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US Hereditary Angioedema Association Medical Advisory Board 2013 Recommendations for the Management of Hereditary Angioedema Due to C1 Inhibitor Deficiency Zuraw et al 458 What is already known about this topic? The treatment of hereditary angioedema (HAE) has undergone dramatic changes as newer medicines have become available and management has become more complex. What does this article add to our knowledge? This article provides recommendations for the treatment and management of HAE due to C1 inhibitor deficiency in the United States, which covers development of an overall management plan, treatment of angioedema attacks, prophylactic treatment, and patient monitoring. How does this study impact current management guidelines? Based on the criteria developed in this article, physicians can provide optimized management of patients with HAE by using any of the medications and approaches available for the treatment of HAE. Pollen Count and Presentation of Angiotensin-Converting Enzyme InhibitoreAssociated Angioedema Straka et al 468 What is already known about this topic? The incidence of angiotensin-converting enzyme (ACE) inhibitor-associated angioedema is increased in patients with seasonal allergies What does this article add to our knowledge? This article reports an association of the presentation of ACE inhibitor-associated angioedema with elevated pollen counts. Patients are more likely to present with this adverse drug event during months when pollen counts are increased. How does this study impact current management guidelines? These data suggest that environmental exposure may explain why patients can present with angioedema even after prolonged ACE inhibitor use and remind physicians to be vigilant to this possibility. Venom Immunotherapy in Patients with Clonal Mast Cell Disorders: Efficacy, Safety, and Practical Considerations Bonadonna et al 474 What is already known about this topic? Hymenoptera venom allergy and systemic mastocytosis are rare, and management of their association with immunotherapy is still a matter of debate. What does this article add to our knowledge? We report herein a case series of 84 patients with mastocytosis and hymenoptera allergy who received immunotherapy. The treatment was overall well tolerated and achieved protection against stings in most patients. How does this study impact current management guidelines? The results from this large case series should encourage and support the use of immunotherapy in patients with mastocytosis and hymenoptera allergy. Food Allergy and Increased Asthma Morbidity in a School-Based Inner-City Asthma Study Friedlander et al 479 What is already known about this topic? Food allergy prevalence is increased in people with asthma. The relationship between food allergy and asthma morbidity is not well described. What does this article add to our knowledge? The presence of food allergy and multiple food allergies is associated with increased asthma morbidity, resource utilization, and decreased lung function. How does this study impact current management guidelines? Impoverished, urban, nonwhite children with both food allergies and asthma may require greater asthma surveillance than those with asthma alone. 8A
Transcript of Highlights Page
US Hereditary Angioedema Association Medical Advisory Board 2013 Recommendations for theManagement of Hereditary Angioedema Due to C1 Inhibitor Deficiency
Zuraw et al8A
458
What is already known about this topic? The treatment of hereditary angioedema (HAE) has undergone dramatic changes as newermedicines have become available and management has become more complex.
What does this article add to our knowledge? This article provides recommendations for the treatment and management of HAE due toC1 inhibitor deficiency in the United States, which covers development of an overall management plan, treatment of angioedema attacks,prophylactic treatment, and patient monitoring.
How does this study impact current management guidelines? Based on the criteria developed in this article, physicians can provideoptimized management of patients with HAE by using any of the medications and approaches available for the treatment of HAE.
Pollen Count and Presentation of Angiotensin-Converting Enzyme InhibitoreAssociated Angioedema
Straka et al 468What is already known about this topic? The incidence of angiotensin-converting enzyme (ACE) inhibitor-associated angioedema isincreased in patients with seasonal allergies
What does this article add to our knowledge? This article reports an association of the presentation of ACE inhibitor-associatedangioedema with elevated pollen counts. Patients are more likely to present with this adverse drug event during months when pollencounts are increased.
How does this study impact current management guidelines? These data suggest that environmental exposure may explain why patientscan present with angioedema even after prolonged ACE inhibitor use and remind physicians to be vigilant to this possibility.
Venom Immunotherapy in Patients with Clonal Mast Cell Disorders: Efficacy, Safety, and PracticalConsiderations
Bonadonna et al 474What is already known about this topic? Hymenoptera venom allergy and systemic mastocytosis are rare, and management of theirassociation with immunotherapy is still a matter of debate.
