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World Allergy Organization
WAO's mission: To be a global resource and advocate in the field of allergy, advancing excellence in clinical care through education, research and training as a world-wide alliance of allergy and clinical immunology societies.

Medical Journal Reviews

October 2014

1. Network meta-analysis (NMA) to examine the comparative effectiveness of medical interventions.

Puhan MA, Schünemann HJ, Murad MH, Li T, Brignardello-Petersen R, Singh JA, Kessels AG, and Guyatt GH. A GRADE Working Group approach for rating the quality of treatment effect estimates from network meta-analysis. BMJ 2014; 349: g5630.  (doi:

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Editor’s comment:  Acknowledging that there is minimal guidance available regarding how to rate the quality of evidence supporting treatment effect estimates obtained from NMA, the authors present a four-step approach to rate the quality of evidence in each of the direct, indirect, and NMA estimates based on methods developed by the GRADE Working Group.

2. The picture of pulmonary health in Germany is growing more complex.

Dumiak M. Ageing society and allergies challenge German health care. The Lancet Respiratory Medicine 2014; 2(9): 892-693. (doi:10.1016/S2213-2600(14)70209-7)


Editor’s comment: Via data collected in Germany's most comprehensive survey of pulmonary health in a decade (the Weißbuch Lung), the authors demonstrate a varied picture of an ageing society. While people as a whole are living longer, the elderly are suffering from an increase in chronic obstructive pulmonary disease (COPD), and the young are suffering from an increase in asthma (perhaps linked to air pollution or aggressive new allergens).

3. Overview of the pharmacodynamics and pharmacology of five-grass-pollen sublingual immunotherapy tablet.

Didier A, Wahn U, Horak F, and Cox LS. Five-grass-pollen sublingual immunotherapy tablet for the treatment of grass-pollen-induced allergic rhinoconjunctivitis: 5 years of experience. Expert Review of Clinical Immunology 2014; 10(10): 1309-1324. (doi:101586/1744666X.2014.957677)

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Editor’s comment: This review focuses on the 5-grass-pollen allergen tablet for the treatment of allergic rhinitis and allergic rhinoconjunctivitis, and discusses its notable features and characteristics, including: pharmacology, recent data regarding its clinical efficacy and safety/tolerability, as well as its role in clinical practice.

4. Proportion of chronic urticaria patients that are candidates for anti-IgE.

Košnik M, Kopac P, Eržen R, Bajrovic N, Adamic K, Lalek N, Korošec P, and Zidarn M. Omalizumab in chronic urticaria: our experience and literature review. Acta Dermatovenerologica Alpina, Pannonica et Adriatica 2014; 23(3): 57-61. (doi:10.15570/actaapa.2014.14)

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Editor’s comment: In this paper, they report on the use of omalizumab in four patients with chronic urticarial (CU) and then go on to review medical files in their institution to estimate the proportion of CU patients that are candidates for such treatment. They conclude that up to 14% of CU patients referred to a tertiary center are candidates for omalizumab.

5. Mepolizumab reduces the use of maintenance oral glucocorticoids in patients with severe eosinophilic asthma.

Bel EH, Wenzel SE, Thompson PJ, Prazma CM, Keene ON et al. Oral glucocorticoid-sparing effect of mepolizumab in eosinophilic asthma. The New England Journal of Medicine 2014; 371: 1189-1197. (doi:10.1056/NEJMo1403291)


Editor’s comment: The authors concluded that in patients requiring daily oral glucocorticoid therapy to maintain asthma control, mepolizumab had a significant glucocorticoid-sparing effect, reduced exacerbations, and improved control of asthma symptoms.