma and a demonstrated need for inhaled corticosteroids.
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Affiliation(s)
- Eli O Meltzer
- Allergy and Asthma Medical Group and Research Center, San Diego, California.
| | | | | | - Tom Uryniak
- T-STAT, LLC Statistical Consulting and Contracting, Downingtown, Pennsylvania
| | | | - Kathy Lampl
- T-STAT, LLC Statistical Consulting and Contracting, Downingtown, Pennsylvania
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40
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Gross N, Greos LS, Meltzer EO, Spangenthal S, Fishman RS, Spyker DA, Cassella JV. Safety and tolerability of inhaled loxapine in subjects with asthma and chronic obstructive pulmonary disease--two randomized controlled trials. J Aerosol Med Pulm Drug Deliv 2015; 27:478-87. [PMID: 24745666 DOI: 10.1089/jamp.2013.1114] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Loxapine, a first-generation antipsychotic, delivered with a novel inhalation delivery device developed for the acute treatment of agitation in patients with schizophrenia or bipolar disorder was evaluated in subjects with asthma or chronic obstructive pulmonary disease (COPD). METHODS Separate randomized, double-blind, parallel-arm, placebo-controlled trials compared two administrations of inhaled loxapine (10 mg) 10 hr apart with placebo in 52 subjects with asthma and in 53 subjects with COPD. A thermally-generated drug aerosol of loxapine was delivered to the deep lung for rapid systemic absorption. Controller medications were continued throughout the study, but quick-relief bronchodilators were withheld from 6-8 hr before through 34 hr after dose 1, unless indicated as rescue. RESULTS All airway adverse events (AEs) were of mild or moderate severity. Symptomatic bronchospasm occurred in 53.8% of subjects with asthma after inhaled loxapine and 11.5% after placebo; and in 19.2% of COPD subjects after inhaled loxapine and 11.1% after placebo. Subjects required inhaled albuterol as follows: asthma: 53.8% after inhaled loxapine and 11.5% after placebo; and COPD: 23.1% after inhaled loxapine and 14.8% after placebo. Respiratory signs/symptoms requiring treatment responded to rescue bronchodilator [forced expiratory volume in 1 sec (FEV(1)) return to within 10% of baseline] within 1 hr in 11 of 15 events in asthma subjects and four of seven events in COPD subjects, the remainder by the last spirometry. CONCLUSIONS In subjects with either asthma or COPD, FEV(1) decline and bronchospasm can occur following inhaled loxapine, but more frequently in asthmatic subjects. Most subjects with bronchospasm responded to rescue bronchodilator within 1 hr. No treatment-related serious AE occurred. Although inhaled loxapine is contraindicated in patients with active airways disease per the current approved US labeling, these studies demonstrated that rescue bronchodilator mitigated the symptomatic bronchospasms that may occur in case of inadvertent use.
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Affiliation(s)
- Nicholas Gross
- 1 St. Francis Hospital, Hartford CT, and University Medical Research , Farmington, CT
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41
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Bousquet J, Schunemann HJ, Fonseca J, Samolinski B, Bachert C, Canonica GW, Casale T, Cruz AA, Demoly P, Hellings P, Valiulis A, Wickman M, Zuberbier T, Bosnic-Anticevitch S, Bedbrook A, Bergmann KC, Caimmi D, Dahl R, Fokkens WJ, Grisle I, Lodrup Carlsen K, Mullol J, Muraro A, Palkonen S, Papadopoulos N, Passalacqua G, Ryan D, Valovirta E, Yorgancioglu A, Aberer W, Agache I, Adachi M, Akdis CA, Akdis M, Annesi-Maesano I, Ansotegui IJ, Anto JM, Arnavielhe S, Arshad H, Baiardini I, Baigenzhin AK, Barbara C, Bateman ED, Beghé B, Bel EH, Ben Kheder A, Bennoor KS, Benson M, Bewick M, Bieber T, Bindslev-Jensen C, Bjermer L, Blain H, Boner AL, Boulet LP, Bonini M, Bonini S, Bosse I, Bourret R, Bousquet PJ, Braido F, Briggs AH, Brightling CE, Brozek J, Buhl R, Burney PG, Bush A, Caballero-Fonseca F, Calderon MA, Camargos PAM, Camuzat T, Carlsen KH, Carr W, Cepeda Sarabia AM, Chavannes NH, Chatzi L, Chen YZ, Chiron R, Chkhartishvili E, Chuchalin AG, Ciprandi G, Cirule I, Correia de Sousa J, Cox L, Crooks G, Costa DJ, Custovic A, Dahlen SE, Darsow U, De Carlo G, De Blay F, Dedeu T, Deleanu D, Denburg JA, Devillier P, Didier A, Dinh-Xuan AT, Dokic D, Douagui H, Dray G, Dubakiene R, Durham SR, Dykewicz MS, El-Gamal Y, Emuzyte R, Fink Wagner A, Fletcher M, Fiocchi A, Forastiere F, Gamkrelidze A, Gemicioğlu B, Gereda JE, González Diaz S, Gotua M, Grouse L, Guzmán MA, Haahtela T, Hellquist-Dahl B, Heinrich J, Horak F, Hourihane JO', Howarth P, Humbert M, Hyland ME, Ivancevich JC, Jares EJ, Johnston SL, Joos G, Jonquet O, Jung KS, Just J, Kaidashev I, Kalayci O, Kalyoncu AF, Keil T, Keith PK, Khaltaev N, Klimek L, Koffi N'Goran B, Kolek V, Koppelman GH, Kowalski ML, Kull I, Kuna P, Kvedariene V, Lambrecht B, Lau S, Larenas-Linnemann D, Laune D, Le LTT, Lieberman P, Lipworth B, Li J, Louis R, Magard Y, Magnan A, Mahboub B, Majer I, Makela MJ, Manning P, De Manuel Keenoy E, Marshall GD, Masjedi MR, Maurer M, Mavale-Manuel S, Melén E, Melo-Gomes E, Meltzer EO, Merk H, Miculinic N, Mihaltan F, Milenkovic B, Mohammad Y, Molimard M, Momas I, Montilla-Santana A, Morais-Almeida M, Mösges R, Namazova-Baranova L, Naclerio R, Neou A, Neffen H, Nekam K, Niggemann B, Nyembue TD, O'Hehir RE, Ohta K, Okamoto Y, Okubo K, Ouedraogo S, Paggiaro P, Pali-Schöll I, Palmer S, Panzner P, Papi A, Park HS, Pavord I, Pawankar R, Pfaar O, Picard R, Pigearias B, Pin I, Plavec D, Pohl W, Popov TA, Portejoie F, Postma D, Potter P, Price D, Rabe KF, Raciborski F, Radier Pontal F, Repka-Ramirez S, Robalo-Cordeiro C, Rolland C, Rosado-Pinto J, Reitamo S, Rodenas F, Roman Rodriguez M, Romano A, Rosario N, Rosenwasser L, Rottem M, Sanchez-Borges M, Scadding GK, Serrano E, Schmid-Grendelmeier P, Sheikh A, Simons FER, Sisul JC, Skrindo I, Smit HA, Solé D, Sooronbaev T, Spranger O, Stelmach R, Strandberg T, Sunyer J, Thijs C, Todo-Bom A, Triggiani M, Valenta R, Valero AL, van Hage M, Vandenplas O, Vezzani G, Vichyanond P, Viegi G, Wagenmann M, Walker S, Wang DY, Wahn U, Williams DM, Wright J, Yawn BP, Yiallouros PK, Yusuf OM, Zar HJ, Zernotti ME, Zhang L, Zhong N, Zidarn M, Mercier J. MACVIA-ARIA Sentinel NetworK for allergic rhinitis (MASK-rhinitis): the new generation guideline implementation. Allergy 2015; 70:1372-92. [PMID: 26148220 DOI: 10.1111/all.12686] [Citation(s) in RCA: 137] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2015] [Indexed: 12/20/2022]
Abstract
