The Journal of allergy and clinical immunology
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J. Allergy Clin. Immunol. · Dec 2013
ReviewAssessment of clinical signs of atopic dermatitis: a systematic review and recommendation.
Clinical signs are a core outcome domain for atopic dermatitis (AD) trials. The current lack of standardization of outcome measures in AD trials hampers evidence-based communication. ⋯ The Eczema Area and Severity Index and SCORAD are the best instruments to assess the clinical signs of AD. The other 14 instruments identified are (currently) not recommended because of unclear or inadequate measurement properties.
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J. Allergy Clin. Immunol. · Dec 2013
ReviewAn evidence-based analysis of house dust mite allergen immunotherapy: a call for more rigorous clinical studies.
According to meta-analyses and reviews, subcutaneous allergen immunotherapy (SCIT) and sublingual allergen immunotherapy (SLIT) are beneficial in patients with allergic rhinitis (AR) and allergic asthma (AA) induced by house dust mites (HDMs). However, the reported effect sizes have varied greatly from one study to another. ⋯ There is no consensus on basic treatment parameters (eg, dose and duration) in HDM SCIT and SLIT. There is an urgent need for rigorous, long-term, double-blind, placebo-controlled randomized clinical trials with an efficacy criterion that reflects the particular features of HDM-induced allergic disease.
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J. Allergy Clin. Immunol. · Nov 2013
Randomized Controlled Trial Clinical TrialPredictors of response to tiotropium versus salmeterol in asthmatic adults.
Tiotropium has activity as an asthma controller. However, predictors of a positive response to tiotropium have not been described. ⋯ Although these results require confirmation, predictors of a positive clinical response to tiotropium include a positive response to albuterol and airway obstruction, factors that could help identify appropriate patients for this therapy.
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J. Allergy Clin. Immunol. · Nov 2013
Anaphylaxis: clinical patterns, mediator release, and severity.
Prospective human studies of anaphylaxis and its mechanisms have been limited, with few severe cases or examining only 1 or 2 mediators. ⋯ The results suggest that multiple inflammatory pathways drive reaction severity and support recommendations for safe observation periods after initial treatment.
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J. Allergy Clin. Immunol. · Nov 2013
Randomized Controlled Trial Multicenter StudyEffects of benralizumab on airway eosinophils in asthmatic patients with sputum eosinophilia.
Many asthmatic patients exhibit sputum eosinophilia associated with exacerbations. Benralizumab targets eosinophils by binding IL-5 receptor α, inducing apoptosis through antibody-dependent cell-mediated cytotoxicity. ⋯ Single-dose intravenous and multiple-dose subcutaneous benralizumab reduced eosinophil counts in airway mucosa/submucosa and sputum and suppressed eosinophil counts in bone marrow and peripheral blood. The safety profile supports further development. Additional studies are needed to assess the clinical benefit in asthmatic patients.