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Article ; Online: Mepolizumab prefilled syringe for the treatment of severe eosinophilic asthma: focus on the pediatric population.

Revier, Michelle Dilley / Geng, Bob

2022 Volume 16, Issue 8, Page(s) 857–865

Abstract: Introduction: Eosinophil-targeted therapy with mepolizumab for severe eosinophilic asthma has significantly improved asthma control and patient quality of life though administration in children had been restricted to health-care provider reconstitution ... ...

Abstract	Introduction: Eosinophil-targeted therapy with mepolizumab for severe eosinophilic asthma has significantly improved asthma control and patient quality of life though administration in children had been restricted to health-care provider reconstitution of a lyophilized powder into a solution with in-clinic administration until recently. Here, we profile the newly FDA-approved use of mepolizumab as a prefilled syringe for the treatment of severe eosinophilic asthma in children aged 6-11 years old, allowing for home administration. Areas covered: A literature search was conducted on PubMed using keywords such as mepolizumab, severe asthma, eosinophils, IL-5, anti-IL-5, children, pediatric, prefilled syringe, and home administration in several combinations. Published literature through July 2022 including clinical trials and prescribing information for mepolizumab for severe eosinophilic asthma, particularly for use in children and as administration as a prefilled syringe, is reviewed. Expert opinion: Asthma affects a significant number of children worldwide, and having efficacious, tolerable, targeted precision therapies for this population is crucial. Mepolizumab remains the only targeted anti-IL-5 therapy approved for pediatric asthma down to 6 years of age. The innovation of the prefilled syringe will enable home administration, which would decrease the burden of treatment, and could potentially increase adoption of therapy.
MeSH term(s)	Anti-Asthmatic Agents ; Antibodies, Monoclonal, Humanized ; Asthma/drug therapy ; Child ; Eosinophils ; Humans ; Powders/therapeutic use ; Pulmonary Eosinophilia/drug therapy ; Quality of Life ; Syringes
Chemical Substances	Anti-Asthmatic Agents ; Antibodies, Monoclonal, Humanized ; Powders ; mepolizumab (90Z2UF0E52)
Language	English
Publishing date	2022-08-05
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2479146-5
ISSN	1747-6356 ; 1747-6348
ISSN (online)	1747-6356
ISSN	1747-6348
DOI	10.1080/17476348.2022.2109465
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Article ; Online: Low rates of headache and migraine associated with intravenous immunoglobulin infusion using a 15-minute rate escalation protocol in 123 patients with primary immunodeficiency.

Geng, Bob / Clark, Kim / Evangelista, Mark / Wolford, Eric

Frontiers in immunology

2023 Volume 13, Page(s) 1075527

Abstract: Introduction: Headache and migraine adverse events are common concerns in the administration of intravenous immune globulins (IVIG). Trials of IVIG for primary immunodeficiency (PI) are typically small and have reported headache and migraine data ... ...

Abstract	Introduction: Headache and migraine adverse events are common concerns in the administration of intravenous immune globulins (IVIG). Trials of IVIG for primary immunodeficiency (PI) are typically small and have reported headache and migraine data inconsistently. Methods: We analyzed headache and migraine in pooled data from three pivotal trials of Gammaplex Results: In total, 1482 infusions were administered to 123 patients, with 94.6% of infusions achieving the maximum infusion rate. At least one product-related headache was reported in 6.1% (90/1482) of infusions. At least one product-related migraine was reported in 0.5% (7/1482) of infusions. Headache rates were higher for adults vs pediatric patients, females vs males, and 21-day vs 28-day dosing schedules, but were similar for the 5% and 10% IVIG products. Most headaches and migraines occurred during or within 72 hours of the infusion. Rates decreased after the first few infusions. Discussion: Patients receiving this IVIG product on a 15-minute rate escalation protocol had low rates of headache and migraine for both the 5% and 10% formulations.
MeSH term(s)	Adult ; Child ; Female ; Humans ; Male ; Headache ; Immunoglobulins, Intravenous ; Infusions, Intravenous ; Migraine Disorders ; Retrospective Studies
Chemical Substances	Immunoglobulins, Intravenous
Language	English
Publishing date	2023-02-02
Publishing country	Switzerland
Document type	Clinical Trial ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2606827-8
ISSN	1664-3224 ; 1664-3224
ISSN (online)	1664-3224
ISSN	1664-3224
DOI	10.3389/fimmu.2022.1075527
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Article ; Online: Small molecule drugs for atopic dermatitis, rheumatoid arthritis, and hereditary angioedema.