Several unmet needs have been identified in allergic rhinitis: identification of the time of onset of the pollen season, optimal control of rhinitis and comorbidities, patient stratification, multidisciplinary team for integrated care pathways, innovation in clinical trials and, above all, patient empowerment. MASK-rhinitis (MACVIA-ARIA Sentinel NetworK for allergic rhinitis) is a simple system centred around the patient which was devised to fill many of these gaps using Information and Communications Technology (ICT) tools and a clinical decision support system (CDSS) based on the most widely used guideline in allergic rhinitis and its asthma comorbidity (ARIA 2015 revision). It is one of the implementation systems of Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA). Three tools are used for the electronic monitoring of allergic diseases: a cell phone-based daily visual analogue scale (VAS) assessment of disease control, CARAT (Control of Allergic Rhinitis and Asthma Test) and e-Allergy screening (premedical system of early diagnosis of allergy and asthma based on online tools). These tools are combined with a clinical decision support system (CDSS) and are available in many languages. An e-CRF and an e-learning tool complete MASK. MASK is flexible and other tools can be added. It appears to be an advanced, global and integrated ICT answer for many unmet needs in allergic diseases which will improve policies and standards.
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Affiliation(s)
- J Bousquet
- University Hospital, Montpellier, France.,MACVIA-LR, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc - Roussillon, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France.,INSERM, VIMA: Ageing and Chronic Diseases, Epidemiological and Public Health Approaches, Paris, France.,UVSQ, UMR-S 1168, Université Versailles St-Quentin-en-Yvelines, Paris, France
| | - H J Schunemann
- Department of Clinical Epidemiology and Biostatistics and Medicine, McMaster University, Hamilton, ON, Canada
| | - J Fonseca
- Center for Research in Health Technologies and Information Systems - CINTESIS, Universidade do Porto, Porto, Portugal.,Allergy Unit, Instituto CUF Porto e Hospital CUF Porto, Porto, Portugal.,Health Information and Decision Sciences Department - CIDES, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.,Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - B Samolinski
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - C Bachert
- Upper Airways Research Laboratory, ENT Department, Ghent University Hospital, Ghent, Belgium
| | - G W Canonica
- Allergy and Respiratory Diseases Clinic, DIMI, University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy
| | - T Casale
- Division of Allergy/Immunology, University of South Florida, Tampa, FL, USA
| | - A A Cruz
- ProAR - Nucleo de Excelencia em Asma, Federal University of Bahia, Bahia, Brasil.,GARD Executive Committee, Bahia, Brasil
| | - P Demoly
- Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France.,EPAR U707 INSERM, Paris, France.,EPAR UMR-S UPMC, Paris, France
| | - P Hellings
- Laboratory of Clinical Immunology, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - A Valiulis
- Vilnius University Clinic of Children's Diseases, Vilnius, Lithuania
| | - M Wickman
- Sachs' Children's Hospital, Stockholm, Sweden.,Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - T Zuberbier
- Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Member of the Global Allergy and Asthma European Network (GA2LEN), Oslo, Norway
| | - S Bosnic-Anticevitch
- Woolcock Institute of Medical Research, University of Sydney and Sydney Local Health District, Glebe, NSW, Australia
| | - A Bedbrook
- MACVIA-LR, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc - Roussillon, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France
| | - K C Bergmann
- Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Member of the Global Allergy and Asthma European Network (GA2LEN), Oslo, Norway
| | - D Caimmi
- Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France
| | - R Dahl
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark
| | - W J Fokkens
- Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, The Netherlands
| | - I Grisle
- Latvian Association of Allergists, Center of Tuberculosis and Lung Diseases of Latvia, Riga, Latvia
| | - K Lodrup Carlsen
- Department of Paediatrics, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - J Mullol
- Unitat de Rinologia i Clínica de l'Olfacte, Servei d'ORL, Hospital Clínic, Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Catalonia, Spain
| | - A Muraro
- Food Allergy Referral Centre Veneto Region, Department of Women and Child Health, Padua General University Hospital, Padua, Italy
| | - S Palkonen
- EFA European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium
| | - N Papadopoulos
- Center for Pediatrics and Child Health, Institute of Human Development, Royal Manchester Children's Hospital, University of Manchester, Manchester, UK.,Allergy Department, 2nd Pediatric Clinic, Athens General Children's Hospital "P&A Kyriakou", University of Athens, Athens, Greece
| | - G Passalacqua
- Allergy and Respiratory Diseases Clinic, DIMI, University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy
| | - D Ryan
- General Practitioner, Woodbrook Medical Centre, Loughborough, UK.,Honorary Clinical Research Fellow, Allergy and Respiratory Research Group, The University of Edinburgh, Edinburgh, UK
| | - E Valovirta
- Department of Lung Diseases and Clinical Allergology, University of Turku, Turku, Finland
| | - A Yorgancioglu
- Department of Pulmonology, Celal Bayar University, Manisa, Turkey
| | - W Aberer
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - I Agache
- Transylvania University Brasov, Brasov, Romania
| | - M Adachi
- Department of Clinical Research Center, International University of Health and Welfare/Sanno Hospital, Tokyo, Japan
| | - C A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - M Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | | | - I J Ansotegui
- Department of Allergy and Immunology, Hospital Quirón Bizkaia, Erandio, Spain
| | - J M Anto
- Centre for Research in Environmental Epidemiology, Barcelona, Spain.,Hospital del Mar Research Institute, Barcelona, Spain.,CIBER Epidemiología y Salud Pública, Barcelona, Spain.,Department of Experimental and Health Sciences, University of Pompeu Fabra, Barcelona, Spain
| | | | - H Arshad
- David Hide Asthma and Allergy Research Centre, Isle of Wight, UK
| | - I Baiardini
- Allergy and Respiratory Diseases Clinic, DIMI, University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy
