Presence of positive skin prick tests to inhalant allergens and markers of T2 inflammation in subjects with chronic spontaneous urticaria (CSU): a systematic literature review

Wong, Melanie; Keith, Paul K.

doi:10.1186/s13223-020-00461-x

Cited by 15 publications

(15 citation statements)

References 129 publications

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“…However, a positive skin prick test is thought to be likely if it has been ordered by a specialist, and omalizumab is indicated for use in allergic asthma and not in nonallergic asthma. Although it is possible that omalizumab could be prescribed for chronic spontaneous urticaria in patients with nonallergic asthma, and these patients could have been misclassified as having allergic asthma, the presence of asthma as a comorbid condition in patients with chronic spontaneous urticaria is low [38]. In addition, the database does not cover all health care facilities in the United States and may not be nationally representative of patients who attend smaller ambulatory practices.…”

Section: Discussionmentioning

confidence: 99%

Patients with allergic asthma have lower risk of severe COVID-19 outcomes than patients with nonallergic asthma

Murphy

Busse

Holweg³

et al. 2022

BMC Pulm Med

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Background Although asthma does not appear to be a risk factor for severe coronavirus disease 2019 (COVID-19), outcomes could vary for patients with different asthma subtypes. The objective of this analysis was to compare COVID-19 outcomes in real-world cohorts in the United States among patients with asthma, with or without evidence of allergy. Methods In a retrospective analysis of the COVID-19 Optum electronic health record dataset (February 20, 2020–January 28, 2021), patients diagnosed with COVID-19 with a history of moderate-to-severe asthma were divided into 2 cohorts: those with evidence of allergic asthma and those without (nonallergic asthma). After 1:1 propensity score matching, in which covariates were balanced and potential bias was removed, COVID-19 outcomes were compared between cohorts. Results From a COVID-19 population of 591,198 patients, 1595 patients with allergic asthma and 8204 patients with nonallergic asthma were identified. After propensity score matching (n = 1578 per cohort), risk of death from any cause after COVID-19 diagnosis was significantly lower for patients with allergic vs nonallergic asthma (hazard ratio, 0.48; 95% CI 0.28–0.83; P = 0.0087), and a smaller proportion of patients with allergic vs nonallergic asthma was hospitalized within − 7 to + 30 days of COVID-19 diagnosis (13.8% [n = 217] vs 18.3% [n = 289]; P = 0.0005). Among hospitalized patients, there were no significant differences between patients with allergic or nonallergic asthma in need for intensive care unit admission, respiratory support, or COVID-19 treatment. Conclusions Asthma subtype may influence outcomes after COVID-19; patients with allergic asthma are at lower risk for hospitalization/death than those with nonallergic asthma.

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Section: Discussionmentioning

confidence: 99%

Patients with allergic asthma have lower risk of severe COVID-19 outcomes than patients with nonallergic asthma

Murphy

Busse

Holweg³

et al. 2022

BMC Pulm Med

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“…Additionally, results from a previous study suggest that at least chronic spontaneous urticaria is associated with increased T2 markers. 48 Although urticaria may be accompanied by angioedema or angioedema may occur independently, angioedema was not included in the a priori analysis plan. Therefore, it is possible that inclusion of both components separately may provide additional information related to cT2.…”

Section: Discussionmentioning

confidence: 99%

Association Between a Type 2 Inflammatory Disease Burden Score and Outcomes Among Patients with Asthma