Geng, Bob / Craig, Timothy J

Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology

2021 Volume 128, Issue 3, Page(s) 263–268

Abstract: Objective: To review recent trends in the development of targeted small molecule drugs (SMDs) for the treatment of immunologically driven disorders, including atopic dermatitis, rheumatoid arthritis, and hereditary angioedema.: Data sources: Data ... ...

Abstract	Objective: To review recent trends in the development of targeted small molecule drugs (SMDs) for the treatment of immunologically driven disorders, including atopic dermatitis, rheumatoid arthritis, and hereditary angioedema. Data sources: Data sources included peer-reviewed published literature from the PubMed database, published abstracts from scientific and medical meetings, and medication information from the Drugs@FDA database. Study selections: Articles with primary or retrospective trial results, articles with patient or physician survey results, articles providing expert perspectives, and commentary on chronic immunologic disorders, Food and Drug Administration package inserts, and abstracts from scientific meetings were selected. Results: Targeted biological therapies have greatly improved response rates and symptom relief for patients with long-term immunologically driven disorders over the past 2 decades. However, recent advances in the understanding of molecular pathways involved in the pathogenesis of these disorders have led to the development of novel targeted SMDs, such as tofacitinib and berotralstat, that can be delivered orally or topically. Few head-to-head studies that compare the safety and efficacy of biologics to SMDs in immunologically driven disorders exist, although some studies suggest that oral and topical modes of administration are preferred by patients and may improve patient quality of life over time. Conclusion: Scientific advances have led to an increase in the development of targeted SMDs for the treatment of chronic immunologic disorders, which may revolutionize the management of these diseases. Head-to-head studies and real-world evidence are needed to fully compare treatment attributes between biologics and SMDs, including safety, efficacy, adherence, impact on quality of life, and cost-effectiveness.
MeSH term(s)	Angioedemas, Hereditary/drug therapy ; Arthritis, Rheumatoid/drug therapy ; Dermatitis, Atopic/drug therapy ; Drug Development/trends ; Humans ; Pharmaceutical Preparations ; Quality of Life ; Retrospective Studies
Chemical Substances	Pharmaceutical Preparations
Language	English
Publishing date	2021-10-18
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	1228189-x
ISSN	1534-4436 ; 0003-4738 ; 1081-1206
ISSN (online)	1534-4436
ISSN	0003-4738 ; 1081-1206
DOI	10.1016/j.anai.2021.10.015
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Article ; Online: Immediate and Delayed Hypersensitivity Reactions to Antibiotics: Aminoglycosides, Clindamycin, Linezolid, and Metronidazole.

Dilley, Michelle / Geng, Bob

Clinical reviews in allergy & immunology

2021 Volume 62, Issue 3, Page(s) 463–475

Abstract: Hypersensitivity reactions including IgE-mediated and delayed cell-mediated reactions to aminoglycosides, clindamycin, linezolid, and metronidazole are rare. For aminoglycosides, allergic contact dermatitis is the most frequent reaction for which patch ... ...

