January 2012

Articles are selected for their importance to clinicians who care for patients with asthma and allergic/immunologic diseases by Juan Carlos Ivancevich, MD, WAO Web Editor-in-Chief, and Phillip Lieberman, MD, WAO Reviews Editor.

1. The level of asthma control is directly proportional to adherence rate.

Jentzsch NS, Camargos P, Sarinho ESC, Bousquet J. Adherence rate to beclomethasone dipropionate and the level of asthma control. Respiratory Medicine 2012; 106 (3): 338-343, 2012.

Abstract

Editor's comment: In this year long study of children with mild or moderate persistent asthma adherence to inhaled corticosteroid treatment was directly related to asthma control. Therefore, the adherence rate to inhaled corticosteroids and the level of asthma control should be systematically checked in scheduled and non-scheduled appointments. The authors found that a minimum of 60% adherence to the prescribed regimen was enough to achieve asthma control, as defined by symptoms – including exercise induced asthma – and lung function. In addition, they noted that a dose of 300 micrograms of beclomethasone daily was sufficient to achieve control in most patients in this population.

2. Multi-allergen or single-allergen immunotherapy in polysensitized patients?

Calderón MA, Cox L, Casale TB, Moingeon P, Demoly P. Multiple-allergen and single-allergen immunotherapy strategies in polysensitized patients: Looking at the published evidence. The Journal of Allergy and Clinical Immunology In press, corrected proof. 13 January 2012. (doi:10.1016/j.jaci.2011.11.019)

Abstract

Editor's comment: The goal of this review article was to clarify the roles of multi-allergen vs single allergen immunotherapy in multi-sensitized patients. Both multi-allergen and single-allergen immunotherapy have proved to be safe and effective in polysensitized patients. The authors concluded that more work is required to determine whether single-allergen and multi-allergen immunotherapy protocols elicit distinct immune responses in monosensitized and polysensitized patients. They also felt that sublingual and subcutaneous multiallergen immunotherapy in polysensitized patients requires more supporting data to validate its efficacy in practice.

3. Vasculitides associated with antineutrophil cytoplasmic antibodies (ANCAs).

Berden A, Göçeroglu A, Jayne D, Luqmani DJ, Rasmussen N et al. Diagnosis and management of ANCA associated vasculitis. BMJ 2012; 344:e26.

Abstract

Editor's comment: This is an excellent review, drawing on the findings of observational studies, randomized controlled trials, and meta-analyses, of ANCA associated vasculitides. It focuses on granulomatosis with polyangiitis and microscopic polyangiitis. The authors emphasize the importance of early diagnosis and treatment of ANCA associated vasculitides to prevent the progression of disease.