The Net Guide: Allergies

MDNG Primary Care, August 2010, Volume 12, Issue 8

//The Educated Patient™

The Food Allergy and Anaphylaxis Network

This site serves as an excellent starting point for patients with food allergies; visitors can access information specific to a certain type of food allergy, such as milk, egg, peanut, tree nuts, fish, shellfish, soy, and wheat, or obtain more general information. Also featured are tips on grocery shopping; an animation depicting how an allergic reaction occurs; articles on food allergies; a back-to-school toolkit featuring lunch suggestions, field trip tips, and a Food Allergy Action Plan; pointers on how to read a food label; allergy-friendly recipes; daily tips; and a support network for teens with food allergies.

Nut and Peanut Allergy

A growing number of children are developing allergies to nuts; with that in mind, KidsHealth.org created this page to educate young patients on how nut allergies can be managed. The site provides easy-to-read content focusing on topics such as why the body goes “nuts over nuts,” how nut or peanut allergies are diagnosed and treated, creating an emergency plan, how to handle a nut or peanut allergy, and the effects of allergic reactions. Visitors can also download audio of the article, and print a list of foods to avoid.

//Medical Websites

American Academy of Allergy, Asthma & Immunology

At this site, healthcare professionals who treat patients with allergies can find an abundance of useful resources. Here, physicians can learn about a program designed to “advance allergy and asthma care for underserved populations by placing participating volunteer allergist/immunologists at community clinics in underserved areas;” read the “Ask the Expert” column, which has recently focused on topics such as cashew allergy and anaphylaxis possibly due to wheatgrass; access tools to help keep children with allergic diseases safe in school and access resources on converting to electronic records.

New England Journal of Medicine: Allergy/Immunology

This page features a collection of hundreds of articles covering topics such as allergy, monoclonal antibodies, immunodeficiency, and autoimmune diseases—some of which offer CME credit. Also included are case reports, reviews, and editorial commentary. Among the titles currently available are: “Allogeneic Hematopoietic Stem-Cell Transplantation for Sickle Cell Disease,” “Case 21-2008: An 11-Month-Old Boy with Fever and Pulmonary Infiltrates,” and “Food Allergy.” (Note: to access full content, a subscription to the journal is required.)

//Online CME

Allergic Rhinitis and the Costs of Undertreatment: A Clinical and EconomicUpdate for Managed Care—Case Vignettes

Credits:1.00

Fee:None

Expires:November 24, 2010

Multimedia:Audio/Video

Featuring four patient case studies, this program will focus on the clinical and economic burden of allergic rhinitis (AR) and disease sequelae; guidelines and methods designed to promote adherence to evidence-based treatment; the benefits, limitations, and pharmacoeconomics of all available treatment modalities, including pharmacotherapy and allergen immunotherapy; and methods used to support best practices in the management of AR and disease sequelae.

Critical Challenges in Allergic Diseases: Optimizing Outcomes in Patients with Allergic Rhinitis and Urticaria

Credits:1.50

Fee:None

Expires:November 30, 2010

Multimedia:Audio/Video

This educational webcast aims to “improve the diagnosis and treatment of allergic rhinitis (AR) and chronic idiopathic urticaria and to provide a rational foundation for the development of effective allergen avoidance and treatment strategies.” Content covers the pathophysiology and immunologic underpinnings of AR and urticaria, risk factors for AR and urticaria and triggers of symptoms, comorbid conditions associated with poorly controlled AR, and the latest management strategies for AR and urticaria.

//PODCASTS

Emergency Medicine: Allergic Reaction and Emergency Care

In this podcast, part of a collection offered by the Medical University of South Carolina, Sam Kini, MD, talks about emergency care for allergic reactions triggered by events such as insect stings and bites, food allergies, and drug allergies. Kini also identifies common symptoms of allergic reactions and explains how they are treated in the emergency department.

Allergy and Asthma Network Mothers of Asthmatics

Direct your patients and their families to this podcast channel from the Allergy and Asthma Network Mothers of Asthmatics, where they can listen as James Sublett, MD, discusses ways to reduce allergens and irritants in the home. Viewers can also learn about asthma-centered awareness efforts taking place in Washington, DC.

