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Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines—2016 revision
Broż,ek, Jan L.,Bousquet, Jean,Agache, Ioana,Agarwal, Arnav,Bachert, Claus,Bosnic-Anticevich, Sinthia,Brignardello-Petersen, Romina,Canonica, G. Walter,Casale, Thomas,Chavannes, Niels H.,Correia Elsevier 2017 The journal of allergy and clinical immunology Vol.140 No.4
<P><B>Background</B></P> <P>Allergic rhinitis (AR) affects 10% to 40% of the population. It reduces quality of life and school and work performance and is a frequent reason for office visits in general practice. Medical costs are large, but avoidable costs associated with lost work productivity are even larger than those incurred by asthma. New evidence has accumulated since the last revision of the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines in 2010, prompting its update.</P> <P><B>Objective</B></P> <P>We sought to provide a targeted update of the ARIA guidelines.</P> <P><B>Methods</B></P> <P>The ARIA guideline panel identified new clinical questions and selected questions requiring an update. We performed systematic reviews of health effects and the evidence about patients' values and preferences and resource requirements (up to June 2016). We followed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) evidence-to-decision frameworks to develop recommendations.</P> <P><B>Results</B></P> <P>The 2016 revision of the ARIA guidelines provides both updated and new recommendations about the pharmacologic treatment of AR. Specifically, it addresses the relative merits of using oral H<SUB>1</SUB>-antihistamines, intranasal H<SUB>1</SUB>-antihistamines, intranasal corticosteroids, and leukotriene receptor antagonists either alone or in combination. The ARIA guideline panel provides specific recommendations for the choice of treatment and the rationale for the choice and discusses specific considerations that clinicians and patients might want to review to choose the management most appropriate for an individual patient.</P> <P><B>Conclusions</B></P> <P>Appropriate treatment of AR might improve patients' quality of life and school and work productivity. ARIA recommendations support patients, their caregivers, and health care providers in choosing the optimal treatment.</P>
Personalized Medicine in Allergy
Matteo Ferrando,Diego Bagnasco,Gilda Varricchi,Stefano Bernardi,Alice Bragantini,Giovanni Passalacqua,Giorgio Walter Canonica 대한천식알레르기학회 2017 Allergy, Asthma & Immunology Research Vol.9 No.1
Allergic disease is among the most common pathologies worldwide and its prevalence has constantly increased up to the present days, even if according to the most recent data it seems to be slightly slowing down. Allergic disease has not only a high rate of misdiagnosis and therapeutic inefficacy, but represents an enormous, resource-absorbing black hole in respiratory and general medicine. The aim of this paper is to summarize principal therapeutic innovations in atopic disease management befallen in the recent years in terms of personalized/precision medicine.
Sex Differences in Severe Asthma: Results From Severe Asthma Network in Italy-SANI
Senna Gianenrico,Latorre Manuela,Bugiani Massimo,Caminati Marco,Heffler Enrico,Morrone Daniela,Paoletti Giovanni,Parronchi Paola,Puggioni Francesca,Blasi Francesco,Canonica Giorgio Walter,Paggiaro Pie 대한천식알레르기학회 2021 Allergy, Asthma & Immunology Research Vol.13 No.2
Purpose: After adolescence, asthma is more frequent in females than in males due to different hormonal, immunologic, and occupational/environmental factors. The higher prevalence and severity of the disease in females have already been reported in international registries. The aim of this study was to explore the difference in terms of clinical, functional, and biological characteristics between male and female patients with severe asthma in a real-life, registry-based setting. Methods: Baseline data from the Severe Asthma Network in Italy registry were analyzed in 1,123 patients with severe asthma, according to sex. Results: Almost 2/3 of severe asthmatics were female. Late-onset asthma, obesity and gastro-esophageal reflux were more frequent in females than in males, while previous smoking habits and nasal polyposis were more frequent in males. Females had poor asthma control and a higher number of severe exacerbations leading to hospitalization, in comparison to males. Biomarkers of type 2 inflammation (blood eosinophil, exhaled nitric oxide, and serum immunoglobulin E levels) were significantly higher in males than in females. The type 2 profile (defined by a combination of these 3 biomarkers) was significantly more frequent in males than in females. In multivariate analysis, late-onset asthma and a normal body mass index were only independent variables associated with the type 2 profile, while male sex and age showed only a trend toward the association with the type 2 profile. Conclusions: Significant differences may be observed between male and female patients with severe asthma, influencing the asthma pheno-endotyping in both sexes.