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Archives: Medical Journal Reviews

WAO Reviews - Editors' Choice

October 2014

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 John J. Oppenheimer, MD, FACAAI, FAAAAI, WAO Reviews Editor. 

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:http://dx.doi.org/10.1136/bmj.g5630)

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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)

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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)

Preview

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.

6. A clear need for a disease-modifying treatment in peanut allergy.

Anagnostou K and Clark A. Peanut immunotherapy. Clinical and Translational Allergy 2014; 4:30. (doi:10.1186/2045-7022-4-30)

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Editor’s comment: After an extensive review, the authors conclude that peanut immunotherapy presents an exciting, potentially disease-modifying treatment approach for peanut allergy, but is not yet recommended for routine clinical use and should not be attempted outside specialist allergy units.

7. All India Coordinated Project on Aeroallergens and Human Health.

Singh AB. Pollen and fungal aeroallergens associated with allergy and asthma in India. Global Journal of Immunology and Allergic Diseases 2014; 2(1):19-28. (doi:http://dx.doi.org/10.14205/2310-6980.2014.02.01.4)

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Editor’s comment: Through the “All India Coordinated Project on Aeroallergens and Human Health” (sponsored by the Ministry of Environment and Forests, Government of India), which was undertaken to examine the national database on atmospheric pollen and spores in India, the authors were able to identify important pollen and fungal allergens from 18 regions in India and then went on to quantify and characterize their allergenic properties.

8. Household air pollution accounts about 3.5 to 4 million deaths every year.

Gordon SB, Bruce NG, Grigg J, Hibberd PL, Kurmi OP, Lam KBH, Mortimer K et al. Respiratory risks from household air pollution in low and middle income countries. The Lancet Respiratory Medicine 2014; 2(10): 823-860. (doi:10.1016/S2213-2600(14)70168-7)

Summary

Editor’s comment: The authors review the association between household air pollution and respiratory infections, respiratory tract cancers, and chronic lung diseases as well as appropriate ways to measure exposure to household air pollution, study design issues and potential effective interventions to prevent these disease burdens.

9. Sublingual immunotherapy (SLIT) is a well-tolerated and effective approach to treat allergic rhinitis and allergic rhinoconjunctivitis in pediatric patients.

Pleskovic N, Bartholow A, and Skoner DP. Sublingual immunotherapy in children: the recent experiences. Current Opinion in Allergy and Clinical Immunology 2014; published online ahead of print 3 September. (doi:10.1097/ACI.0000000000000112)

Abstract

Editor’s comment: This review focuses on recent relevant studies examining the use of SLIT in children, by examining efficacy, safety, and immunological data and comparing these data to subcutaneous immunotherapy, other therapeutic treatments, and placebo.

10. Influenza virus infection predisposes patients to complicated and difficult-to-treat bacterial secondary infections or co-infections.

Mina MJ and Klugman KP. The role of influenza in the severity and transmission of respiratory bacterial disease. The Lancet Respiratory Medicine 2014; 2(9): 750-763. (doi:10.1016/S2213-2600(14)70131-6)

Summary

Editor’s comment: The authors describe and interpret what is known about transmission and phenotypic shifts in bacterial dynamics and the immunological, cellular, and molecular modifications that underlie these processes during influenza pandemics.

11. Acute bronchiolitis of infancy and subsequent development of asthma are strongly associated.

Gidaris D, Urquhart D and Anthracopoulos MB. ‘They said it was bronchiolitis; is it going to turn into asthma doctor?’ Respirology 2014; 19(8): 1158-1164. (doi:10.1111/resp.12371)

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Editor’s comment: Acute bronchiolitis association with subsequent asthma development has puzzled clinicians and epidemiologists for decades. This article reviews the current state of knowledge regarding the role of acute bronchiolitis in the inception of asthma.

12. Cardiac safety profiles of macrolides.

Svanström H, Pasternak B and Hviid A. Use of clarithromycin and roxithromycin and risk of cardiac death: cohort study. BMJ 2014; 349:g4930. (doi:http://dx.doi.org/10.1136/bmj.g4930)

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Editor’s comment: A nationwide registry based cohort study to investigate the risk of cardiac death associated with clarithromycin and roxithromycin found a significantly increased risk of cardiac death associated with clarithromycin. No increased risk however was seen with the use of roxithromycin.