The CHRONICLE study (ClinicalTrials.gov Identifier: NCT03373045) is an ongoing, non-interventional, prospective, cohort study of adults with severe asthma who are currently receiving care from a specialist physician. Patients were eligible for the study if they had severe asthma for at least 12 months, were uncontrolled while receiving high-dose inhaled corticosteroids with additional controllers, and/or required systemic corticosteroids or monoclonal antibody therapy. 

To better understand the effectiveness of biologic therapy on patients with severe asthma, the researchers examined data from patients enrolled from February 2018 to February 2023 who had started a biologic. Annualized asthma exacerbation rates were compared by age group (18-49, 50-64, ≥65 years) and by biologic type (anti-immunoglobulin E [IgE] vs other biologics [anti-interleukin-5/5R/4Rs or antithymic stromal lymphopoietin]) 6 months before and after initiation of treatment. 

Results showed annualized asthma exacerbation rates were reduced in all age groups 6 months after compared with 6 months before initiating a biologic. Exacerbation rate reductions were found to trend higher among patients who received other biologics compared with those who received anti-IgE, respectively:

• 18 to 49 years of age: 61% (P <.0001) vs 40% 
• 50 to 64 years of age: 52% (P <.0001) vs 49% (P <.01)
• ≥65 years of age: 58% (P <.0001) vs 51%

Study authors concluded that “Biologic use improved asthma outcomes in adult patients with [severe asthma] in all age groups, without evidence of reduced effectiveness in older age. A trend of slightly reduced effectiveness of anti-IgE vs other biologics was observed.”

Disclosure: Some of the study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

Lianne Soller, PhD, from the University of British Columbia in Vancouver, Canada, and colleagues assessed the safety of multifood SLIT in 188 pediatric patients (aged 4 to 18 years) and the effectiveness of bypassing oral immunotherapy (OIT) buildup with an initial phase of SLIT.

The researchers found that 4 patients received epinephrine (2.10%) during buildup (2mg protein SLIT maintenance over the course of 3 to 5 visits) and went to the emergency department, although none experienced grade 4 (severe) reaction. Twenty patients had 50 low-dose oral food challenges to 300mg protein, with 70% of the oral food challenges successful in bypassing OIT buildup.

“Allergists are often quite burdened by the oral immunotherapy buildup phase, where a patient may require 11 or more visits to the clinic,” coauthor Edmond Chan, MD, also from the University of British Columbia, said in a statement. “In our clinic, we are starting to do more home-based approaches because the demand for medical appointments that would allow supervision far outstrips the supply. Our SLIT data suggests that home-based SLIT buildup is safe.”

Several authors disclosed ties to the pharmaceutical industry.

Abstract/Full Text

(HealthDay News) — In two January data briefs published by the U.S. Centers for Disease Control and Prevention National Center for Health Statistics, data are presented regarding the prevalence of seasonal allergy, eczema, and food allergy among children and adults in 2021.

Benjamin Zablotsky, PhD, from the National Center for Health Statistics in Hyattsville, Maryland, and colleagues used data from the 2021 National Health Interview Survey (NHIS) to describe the percentage of children who had diagnosed seasonal allergy, eczema, or food allergy. The researchers found that 18.9%, 10.8% and 5.8% had a seasonal allergy, eczema, and a food allergy, respectively, in 2021. The likelihood of having a seasonal allergy was higher for boys than girls (20.0% vs 17.7%). There was variation observed by age in the percentage of children with eczema (10.4%, 12.1%, and 9.8% in children aged 0 to 5, 6 to 11, and 12 to 17 years, respectively). The likelihood of having a food allergy was increased for non-Hispanic Black versus non-Hispanic White and Hispanic children.

Amanda E. Ng, MPH, and Peter Boersma, MPH, both from the National Center for Health Statistics, used 2021 NHIS data to describe the prevalence of seasonal allergy, eczema, or food allergy among adults. The researchers found that 25.7%, 7.3%, and 6.2% of adults had a seasonal allergy, eczema, and a food allergy, respectively, in 2021. Compared with Hispanic, non-Hispanic Black, and non-Hispanic Asian adults, the percentage of adults with a seasonal allergy was higher in non-Hispanic White adults. Women were more likely than men to have eczema (8.9% vs 5.7%). With increasing age, the prevalence of food allergy decreased.

“For all three allergies, women were more likely than men to have a diagnosed allergy,” Ng and Boersma write.

Data Brief – Children

Data Brief – Adults

The popularity of ChatGPT, an artificial intelligence (AI) chatbot, left researchers from the Cleveland Clinic wondering about its reliability as a medical information provider. To assess its capabilities, the researchers asked the chatbot to provide information on the prevalence, symptoms, diagnostic tests, management and prevention of drug allergies. The DISCERN instrument was used to assess the quality of the information provided by the chatbot and 4 reviewers were tasked with determining whether the AI answers matched the AAAAI/ACAAI drug allergy guidelines.

Results showed ChatGPT provided fair to good quality information (DISCERN score of 3.44/5) with 76% of the information matching guideline recommendations. “Fleiss κ score was 0.65, which represented substantial agreement between the graders of ChatGPT responses,” the authors added.

However, the chatbot failed when it came to providing accurate sources, with 60% consisting of expired web pages. Twenty-seven percent of the sources consisted of irrelevant or inaccurate links and 13% included nonspecific links.

“Artificial intelligence ChatGPT information on drug allergies appeared to reflect the currently accepted Allergy/Immunology guidelines but the chatbot was an unreliable source of information due to errors in all of the provided sources,” the authors concluded.