The 2023 Annual Meeting of the American College of Allergy, Asthma & Immunology
By Beth Gilbert HealthDay Reporter
The annual meeting of the American Academy of Allergy, Asthma & Immunology (AAAAI) was held from Feb. 24 to 27 in San Antonio and attracted 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 the fields of allergy, asthma, and immunology.
“The theme of the conference was ‘optimizing patient care,'” David Khan, M.D., of the University of Texas Southwestern Medical Center in Dallas and president of the AAAAI, said in an interview with HealthDay. “As president, we get to have a little flavor of the conference, and one of my areas of interest is drug allergy, so there were certain sessions on drug allergy as well.”
In one particular study, researchers described cases of COVID-19 mRNA vaccine-induced immunization stress-related response (ISRR), demonstrating that what appear to be allergies to a vaccine may be nonallergic manifestations. Muhammad Khalid, M.D., from the Laboratory of Allergic Diseases of the National Institute of Allergy and Infectious Diseases in Bethesda, Maryland, and colleagues evaluated patients who reported a history of allergic reactions to the Pfizer COVID-19 vaccine. In the small study of 16 patients, researchers randomly assigned patients to either a second dose of the vaccine or a placebo in a hospital intensive care unit setting.
“As it turned out, there were more people who had reactions to the placebo than the actual vaccine,” Khan said. “In fact, almost all of them had some type of symptoms, and the typical symptoms that we saw were not really allergic but could be mimics of an allergic reaction.”
Nonallergic manifestations were reported by nine patients after the second dose of the vaccine and 11 patients after receiving placebo. These included numbness, tingling, dizziness, throat tightness, dysphagia, and transient hypertension consistent with ISRR. Skin tests revealed that three of the 16 participants experienced an actual allergic reaction to their second Pfizer shot.
In a single center, retrospective study, Ellen D. Stephen, M.D., of the Rush University Medical Center in Chicago, and colleagues found that Black children with asthma and eczema are less likely to be evaluated by an allergist specialist and less likely to undergo environmental allergy testing than White children with asthma and eczema.
The authors performed a retrospective chart review of children aged 18 years or younger diagnosed with atopic dermatitis to determine if each child was diagnosed with asthma and if they were evaluated for asthma. After identifying 728 Black children and 246 non-Hispanic White children with atopic dermatitis, the researchers found that 31.2 percent of Black children were likely to have an asthma diagnosis, while 10 percent of White children were likely to have the same diagnosis. In addition, the investigators found that 47 percent of Black children were evaluated by an allergist, while 69 percent of White children were evaluated by an allergist.
“All children with asthma should ideally undergo allergist evaluation, including environmental allergy testing, as management of comorbid allergic rhinitis is known to be important in achieving optimal asthma control,” Stephen said. “It is important, as part of the care plan for these patients, to consider allergist referral and to assess for socioeconomic barriers to accessing this specialty care that can be addressed by providers.”
In another study, Elizabeth A. Kudlaty, M.D., of Northwestern University in Evanston, Illinois, and colleagues found that patients with asthma had higher rates of systemic corticosteroid prescriptions during the delta and omicron COVID-19 waves compared with the alpha wave; however, rates of antibiotic prescriptions were higher for the alpha compared with delta and omicron waves.
The authors evaluated how patients with asthma behaved during periods of the three different COVID-19 variants: alpha, delta, and omicron. Specifically, rates of systemic corticosteroid and antibiotic prescriptions for asthma patients diagnosed with COVID-19 were assessed in an effort to identify differences in the rates of prescriptions and provide insight into rates of upper and lower respiratory tract exacerbations. The authors examined health care utilization, mainly emergency room visits and hospitalizations, for patients with and without asthma during the three waves.
The researchers found that patients with asthma had higher rates of systemic corticosteroid prescriptions during the delta and omicron waves compared with the alpha wave. Furthermore, rates of antibiotic prescriptions were higher for the alpha wave compared with the delta and omicron waves, which may reflect prescribing patterns at the time.
“We also found that rates of emergency room visits and hospitalizations for COVID-19 in patients with asthma were lower during omicron compared to delta and alpha,” Kudlaty said. “This is reassuring as it suggests that even though rates of steroid prescriptions were higher during omicron compared to alpha, asthma patients did not seem to be hospitalized at greater rates.”
Ami Shah, M.D., of the Ichan School of Medicine at Mount Sinai in New York City, and colleagues found that sesame oral desensitization using crushed sesame seeds and tahini can be a safe and effective way to achieve sustained unresponsiveness to sesame.
The authors performed a retrospective chart review of 86 pediatric patients undergoing oral desensitization to sesame. They found that 61 (71 percent) reached a daily dose of 1 teaspoon of tahini/sesame paste (approximately 2,000 crushed sesame seeds). At the time of data analysis, 14 of those patients were able to ingest three times their daily amount (1 tablespoon of tahini, approximately 6,000 crushed sesame seeds) after ingesting their daily dose for at least six months. All 14 of these patients (100 percent) were also able to tolerate the 1 tablespoon of tahini after cessation of ingestion of their daily dose for four weeks (i.e., achieve sustained unresponsiveness). About 30 percent of patients experienced treatment-related adverse reactions, of which the majority were mild.
“Allergists should consider sesame oral immunotherapy as a treatment option for their pediatric patients with sesame allergy,” Shah said.
AAAAI: EMR Alert Effective for Reducing Food Allergy Panel Testing
MONDAY, Feb. 27, 2023 (HealthDay News) — An electronic medical record (EMR) alert is effective for reducing food allergy panel ordering among pediatric and adult patients, according to a study presented at the annual meeting of the American Academy of Allergy, Asthma & Immunology, held from Feb. 24 to 27 in San Antonio.
AAAAI: Black Children With Eczema More Likely to Have Asthma
MONDAY, Feb. 27, 2023 (HealthDay News) — Black children with atopic dermatitis are more likely to have asthma than non-Hispanic White children, but they are less likely to be evaluated by an allergist, according to a study presented at the annual meeting of the American Academy of Allergy, Asthma & Immunology, held from Feb. 24 to 27 in San Antonio.
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