What does this article add to our knowledge? We report herein a case series of 84 patients with mastocytosis and hymenoptera allergywho received immunotherapy. The treatment was overall well tolerated and achieved protection against stings in most patients.
How does this study impact current management guidelines? The results from this large case series should encourage and support theuse of immunotherapy in patients with mastocytosis and hymenoptera allergy.
Food Allergy and Increased Asthma Morbidity in a School-Based Inner-City Asthma Study
Friedlander et al 479What is already known about this topic? Food allergy prevalence is increased in people with asthma. The relationship between foodallergy and asthma morbidity is not well described.
What does this article add to our knowledge? The presence of food allergy and multiple food allergies is associated with increasedasthma morbidity, resource utilization, and decreased lung function.
How does this study impact current management guidelines? Impoverished, urban, nonwhite children with both food allergies andasthma may require greater asthma surveillance than those with asthma alone.
J ALLERGY CLIN IMMUNOL: IN PRACTICEVOLUME 1, NUMBER 5
9A
The Impact of Peer Support and mp3 Messaging on Adherence to Inhaled Corticosteroids in MinorityAdolescents with Asthma: A Randomized, Controlled Trial
Mosnaim et al 485What is already known about this topic? A lack of adherence to inhaled corticosteroids is a significant risk factor for poor asthmaoutcomes among low-income African American and Hispanic adolescents with persistent asthma.
What does this article add to our knowledge? Face-to-face coping peer support and mp3-delivered peer asthma messages do not appearto influence adherence to inhaled corticosteroids among inner-city minority adolescents with persistent asthma.
How does this study impact current management guidelines? Asthma guidelines recommend monitoring patient adherence to his or herpharmacotherapeutic regimen at each visit. Reliance on self-report of adherence to inhaled corticosteroid medications among urbanminority adolescents may give clinicians inadequate information to adjust their treatment regimens.
Carboplatin-, Oxaliplatin-, and Cisplatinespecific IgE: Cross-reactivity and Value in the Diagnosis ofCarboplatin and Oxaliplatin Allergy
Caiado et al 494What is already known about this topic? Cross-reactivity among platins has been documented through skin testing, but platin intra-dermal injection may induce cutaneous toxicity. Patients with anaphylactic reactions are at risk for a reaction due to skin testing.
What does this article add to our knowledge? Specific IgE to carboplatin and oxaliplatin can be detected in patients who are sensitized toplatin. Cross-reactivity among platins may also be assessed by platin specific IgE measurement. Oxaliplatin appears to be the mostimmunogenic platin.
How does this study impact current management guidelines? Platin specific IgE seems to be a valuable diagnostic aid. Patients who aresensitized to oxaliplatin seem to be at a higher risk of developing a reaction to carboplatin and cisplatin, whereas patients reactive tocarboplatin may be able to tolerate oxaliplatin.
The Relationship Between a Specific IgE Level and Asthma Outcomes: Results from the 2005-2006National Health and Nutrition Examination Survey
Arroyave et al 501What is already known about this topic? Absolute specific IgE may be predictive of asthma outcomes in the absence of exposure data.
What does this article add to our knowledge? This analysis demonstrated that, in a general population, there may be a dose-responserelationship between total IgE and specific IgE to certain allergens and asthma outcomes in adults and children.
How does this study impact current management guidelines? The absolute level of specific IgE to certain allergens may be a morerelevant and useful clinical tool than an arbitrary sensitized or nonsensitized cut-point value in the prediction of severe asthma outcomes.
Quality of Care for Acute Asthma in Emergency Departments in Japan: A Multicenter ObservationalStudy
Hasegawa et al 509What is already known about this topic? North American studies have highlighted gaps in the quality of acute asthma care in emergencydepartments. However, little is known about the quality of care and the association between process of care and outcomes in otherindustrialized nations.
What does this article add to our knowledge? This multicenter study showed that the concordance of acute asthma care with evidence-based guidelines was suboptimal in Japan. Greater concordance with guideline-recommended management might reduce unnecessaryhospitalizations.
How does this study impact current management guidelines? Greater concordance with guideline-recommended management mightreduce unnecessary hospitalizations. Knowledge translation initiatives aimed at increasing concordance are likely to improve patientoutcomes internationally.