//eAbstracts

Allergic and Non-allergic Rhinitis in Swimmers: Clinical and Cytological Aspects

Journal:British Journal of Sports Medicine (June 2010)

Authors:Gelardi M, Ventura M, Fiorella R, et al

Purpose:To describe the clinical and cytological characteristics of rhinitis in swimmers, and to assess the possible role of chlorine-induced symptoms.

Results:A group of elite swimmers aged 9-21 with rhinitis symptoms underwent a complete diagnostic workup both before and after one month of using a nasal clip while swimming. Of the swimmers, 44% had allergic rhinitis (AR), and 35% had a predominant neutrophilic inflammation. “The use of a nose clip reduced cellular infiltration and nasal resistances only in the subjects with neutrophilic rhinitis, whereas a clinical improvement was seen also in AR.”

Diet and Nutritional Status of Children with Food Allergies

Journal:Pediatric Allergy and

Immunology (June 2010)

Authors:Flammarion S, Santos C, Guimber D, et al

Purpose:To assess the food intake and nutritional status of children with food allergies following an elimination diet.

Results:Results of a cross-sectional study demonstrated that children with food allergies had weight-for-age and height-for-age scores lower than controls, even when they received similar nutrient intakes. Therefore, “nutritional evaluation is essential for the follow up of children with food allergies.”

//Clinical Trials

Allergy Immunotherapy for the Reduction of Asthma (AIR)

Study Type:Interventional

Age/Gender Requirement:18 months—3 years (male/female)

Sponsor:Albert Einstein College of Medicine of Yeshiva University

Purpose:To determine the effect of allergy immunotherapy in decreasing asthma- and allergy-related disease in children who have multiple episodes of wheezing and who are at high risk for developing persisting asthma. Although allergy immunotherapy has been practiced for many years to treat asthma and environmental allergies in older children and adults, it has not yet been systematically studied in young children.

From the HCPLive Network

Peanut and Tree Nut Allergies on the Rise

More and more, peanut allergies and tree nut allergies are being reported in adults and children across the country. According to the results of a study published in The Journal of Allergy and Clinical Immunology, 3 million Americans reported having a peanut allergy, a TN allergy, or both.

Food Allergies and Apple Fudge

In this “Pediatric Points” blog post, Jill Taylor discusses findings from a National Institute of Allergy and Infectious Diseases study indicating that due to a lack of uniformity in diagnostic criteria, there are many people who think that they have a food allergy when they actually don’t.

Asthma & Allergy Watch

Among the content examined in this report is a study presented at the American Academy of Allergy, Asthma & Immunology 2010 Annual Meeting examining the safety and efficacy of oral immunotherapy (OIT) for egg allergy in children. Results showed that children in the OIT group were more likely to pass an oral food challenge, and showed significant decreases in both egg IgE levels and egg percutaneous skin tests compared with the placebo group.

Pharma Focus

Clinical Trials

Omalizumab in the Treatment of Peanut Allergy

Study Type:Interventional

Age /Gender Requirement:18-50 years (male/female)

Sponsor:Johns Hopkins University

Purpose:This open-label, non-randomized trial aims to assess whether treatment with omalizumab can eliminate or reduce symptoms of peanut allergy. The primary outcome measure will be the “proportion of patients who have a four-fold increase in the dose of peanut protein needed to induce positive challenge (with final threshold dose >1000 mg) at the 6-month oral food challenge.”

eAbstract

The Costs and Consequences of Omalizumab in Uncontrolled Asthma from a USA Payer Perspective

Journal:Allergy (February 2010)

Author:Campbell J, Spackman D, and Sullivan S

Purpose:To estimate the costs and consequences of treatment with omalizumab—an anti-immunoglobulin E antibody that improves symptoms in uncontrolled allergic asthma—compared to usual care from a US payer perspective.

Results:Researchers estimated payer costs, quality-adjusted survival (QALY), and the incremental cost-effectiveness ratio (ICER) of omalizumab compared to usual care using a state-transition simulation model that included sensitivity analyses, and found that “adding omalizumab to usual care improves QALYs at an increase in direct medical costs. The cost-effectiveness of omalizumab is similar to other chronic disease biologics. The value increases when omalizumab response is used to guide long-term treatment.”