| | | | - C Barbara
- Faculdade de Medicina de Lisboa, Portuguese National Programme for Respiratory Diseases, Lisbon, Portugal
| | - E D Bateman
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - B Beghé
- Section of Respiratory Disease, Department of Oncology, Haematology and Respiratory Diseases, University of Modena and Reggio Emilia, Modena, Italy
| | - E H Bel
- Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - A Ben Kheder
- Service de Pneumologie IV, Hôpital Abderrahman Mami, Ariana, Tunisie
| | - K S Bennoor
- Department of Respiratory Medicine, National Institute of Diseases of the Chest and Hospital, Dhaka, Bangladesh
| | - M Benson
- Centre for Individualized Medicine, Department of Pediatrics, Faculty of Medicine, Linköping University, Linköping, Sweden
| | - M Bewick
- Deputy National Medical Director, NHS England, England, UK
| | - T Bieber
- Department of Dermatology and Allergy, Rheinische Friedrich-Wilhelms-University Bonn, Bonn, Germany
| | - C Bindslev-Jensen
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark
| | - L Bjermer
- Department of Respiratory Medicine and Allergology, University Hospital, Lund, Sweden
| | - H Blain
- Department of Geriatrics, Montpellier University Hospital, Montpellier, France.,EA 2991 Movement To Health, Euromov, University Montpellier, Montpellier, France
| | - A L Boner
- Pediatric Department, University of Verona Hospital, Verona, Italy
| | - L P Boulet
- Québec Heart and Lung Institute, Laval University, Québec City, QC, Canada
| | - M Bonini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - S Bonini
- Second University of Naples and Institute of Translational Medicine, Italian National Research Council, Naples, Italy
| | - I Bosse
- Allergist, La Rochelle, France
| | - R Bourret
- Directeur Général Adjoint, Montpellier University Hospital, Montpellier, France
| | - P J Bousquet
- EPAR U707 INSERM, Paris, France.,EPAR UMR-S UPMC, Paris, France
| | - F Braido
- Allergy and Respiratory Diseases Clinic, DIMI, University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy
| | - A H Briggs
- Health Economics and Health Technology Assessment, Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - C E Brightling
- Institute of Lung Health, Respiratory Biomedical Unit, University Hospitals of Leicester NHS Trust, Leicestershire, UK.,Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
| | - J Brozek
- Department of Clinical Epidemiology and Biostatistics and Medicine, McMaster University, Hamilton, ON, Canada
| | - R Buhl
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - P G Burney
- National Heart and Lung Institute, Imperial College, London, UK.,Wellcome Centre for Global Health, Imperial College, London, UK.,MRC-PHE Centre for Environment and Health, Imperial College, London, UK
| | - A Bush
- Imperial College and Royal Brompton Hospital, London, UK
| | | | - M A Calderon
- Imperial College London - National Heart and Lung Institute, Royal Brompton Hospital NHS, London, UK
| | - P A M Camargos
- Federal University of Minas Gerais, Medical School, Department of Pediatrics, Belo Horizonte, Brazil
| | - T Camuzat
- Assitant Director General, Montpellier, France.,Région Languedoc Roussillon, Roussillon, France
| | - K H Carlsen
- Department of Paediatrics, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - W Carr
- Allergy and Asthma Associates of Southern California, Mission Viejo, CA, USA
| | - A M Cepeda Sarabia
- Allergy and Immunology Laboratory, Metropolitan University, Simon Bolivar University, Barranquilla, Colombia.,SLaai, Sociedad Latinoamericana de Allergia, Asma e Immunologia, Barranquilla, Colombia
| | - N H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - L Chatzi
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Y Z Chen
- National Cooperative Group of Paediatric Research on Asthma, Asthma Clinic and Education Center of the Capital Institute of Pediatrics, Peking and Center for Asthma Research and Education, Beijing, China
| | - R Chiron
- Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France
| | - E Chkhartishvili
- Chachava Clinic, David Tvildiani Medical University-AIETI Medical School, Grigol Robakidze University, Tbilisi, Georgia
| | - A G Chuchalin
- Pulmonolory Research Institute FMBA, Moscow, Russia.,GARD Executive Committee, Moscow, Russia
| | - G Ciprandi
- Medicine Department, IRCCS-Azienda Ospedaliera Universitaria San Martino, Genoa, Italy
| | - I Cirule
- Latvian Association of Allergists, University Children Hospital of Latvia, Riga, Latvia
| | - J Correia de Sousa
- Life and Health Sciences Research Institute, ICVS, School of Health Sciences, University of Minho, Braga, Portugal
| | - L Cox
- Department of Medicine, Nova Southeastern University, Davie, FL, USA
| | - G Crooks
- European Innovation Partnership on Active and Healthy Ageing, Reference Site, NHS Scotland, Glasgow, UK
| | - D J Costa
- MACVIA-LR, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc - Roussillon, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France.,Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France
| | - A Custovic
- Centre for Respiratory Medicine and Allergy, Institute of Inflammation and Repair, University of Manchester and University Hospital of South Manchester, Manchester, UK
| | - S E Dahlen
- The Centre for Allergy Research, The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - U Darsow
- Department of Dermatology and Allergy, Technische Universität Mänchen, Munich, Germany.,ZAUM-Center for Allergy and Environment, Helmholtz Center Munich, Technische Universität München, Munich, Germany
| | - G De Carlo
- EFA European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium
| | - F De Blay
- Allergy Division, Chest Disease Department, University Hospital of Strasbourg, Strasbourg, France
| | - T Dedeu
- European Regional and Local Health Association, Brussels, Belgium
| | - D Deleanu
- Allergology and Immunology Discipline, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - J A Denburg
- Department of Medicine, Division of Clinical Immunology and Allergy, McMaster University, Hamilton, ON, Canada
| | - P Devillier
- Laboratoire de Pharmacologie Respiratoire UPRES EA220, Hôpital Foch, Suresnes Université Versailles Saint-Quentin, Versailles Saint-Quentin, France
| | - A Didier
- Respiratory Diseases Department, Rangueil-Larrey Hospital, Toulouse, France
| | - A T Dinh-Xuan
- Service de physiologie, Hôpital Cochin, Université Paris-Descartes, Assistance publique-Hôpitaux de Paris, Paris, France
| | - D Dokic
- Medical Faculty Skopje, University Clinic of Pulmology and Allergy, Skopje, R. Macedonia
| | - H Douagui