Price¹,

Menzies‐Gow²,

Bachert³

et al. 2021

JAA

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Background Although prevalence of co-existing type 2 inflammatory diseases (cT2) in asthma patients has been reported, limited data exist regarding their impact on asthma outcomes. Objective To assess the impact of cT2 burden on asthma outcomes and to evaluate patterns of clustering of cT2 in a real-world setting. Methods From medical records of 4.5 million enrollees in 650 primary care practices in the UK (January 2010–December 2017), patients with ≥1 diagnosis code for asthma at any time pre-index date (date of most recent asthma-related medical encounter) and ≥2 asthma-related prescriptions during the year before index date were categorized into the Global Initiative of Asthma (GINA) guideline severity steps. A cT2 burden score (range 0–9) was assigned based on the total number of co-existing conditions (allergic conjunctivitis, allergic rhinitis, anaphylaxis, eczema/atopic dermatitis, chronic rhinosinusitis, eosinophilic esophagitis, food allergy, nasal polyps, or urticaria) for which patients received a medical diagnosis. Multivariate regression models evaluated associations between cT2 burden score and asthma exacerbations and asthma control. Factor analysis was performed to assess which cT2 comorbidities were correlated and exhibited patterns of clustering. Results Overall, 245,893 patients with asthma were included (mean [SD] age 44.8 [22.1] years; 43.8% male). Between 55% (GINA step 1) and 60% (GINA step 5) of asthma patients had a medical diagnosis for ≥1 other type2dx. Patients with increased cT2 burden were significantly more likely to experience asthma exacerbations and less likely to achieve asthma control. Conclusion Asthma patients with a higher cumulative cT2 burden score were more likely to experience worse asthma outcomes than those without any cT2 (burden score of 0).

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“…Independent Research Fund Denmark, Grant/Award Number: 2034-00031B Helena Swee-Lin Trige Pedersen 1 , Jennifer Astrup Sørensen 1 , Flemming Madsen 2 , Allan Linneberg 3,4 , Katja Biering Leth-Møller 3 , Christian Vestergaard 5 , Simon Francis Thomsen 1,6 1…”

Section: Acknowledgementmentioning

confidence: 99%

“…Although the symptoms of CU are thought to be caused, at least in part, by auto‐allergic mechanisms mediated by formation of immunoglobulin E (IgE), for example, against thyroid peroxidase or IL‐24, 1 sensitization and/or allergy to external triggering factors are possibly not causative in CU. Still, allergic diseases such as asthma and hay fever, 2 and sensitization to aeroallergens, 3 are more prevalent in patients with CU, and the exact implications of this for patients with CU are not completely understood.…”

Section: Tablementioning

confidence: 99%

Prevalence, predictors, and clinical relevance of α‐gal sensitization in patients with chronic urticaria

Pedersen

Sørensen

Madsen³

et al. 2022

Clinical & Translational All

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Background Little is known about α‐gal (galactose‐α‐1,3‐galactose) sensitization in patients with chronic urticaria (CU). The aim of this study was to examine the prevalence, predictors and clinical relevance of α‐gal sensitization in patients with CU. Methods Two consecutive cohorts of newly referred patients with CU from a primary care allergology practice and a tertiary hospital dermatology department, plus a control group with allergic disease, but not CU, from the allergology practice, were interviewed and screened for α‐gal sensitization (serum specific‐IgE ≥0.35 KU/L). Results Of 733 patients included, 21 (5.6%) and 11 (3.9%) of CU patients from private practice and hospital, respectively, were α‐gal sensitized. In total, 8 patients (38.1% of sensitized patients, and 2.1% of all CU patients) from private practice, and 2 patients (18.2% of sensitized patients, and 0.7% of all CU patients) from hospital, had clinically relevant α‐gal allergy. In private practice, male sex (47.6 vs. 24.7%), p = 0.020, obesity (33.3 vs. 23.6%), p = 0.302, and frequency of angioedema (61.9 vs. 51.4%), p = 0.350; and in hospital, male sex (72.7 vs. 27.9%), p = 0.003, and high total immunoglobulin E (median 168 vs. 70.5 KU/L), p = 0.022 were associated with α‐gal sensitization. Conclusion α‐gal sensitization is observed in a small fraction of CU patients with only few patients experiencing clinically relevant sensitization. Certain patients, particularly from primary care, may constitute a relevant population for aimed testing.

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Presence of positive skin prick tests to inhalant allergens and markers of T2 inflammation in subjects with chronic spontaneous urticaria (CSU): a systematic literature review

Cited by 15 publications

References 129 publications

Patients with allergic asthma have lower risk of severe COVID-19 outcomes than patients with nonallergic asthma

Patients with allergic asthma have lower risk of severe COVID-19 outcomes than patients with nonallergic asthma

Association Between a Type 2 Inflammatory Disease Burden Score and Outcomes Among Patients with Asthma

Prevalence, predictors, and clinical relevance of α‐gal sensitization in patients with chronic urticaria

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