The annual meeting of the American Academy of Allergy, Asthma & and Immunology was held from March 4 to 7 in Los Angeles and attracted more than 5,000 participants from around the world, including clinicians, academicians, allied health professionals, and others interested in allergic and immunologic disease. The conference highlighted recent advances in allergy, asthma, and immunology.
In one study, Harold L. Kim, M.D., of Grand River Allergy in Kitchener, Canada, and colleagues found that currently available epinephrine autoinjectors may inject into bone in a significant proportion of children weighing less than 15 kg, as the needle maybe too long for these children.
“Epinephrine autoinjectors should be prescribed for patients at risk for anaphylaxis. However, in North America there is no autoinjector indicated for children weighing less than 15 kg,” Kim said. “We performed a study with very stringent protocols to measure the bone and muscle depth using a device that very closely mimicked the Auvi-Q device.”
The investigators found that 43 percent of children weighing between 7.5 and 15 kg were at risk of the autoinjector needle hitting the bone. “There are concerns of unpredictable absorption and safety if this happens,” Kim said. “Currently available autoinjectors should be prescribed with caution in this population. Physicians should consider modified methods of injecting autoinjectors to minimize muscle compression and consider using ultrasound in patients. Future devices should be developed with needle length and injection depth in mind.”
Kim disclosed financial ties to Sanofi and Pfizer.
In another study, Evan Li, M.D., of the Baylor College of Medicine in Houston, and colleagues found that asthma and chronic sinusitis are fungal driven in the majority of cases, and that patients with allergic airway disease improve dramatically with anti-fungal therapy.
“The majority of patients with allergic airway disease (asthma, chronic rhinosinusitis, etc.) demonstrate growth of fungus in their airway (over 80 percent) in our population,” Li said. “Conventional methods for culturing sputum are highly insensitive in detecting fungal growth. With our novel, improved culture method, we are able to achieve near 100 percent sensitivity in detecting airway mycosis.”
The investigators found that over 80 percent of patients with asthma and/or chronic sinusitis in the study demonstrated improvement after anti-fungal therapy.
“Allergic airway disease, immunoglobulin E production, and allergies in general may all be driven by airway fungal infection,” Li said. “Future prospective, randomized controlled trials using anti-fungals in allergic individuals need to be performed to confirm our findings as well as to elucidate optimal treatment protocols.”
Two phase III studies were presented at the meeting focusing on the efficacy and safety of crisaborole, 2 percent ointment. In the first study, Mark Boguniewicz, M.D., of National Jewish Health in Denver, and colleagues randomized children, 2 years and older, with mild-to-moderate eczema to crisaborole ointment or a vehicle control twice daily. Children were evaluated on days eight, 15, 22 and 29. At day 29, the investigators found that 51.7 percent of children who received crisaborole reported their eczema as “clear” or “almost clear,” compared to 40.6 percent of those receiving vehicle control. Similar results were found in the second study.
“Improvements in pruritus were achieved earlier with crisaborole than with vehicle — and getting relief from itching is so important for our patients — and a greater proportion of crisaborole-treated patients saw improvement for all clinical signs of atopic dermatitis by day 29,” Boguniewicz said in a news release from the academy.
Boguniewicz disclosed financial ties to Anacor Pharmaceuticals, the manufacturer of crisaborole.
AAAAI: Supervised Exposure Therapy for Peanut Allergy Lasts
MONDAY, March 7, 2016 (HealthDay News) — Once a tolerance to peanuts has developed in children considered at high-risk for developing a peanut allergy, it seems to last, according to research published online March 4 in the New England Journal of Medicine. The findings were published to coincide with the annual meeting of the American Academy of Allergy, Asthma & Immunology, held from March 4 to 7 in Los Angeles.
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