- Service de Pneumo-Allergologie, Centre Hospitalo-Universitaire de Béni-Messous, Algers, Algeria
| | - G Dray
- Ecole des Mines, Alès, France
| | - R Dubakiene
- Medical Faculty, Vilnius University, Vilnius, Lithuania
| | - S R Durham
- Allergy and Clinical Immunology Section, National Heart and Lung Institute, Imperial College London, London, UK
| | - M S Dykewicz
- Section of Allergy and Immunology, Saint Louis University School of Medicine, Saint Louis, MI, USA
| | - Y El-Gamal
- Pediatric Allergy and Immunology Unit, Ain Shams University, Cairo, Egypt
| | - R Emuzyte
- Clinic of Children's Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - A Fink Wagner
- Global Allergy and Asthma Platform GAAPP, Vienna, Austria
| | | | - A Fiocchi
- Allergy Department, The Bambino Gesù Children's Research Hospital Holy see, Rome, Italy
| | - F Forastiere
- Department of Epidemiology, Regional Health Service Lazio Region, Rome, Italy
| | - A Gamkrelidze
- National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia
| | - B Gemicioğlu
- Turkish Thoracic Society Asthma-Allergy Working Group, Kocaeli, Turkey
| | - J E Gereda
- Allergy and Immunology Division, Clinica Ricardo Palma, Lima, Peru
| | - S González Diaz
- Sociedad Latinoamericana de Allergia, Asma e Immunologia, Mexico City, Mexico
| | - M Gotua
- Center of Allergy and Immunology, Georgian Association of Allergology and Clinical Immunology, Tbilisi, Georgia
| | - L Grouse
- Faculty of the Department of Neurology, University of Washington School of Medicine, Seattle, WA, USA
| | - M A Guzmán
- Immunology and Allergy Division, Clinical Hospital, University of Chile, Santiago, Chile
| | - T Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - B Hellquist-Dahl
- Department of Respiratory Diseases, Odense University Hospital, Odense, Denmark
| | - J Heinrich
- Institute of Epidemiology I, German Research Centre for Environmental Health, Helmholtz Zentrum München, Neuherberg, Germany
| | - F Horak
- Vienna Challenge Chamber, Vienna, Austria
| | - J O 'b Hourihane
- Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - P Howarth
- University of Southampton Faculty of Medicine, University Hospital Southampton, Southampton, UK
| | - M Humbert
- Université Paris-Sud, Le Kremlin Bicêtre, France.,Service de Pneumologie, Hôpital Bicêtre, Inserm UMR_S999, Le Kremlin Bicêtre, France
| | - M E Hyland
- School of Psychology, Plymouth University, Plymouth, UK
| | - J C Ivancevich
- Servicio de Alergia e Immunologia, Clinica Santa Isabel, Buenos Aires, Argentina
| | - E J Jares
- Libra Foundation, Buenos Aires, Argentina
| | - S L Johnston
- Airway Disease Infection Section, National Heart and Lung Institute, Imperial College, London, UK.,MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK
| | - G Joos
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - O Jonquet
- Medical Commission, Montpellier University Hospital, Montpellier, France
| | - K S Jung
- Hallym University College of Medicine, Hallym University Sacred Heart Hospital, Gyeonggi-do, South Korea
| | - J Just
- Allergology Department, Centre de l'Asthme et des Allergies. Hôpital d'Enfants Armand-Trousseau, Paris, France.,Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Equipe EPAR, Paris, France
| | - I Kaidashev
- Ukrainian Medical Stomatological Academy, Poltava, Ukraine
| | - O Kalayci
- Pediatric Allergy and Asthma Unit, Hacettepe University School of Medicine, Ankara, Turkey
| | - A F Kalyoncu
- School of Medicine, Department of Chest Diseases, Immunology and Allergy Division, Hacettepe University, Ankara, Turkey
| | - T Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Institute for Clinical Epidemiology and Biometry, University of Wuerzburg, Wuerzburg, Germany
| | - P K Keith
- Department of Medicine, McMaster University, Health Sciences Centre 3V47, Hamilton, ON, Canada
| | | | - L Klimek
- Center for Rhinology and Allergology, Wiesbaden, Germany
| | - B Koffi N'Goran
- Société de Pneumologie de Langue Française et Espace Francophone de Pneumologie, Paris, France
| | - V Kolek
- Department of Respiratory Medicine, Faculty of Medicine and Dentistry, University Hospital Olomouc, Olomouc, Czech Republic
| | - G H Koppelman
- Department of Pediatric Pulmonology and Pediatric Allergology, Beatrix Children's Hospital, GRIAC Research Institute, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - M L Kowalski
- Department of Immunology, Rheumatology and Allergy, Medical University of Lodz, Lodz, Poland
| | - I Kull
- Sachs' Children's Hospital, Stockholm, Sweden.,Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - P Kuna
- Division of Internal Medicine, Asthma and Allergy, KUNA, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - V Kvedariene
- Pulmonology and Allergology Center, Vilnius University, Vilnius, Lithuania
| | - B Lambrecht
- VIB Inflammation Research Center, Ghent University, Ghent, Belgium
| | - S Lau
- Department for Pediatric Pneumology and Immunology, Charité Medical University, Berlin, Germany
| | - D Larenas-Linnemann
- Clínica de Alergia, Asma y Pediatría, Hospital Médica Sur, México City, México
| | - D Laune
- Digi Health, Montpellier, France
| | - L T T Le
- University of Medicine and Pharmacy, Hochiminh City, Vietnam
| | - P Lieberman
- Departments of Internal Medicine and Pediatrics (Divisions of Allergy and Immunology), University of Tennessee College of Medicine, Germantown, TN, USA
| | - B Lipworth
- Scottish Centre for Respiratory Research, Cardiovascular & Diabetes Medicine, Medical Research Institute, Ninewells Hospital, University of Dundee, Dundee, UK
| | - J Li
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - R Louis
- Department of Pulmonary Medicine, CHU Sart-Tilman, Liege, Belgium
| | - Y Magard
- Service de Pneumo-allergologie, Hôpital Saint-Joseph, Paris, France
| | - A Magnan
- Service de Pneumologie, University of Nantes, UMR INSERM, UMR1087/CNR 6291, l'Institut du Thorax, Nantes, France
| | - B Mahboub
- Department of Pulmonary Medicine, Rashid Hospital, Dubai, UAE
| | - I Majer
- Department of Respiratory Medicine, University Hospital, Bratislava, Slovakia
| | - M J Makela
- Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - P Manning
- Department of Medicine (RCSI), Bon Secours Hospital, Glasnevin, Dublin, Ireland
| | | | - G D Marshall
- Division of Clinical Immunology and Allergy, Laboratory of Behavioral Immunology Research, The University of Mississippi Medical Center, Jackson, MS, USA
| | - M R Masjedi
- Respiratory Disease Research, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - M Maurer
- Allergie-Centrum-Charité at the Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - S Mavale-Manuel
- Department of Paediatrics, Maputo Central Hospital, Maputo, Mozambique
| | - E Melén
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - E Melo-Gomes
- Faculdade de Medicina de Lisboa, Portuguese National Programme for Respiratory Diseases, Lisbon, Portugal
| | - E O Meltzer
- Allergy and Asthma Medical Group and Research Center, San Diego, CA, USA
| | - H Merk
- Hautklinik - Klinik für Dermatologie & Allergologie, Universitätsklinikum der RWTH Aachen, Aachen, Deutschland
| | | | - F Mihaltan
- National Institute of Pneumology M. Nasta, Bucharest, Romania
| | - B Milenkovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,Serbian Association for Asthma and COPD, Belgrade, Serbia
| | - Y Mohammad
- National Center for Research in Chronic Respiratory Diseases, Tishreen University School of Medicine, Latakia, Syria
| | - M Molimard
- Département de Pharmacologie, CHU de Bordeaux, Université Bordeaux, INSERM U657, Bordeaux Cedex, France
| | - I Momas
- Department of Public Health and Biostatistics, Paris Descartes University, Paris, France.,Paris Municipal Department of Social Action, Childhood and Health, Paris, France
| | | | - M Morais-Almeida
- Allergy and Clinical Immunology Department, Hospital CUF-Descobertas, Lisboa, Portugal
| | - R Mösges
- Institute of Medical Statistics, Informatics and Epidemiology, Medical Faculty, University of Cologne, Cologne, Germany
| | - L Namazova-Baranova
- Scientific Centre of Children's Health under the Russian Academy of Medical Sciences, Moscow, Russia
| | - R Naclerio
- Section of Otolaryngology-Head and Neck Surgery, The University of Chicago Medical Center and The Pritzker School of Medicine, The University of Chicago, Chicago, IL, USA
| | - A Neou
- Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Member of the Global Allergy and Asthma European Network (GA2LEN), Oslo, Norway
| | - H Neffen
- Hospital de Niños Orlando Alassia, Santa Fe, Argentina
| | - K Nekam
- Hospital of the Hospitaller Brothers in Buda, Budapest, Hungary
| | - B Niggemann
- Pediatric Pneumology and Immunology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - T D Nyembue
- ENT Department, University Hospital of Kinshasa, Kinshasa, Congo
| | - R E O'Hehir
- Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Central Clinical School, Monash University, Melbourne, Vic., Australia.,Department of Immunology, Monash University, Melbourne, Vic., Australia
| | - K Ohta
- National Hospital Organization, Tokyo National Hospital, Tokyo, Japan
| | - Y Okamoto
- Depatment of Otorhinolaryngology, Chiba University Hospital, Chiba, Japan
| | - K Okubo
- Depatment of Otolaryngology, Nippon Medical School, Tokyo, Japan
| | - S Ouedraogo
- Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle, Ouagadougou, Burkina Faso
| | - P Paggiaro
- Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Pisa, Italy
| | - I Pali-Schöll
- Dept. of Comparative Medicine, Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University and University Vienna, Vienna, Austria.,Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University and University Vienna, Vienna, Austria
| | - S Palmer
- Centre for Health Economics, University of York, York, UK
| | - P Panzner
- Department of Immunology and Allergology, Faculty of Medicine and Faculty Hospital in Pilsen, Charles University in Prague, Pilsen, Czech Republic
| | - A Papi
- Respiratory Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - H S Park
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, South Korea
| | - I Pavord
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - R Pawankar
- Department of Pediatrics, Nippon Medical School, Tokyo, Japan
| | - O Pfaar
- Center for Rhinology and Allergology, Wiesbaden, Germany.,Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty Mannheim, Universitätsmedizin Mannheim, Heidelberg University, Mannheim, Germany
| | - R Picard
- Conseil Général de l'Economie. Ministère de l'Economie, de l'Industrie et du Numérique, Paris, France
| | - B Pigearias
- Société de Pneumologie de Langue Française et Espace Francophone de Pneumologie, Paris, France
| | - I Pin
- Département de pédiatrie, CHU de Grenoble, Grenoble cedex 9, France
| | - D Plavec
- Children's Hospital Srebrnjak, Zagreb, School of Medicine, University J.J. Strossmayer, Osijek, Croatia
| | - W Pohl
- Karl Landsteiner Institute for Clinical and Experimental Pneumology, Hietzing Hospital, Vienna, Austria
| | - T A Popov
- Clinic of Allergy & Asthma, Medical University Sofia, Sofia, Bulgaria
| | - F Portejoie
- MACVIA-LR, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc - Roussillon, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France
| | - D Postma
- Department of Pulmonary Medicine and Tuberculosis, GRIAC Research Institute, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - P Potter
- Allergy Diagnostic and Clinical Research Unit, University of Cape Town Lung Institute, Cape Town, South Africa
| | - D Price
- Academic Centre of Primary Care, University of Aberdeen, Aberdeen, UK.,Research in Real-Life, Cambridge, UK
| | - K F Rabe
- LungenClinic Grosshansdorf, Airway Research Center North, Member of the German Center for Lung Research, Grosshansdorf, Germany.,Department of Medicine, Christian Albrechts University, Airway Research Center North, Member of the German Center for Lung Research, Kiel, Germany
| | - F Raciborski
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - F Radier Pontal
- Conseil Départemental de l'Ordre des Pharmaciens, Maison des Professions Libérales, Montpellier, France
| | | | - C Robalo-Cordeiro
- Allergy and Clinical Immunology Department, Hospitais da Universidade de Coimbra, Coimbra, Portugal
| | - C Rolland
- Association Asthme et Allergie, Paris, France
| | - J Rosado-Pinto
- Serviço de Imunoalergologia, Hospital da Luz, Lisboa, Portugal
| | - S Reitamo
- Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - F Rodenas
- Polibienestar Research Institute, University of Valencia, Valencia, Spain
| | - M Roman Rodriguez
- Primary Care Respiratory Research Unit, Institutode Investigación Sanitaria de Palma IdisPa, Palma de Mallorca, Spain
| | - A Romano
- Allergy Unit, Complesso Integrato Columbus, Rome, Italy
| | - N Rosario
- Hospital de Clinicas, University of Parana, Parana, Brazil
| | - L Rosenwasser
- Department of Allergy, Asthma and Immunology, Children's Mercy Hospitals and Clinics and Pediatrics and Medicine University of Misouri-Kansas City School of Medicine, Kansas City, MI, USA
| | - M Rottem
- Division of Allergy Asthma and Clinical Immunology, Emek Medical Center, Afula, Israel
| | - M Sanchez-Borges
- Allergy and Clinical Immunology Department, Centro Médico-Docente la, Trinidad, Venezuela.,Clínica El Avila, 6a transversal Urb, Caracas, Venezuela
| | - G K Scadding
- The Royal National TNE Hospital, University College London, London, UK
| | - E Serrano
- Otolaryngology and Head & Neck Surgery, CHU Rangueil-Larrey, Toulouse, France
| | - P Schmid-Grendelmeier
- Allergy Unit, Department of Dermatology, University Hospital of Zurich, Zürich, Switzerland
| | - A Sheikh
- Allergy and Respiratory Research Group, Medical School, Centre for Population Health Sciences, The University of Edinburgh, Edinburgh, UK
| | - F E R Simons
- Department of Pediatrics & Child Health, Department of Immunology, Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - J C Sisul
- Sociedad Paraguaya de Alergia Asma e Inmunologıa, Paraguay, Paraguay
| | - I Skrindo
- Department of Paediatrics, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - H A Smit
- Julius Center of Health Sciences and Primary Care, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands
| | - D Solé
- Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil
| | - T Sooronbaev
- Kyrgyzstan National Centre of Cardiology and Internal medicine, Euro-Asian respiratory Society, Bishkek, Kyrgyzstan
| | - O Spranger
- Global Allergy and Asthma Platform GAAPP, Vienna, Austria
| | - R Stelmach
- Pulmonary Division, Heart Institute (InCor), Hospital da Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - T Strandberg
- European Union GeriatricMedicine Society, Vienna, Austria
| | - J Sunyer
- Centre for Research in Environmental Epidemiology, Barcelona, Spain.,Hospital del Mar Research Institute, Barcelona, Spain.,CIBER Epidemiología y Salud Pública, Barcelona, Spain.,Department of Experimental and Health Sciences, University of Pompeu Fabra, Barcelona, Spain
| | - C Thijs
- Department of Epidemiology, CAPHRI School of Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - A Todo-Bom
- Centre of Pneumology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - M Triggiani
- Division of Allergy and Clinical Immunology, University of Salerno, Salerno, Italy
| | - R Valenta
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - A L Valero
- Pneumology and Allergy Department, Hospital Clínic, Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain
| | - M van Hage
- Clinical Immunology and Allergy Unit, Department of Medicine Solna, Karolinska Institutet and University Hospital, Stockholm, Sweden
| | - O Vandenplas
- Department of Chest Medicine, Centre Hospitalier Universitaire Dinant-Godinne, Université Catholique de Louvain, Yvoir, Belgium
| | - G Vezzani
- Pulmonary Unit, Department of Cardiology, Thoracic and Vascular Medicine, Arcispedale S.Maria Nuova/IRCCS, Research Hospital, Reggio Emilia, Italy.,Regional Agency for Health and Social Care, Reggio Emilia, Italy
| | - P Vichyanond
- Division of Allergy and Immunology, Department of Pediatrics, Siriraj Hospital, Mahidol University Faculty of Medicine, Bangkok, Thailand
| | - G Viegi
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa, Italy.,CNR Institute of Biomedicine and Molecular Immunology "A. Monroy", Palermo, Italy
| | - M Wagenmann
- Department of Otorhinolaryngology, HNO-Klinik, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | | | - D Y Wang
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore City, Singapore
| | - U Wahn
- Pediatric Pneumology and Immunology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - D M Williams
- Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA
| | - J Wright
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UJ, USA
| | - B P Yawn
- Department of Research, Olmsted Medical Center, Rochester, MN, USA
| | - P K Yiallouros
- Cyprus International Institute for Environmental & Public Health in Association with Harvard School of Public Health, Cyprus University of Technology, Limassol, Cyprus.,Department of Pediatrics, Hospital "Archbishop Makarios III", Nicosia, Cyprus
| | - O M Yusuf
- The Allergy and Asthma Institute, Islamabad, Pakistan
| | - H J Zar
- Department of Paediatrics and Child Health, Red Cross Children's Hospital, MRC Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - M E Zernotti
- Universidad Católica de Córdoba, Córdoba, Argentina
| | - L Zhang
- Department of Otolaryngology, Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - N Zhong
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - M Zidarn
- University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia
| | - J Mercier
- Vice President for Research, University Montpellier, Montpellier, France
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Meltzer EO, Ratner PH, McGraw T. Oral Phenylephrine HCl for Nasal Congestion in Seasonal Allergic Rhinitis: A Randomized, Open-label, Placebo-controlled Study. J Allergy Clin Immunol Pract 2015; 3:702-8. [PMID: 26143019 DOI: 10.1016/j.jaip.2015.05.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 04/29/2015] [Accepted: 05/07/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Phenylephrine hydrochloride (PE HCl) is widely used for the treatment of nasal congestion, but efficacy at the 10-mg dose is not known for certain. The Food and Drug Administration has requested that sufficiently powered, multicenter, dose-ranging studies be conducted to assess the efficacy and safety of PE HCl. OBJECTIVE To evaluate subjective nasal congestion symptom relief and safety of 4 different doses of PE HCl immediate-release 10-mg tablets and placebo in adults with seasonal allergic rhinitis (SAR). METHODS This multicenter, phase 2, parallel, open-label trial randomized 539 adults with SAR (but otherwise healthy) to 7 days of treatment with either PE HCl 10-mg tablets at fixed doses of 10, 20, 30, or 40 mg or placebo. The primary efficacy end point was the mean change from baseline over the entire treatment period in daily reflective nasal congestion score. Other efficacy end points and safety were also evaluated. RESULTS None of the PE HCl treatment groups had a statistically significant change from baseline in instantaneous or reflective nasal congestion scores compared with the placebo group. PE HCl was well tolerated at doses of up to 30 mg. At least 1 treatment-emergent adverse event was experienced by 18.4% of the participants, the most common being headache (3.0%). CONCLUSIONS PE HCl, at doses of up to 40 mg every 4 hours, is not significantly better than placebo at relieving nasal congestion in adults with SAR. The phenylephrine section of the Food and Drug Administration monograph on over-the-counter cold, cough, allergy, bronchodilator, and antiasthmatic products should be revised accordingly.
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Affiliation(s)
- Eli O Meltzer
- Allergy & Asthma Medical Group & Research Center, San Diego, Calif
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Abstract
BACKGROUND Intranasal sprays are recommended as targeted therapy for allergic rhinitis (AR) by providing direct delivery of medication to the nasal mucosa, reducing the potential for systemic adverse effects, decreasing burden of disease, and improving quality of life. OBJECTIVE To review currently available intranasal sprays indicated for maintenance therapy of AR in the United States: intranasal antihistamines (INAH); intranasal corticosteroids (INCS); and MP-AzeFlu, a single formulation nasal spray of the INAH, azelastine hydrochloride, and the INCS, fluticasone propionate. METHODS MEDLINE searches were conducted to identify placebo-controlled studies of commercially available prescription nasal sprays at U.S.-approved doses and indications, and published after an earlier systematic review of AR treatment. Inclusion criteria were ≥20 subjects; duration of ≥2 weeks for seasonal (or episodic) AR, ≥4 weeks for perennial (or persistent) AR, and reporting a total nasal symptom score as a primary or secondary outcome. RESULTS Twenty studies met the inclusion criteria: 4 pediatric, 16 adult/adolescent. There were 4 perennial AR studies (381 children, 1607 adults) and 16 seasonal AR trials (3081 children, 6548 adults). In these studies, 2451 subjects (481 children, 1970 adults) received an INCS, 3001 (1116 children, 1885 adults) received an INAH, and 346 adult subjects received MP-AzeFlu. All active treatments were well tolerated and effective as measured by the reduction in nasal symptoms. Head-to-head comparisons were only available for MP-AzeFlu versus the individual active agent components. MP-AzeFlu provided significantly greater symptom relief than either azelastine or fluticasone propionate alone and with an onset starting at 30 minutes after the dose. CONCLUSION The most recent addition to intranasal sprays for the maintenance therapy of AR is MP-AzeFlu, a single formulation nasal spray of azelastine hydrochloride and fluticasone propionate in an advanced delivery system. Analysis of clinical data showed this to be the first new intranasal medication that provides greater clinical benefit than an INCS in treating AR.
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Affiliation(s)
- William E Berger
- Division of Basic Clinical Immunology, University of California Irvine, School of Medicine, and Allergy and Asthma Associates, Mission Viejo, California, USA
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Kerstjens HAM, Casale TB, Bleecker ER, Meltzer EO, Pizzichini E, Schmidt O, Engel M, Bour L, Verkleij CB, Moroni-Zentgraf P, Bateman ED. Tiotropium or salmeterol as add-on therapy to inhaled corticosteroids for patients with moderate symptomatic asthma: two replicate, double-blind, placebo-controlled, parallel-group, active-comparator, randomised trials. The Lancet Respiratory Medicine 2015; 3:367-76. [DOI: 10.1016/s2213-2600(15)00031-4] [Citation(s) in RCA: 137] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 12/29/2014] [Indexed: 11/26/2022]
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Berger WE, Bernstein JA, Meltzer EO, Ratner PH, Ruiz N. Efficacy of Azelastine HCl/Fluticasone Propionate Nasal Spray in the Treatment of Nasal Congestion in Patients with Seasonal Allergic Rhinitis (SAR). J Allergy Clin Immunol 2015. [DOI: 10.1016/j.jaci.2014.12.1649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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D'Addio A, Ruiz N, Mayer M, Berger WE, Meltzer EO. Quantification of the Distribution of Azelastine HCl/Fluticasone Propionate Nasal Spray in an Anatomical Model of the Human Nasal Cavity. J Allergy Clin Immunol 2015. [DOI: 10.1016/j.jaci.2014.12.1648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Bachert C, Pawankar R, Zhang L, Bunnag C, Fokkens WJ, Hamilos DL, Jirapongsananuruk O, Kern R, Meltzer EO, Mullol J, Naclerio R, Pilan R, Rhee CS, Suzaki H, Voegels R, Blaiss M. ICON: chronic rhinosinusitis. World Allergy Organ J 2014; 7:25. [PMID: 25379119 PMCID: PMC4213581 DOI: 10.1186/1939-4551-7-25] [Citation(s) in RCA: 121] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 08/27/2014] [Indexed: 02/06/2023] Open
Abstract
Chronic rhinosinusitis (CRS) is a public health problem that has a significant socio-economic impact. Moreover, the complexity of this disease due to its heterogeneous nature based on the underlying pathophysiology - leading to different disease variants - further complicates our understanding and directions for the most appropriate targeted treatment strategies. Several International/national guidelines/position papers and/or consensus documents are available that present the current knowledge and treatment strategies for CRS. Yet there are many challenges to the management of CRS especially in the case of the more severe and refractory forms of disease. Therefore, the International Collaboration in Asthma, Allergy and Immunology (iCAALL), a collaboration between EAACI, AAAAI, ACAAI, and WAO, has decided to propose an International Consensus (ICON) on Chronic Rhinosinusitis. The purpose of this ICON on CRS is to highlight the key common messages from the existing guidelines, the differences in recommendations as well as the gaps in our current knowledge of CRS, thus providing a concise reference. In this document we discuss the definition of the disease, its relevance, pharmacoeconomics, pathophysiology, phenotypes and endotypes, genetics and risk factors, natural history and co-morbidities as well as clinical manifestations and treatment options in both adults and children comprising pharmacotherapy, surgical interventions and more recent biological approaches. Finally, we have also highlighted the unmet needs that wait to be addressed through future research.
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Affiliation(s)
- Claus Bachert
- Upper Airways Research Laboratory (URL), University Hospital Ghent, Kragujevac, Belgium
| | - Ruby Pawankar
- Div. of Allergy, Dept. of Pediatrics, Nippon Medical School, Tokyo, Japan
| | - Luo Zhang
- Beijing Key Laboratory of Nasal diseases, Beijing Institute of Otolaryngology, Beijing, China
| | - Chaweewan Bunnag
- Faculty of Medicine, Siriraj Hospital Mahidol University, Bangkok, Thailand
| | - Wytske J Fokkens
- Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, The Netherlands
| | - Daniel L Hamilos
- Division of Rheumatology, Allergy & Immunology, Massachusetts General Hospital, Boston, MA USA
| | | | - Robert Kern
- Department of Otolaryngology Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois USA
| | - Eli O Meltzer
- Allergy & Asthma Medical Group & Research Center, San Diego, California USA
| | - Joaquim Mullol
- Rhinology Unit & Smell Clinic, Hospital Clínic - IDIBAPS, Barcelona, Catalonia Spain
| | - Robert Naclerio
- Section of Otolaryngology Head and Neck Surgery, Department of Surgery, University of Chicago, Chicago, Illinois USA
| | - Renata Pilan
- Department of Otorhinolaryngology, Clinics Hospital/University of Sao Paulo Medical School, Kragujevac, Brazil
| | - Chae-Seo Rhee
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Seoul National University College of Medicine, Seoul, Korea
| | - Harumi Suzaki
- Dept. of Otorhinolaryngology, Showa University, Tokyo, Japan
| | - Richard Voegels
- Department of Rhinology, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Michael Blaiss
- University of Tennessee Health Science Center, Memphis, Tennessee
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Abstract
Intranasal corticosteroids (INSs) have been effectively used for >40 years for the treatment of seasonal allergic rhinitis (SAR) and perennial AR (PAR). Following the Montreal Protocol, the initial aerosol formulations using chlorofluorocarbon (CFC) propellants were phased out. For the past 20 years, aqueous solutions have been the only available option for INS treatment. In 2012, the U.S. Food and Drug Administration approved two new nonaqueous aerosol AR treatments that use a hydrofluoroalkane (HFA) propellant. In 2012, the first intranasal aqueous combination product was also approved. This article reviews the clinical profiles of HFA beclomethasone dipropionate (BDP) and HFA ciclesonide (CIC) and the aqueous combination intranasal antihistamine (INA)/INS formulation of azelastine hydrochloride/fluticasone propionate (AZE/FP). The medical literature was searched for clinical trials investigating the use of BDP, CIC, and AZE/FP in SAR and PAR. Clinical trials involving aqueous solutions and CFC propellant or HFA propellant delivery were included. Data from prescribing information and published efficacy and safety data were presented as part of the clinical profile for the reviewed agents. AZE/FP has shown efficacy and safety comparable or greater with the current AR treatment options. Although efficacy comparisons of new HFA formulations have not been investigated in head-to-head clinical trials with aqueous formulations, HFA formulations have shown similar efficacy rates. Furthermore, HFA formulations may have some additional benefits, including a preferable sensory profile for some patients. These new formulations will provide additional options for clinicians and patients to better individualize therapy for control of AR.
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Hoyte FCL, Meltzer EO, Ostrom NK, Nelson HS, Bensch GW, Spangler DL, Storms WW, Weinstein SF, Katial RK. Recommendations for the pharmacologic management of allergic rhinitis. Allergy Asthma Proc 2014; 35 Suppl 1:S20-7. [PMID: 25582158 DOI: 10.2500/aap.2014.35.3761] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Allergic rhinitis (AR) affects at least 60 million people in the United States each year, resulting in a major impact on patient quality of life, productivity, and direct and indirect costs. As new therapies, data, and literature emerge in the management of AR, there is a need to communicate and disseminate important information to health care professionals to advance the practice of medicine and lessen the disease burden from AR. Treatment recommendations for AR have not been updated since the 2012 Food and Drug Administration approval of nonaqueous intranasal aerosol agents using hydrofluoroalkane propellants and the first aqueous intranasal combination product. Here, we present an updated algorithm for the pharmacologic treatment of AR that includes these new treatment options. Treatment recommendations are categorized by disease severity (mild versus moderate/severe) and duration of symptoms (episodic versus nonepisodic, with episodic defined as <3 days/wk or for <3 weeks). Preferred treatments are suggested, as well as alternative options for consideration by clinicians in the context of individual patient needs. This recommendation article also outlines the importance of treatment monitoring, which can be conducted using the recently developed Rhinitis Control Assessment Test. Successful therapeutic outcomes depend on multiple factors, including use of the most effective pharmacologic agents as well as patient adherence to therapy. Therefore, it is imperative that rhinitis patients not only receive the most effective therapeutic options, but that they also understand and are able to adhere to the comprehensive treatment regimen. Successful treatment, with all of these considerations in mind, results in better disease outcomes, improved quality of life for patients, and greater economic productivity in the home and workplace.
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50
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Emanuel IA, Blaiss MS, Meltzer EO, Evans P, Connor A. Nasal deposition of ciclesonide nasal aerosol and mometasone aqueous nasal spray in allergic rhinitis patients. Am J Rhinol Allergy 2014; 28:117-21. [PMID: 24598007 DOI: 10.2500/ajra.2014.28.4026] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Sensory attributes of intranasal corticosteroids, such as rundown to the back of the throat, may influence patient treatment preferences. This study compares the nasal deposition and nasal retention of a radiolabeled solution of ciclesonide nasal aerosol (CIC-hydrofluoroalkane [HFA]) with a radiolabeled suspension of mometasone furoate monohydrate aqueous nasal spray (MFNS) in subjects with either perennial allergic rhinitis (AR) or seasonal AR. METHODS In this open-label, single-dose, randomized, crossover scintigraphy study, 14 subjects with symptomatic AR received a single dose of radiolabeled 74-μg CIC-HFA (37 μg/spray, 1 spray/each nostril) via a nasal metered-dose inhaler or a single dose of radiolabeled 200-μg MFNS (50 μg/spray, 2 sprays/each nostril), with a minimum 5-day washout period between treatments. Initial deposition (2 minutes postdose) of radiolabeled CIC-HFA and MFNS in the nasal cavity, nasopharynx, and on nasal wipes, and retention of radioactivity in the nasal cavity and nasal run-out on nasal wipes at 2, 4, 6, 8, and 10 minutes postdose were quantified with scintigraphy. RESULTS At 2 and 10 minutes postdose, deposition of radiolabeled CIC-HFA was significantly higher in the nasal cavity versus radiolabeled MFNS (99.42% versus 86.50% at 2 minutes, p = 0.0046; and 81.10% versus 54.31% at 10 minutes, p < 0.0001, respectively; p values unadjusted for multiplicity). Deposition of radioactivity on nasal wipes was significantly higher with MFNS versus CIC-HFA at all five time points, and posterior losses of radiolabeled formulation were significantly higher with MFNS at 6, 8, and 10 minutes postdose. CONCLUSION In this scintigraphic study, significantly higher nasal deposition and retention of radiolabeled aerosol CIC-HFA were observed versus radiolabeled aqueous MFNS in subjects with AR.
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Affiliation(s)
- Ivor A Emanuel
- San Francisco Ear, Nose, Throat & Allergy, San Francisco, California, USA
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