Abstract	Hypersensitivity reactions including IgE-mediated and delayed cell-mediated reactions to aminoglycosides, clindamycin, linezolid, and metronidazole are rare. For aminoglycosides, allergic contact dermatitis is the most frequent reaction for which patch testing can be a useful step in evaluation. For clindamycin, delayed maculopapular exanthems are the most common reactions. There are case reports of clindamycin associated with drug rash with eosinophilia and systemic symptoms (DRESS), acute generalized exanthematous pustulosis (AGEP), acute febrile neutrophilic dermatosis, and symmetrical drug-related intertriginous and flexural exanthema (SDRIFE). For linezolid, cases of hypersensitivity were exceedingly rare and included urticaria, angioedema, anaphylaxis, delayed rashes, and DRESS. For metronidazole, only rare cases were found across a broad spectrum of reactions including allergic contact dermatitis, fixed drug eruption, angioedema, anaphylaxis, serum sickness-like reaction, SJS/TEN, AGEP, SDRIFE, and a possible case of DRESS. IgE-mediated reactions and anaphylaxis to these types of antibiotics are uncommon, and reports of skin testing concentrations and desensitization protocols are largely limited to case reports and series. Non-irritating skin testing concentrations have been reported for gentamycin, tobramycin, and clindamycin. Published desensitization protocols for intravenous and inhaled tobramycin, oral clindamycin, intravenous linezolid, and oral and intravenous metronidazole have also been reported and are reviewed.
MeSH term(s)	Aminoglycosides ; Anaphylaxis ; Angioedema ; Anti-Bacterial Agents/adverse effects ; Clindamycin/adverse effects ; Dermatitis, Allergic Contact ; Drug Eruptions/diagnosis ; Drug Eruptions/etiology ; Drug Hypersensitivity/diagnosis ; Drug Hypersensitivity/etiology ; Eosinophilia ; Humans ; Hypersensitivity, Delayed/etiology ; Immunoglobulin E ; Linezolid/adverse effects ; Metronidazole/adverse effects ; Tobramycin
Chemical Substances	Aminoglycosides ; Anti-Bacterial Agents ; Metronidazole (140QMO216E) ; Immunoglobulin E (37341-29-0) ; Clindamycin (3U02EL437C) ; Linezolid (ISQ9I6J12J) ; Tobramycin (VZ8RRZ51VK)
Language	English
Publishing date	2021-12-15
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1239045-8
ISSN	1559-0267 ; 1080-0549
ISSN (online)	1559-0267
ISSN	1080-0549
DOI	10.1007/s12016-021-08878-x
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Article ; Online: Implementation of a pediatric synchronous multidisciplinary severe asthma clinic and real-world outcomes.

Patel, Divya / Revier, Michelle Dilley / Tambay, Anoushka / Geng, Bob

Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology

2023 Volume 132, Issue 3, Page(s) 392–393

MeSH term(s)	Child ; Humans ; Asthma/drug therapy ; Ambulatory Care Facilities
Language	English
Publishing date	2023-10-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	1228189-x
ISSN	1534-4436 ; 0003-4738 ; 1081-1206
ISSN (online)	1534-4436
ISSN	0003-4738 ; 1081-1206
DOI	10.1016/j.anai.2023.10.028
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Article ; Online: Balancing B cell responses to the allograft: implications for vaccination.

Crane, Clarkson / Loop, Lauren / Anterasian, Christine / Geng, Bob / Ingulli, Elizabeth

Frontiers in immunology

2022 Volume 13, Page(s) 948379

Abstract: Balancing enough immunosuppression to prevent allograft rejection and yet maintaining an intact immune system to respond to vaccinations, eliminate invading pathogens or cancer cells is an ongoing challenge to transplant physicians. Antibody mediated ... ...

Abstract	Balancing enough immunosuppression to prevent allograft rejection and yet maintaining an intact immune system to respond to vaccinations, eliminate invading pathogens or cancer cells is an ongoing challenge to transplant physicians. Antibody mediated allograft rejection remains problematic in kidney transplantation and is the most common cause of graft loss despite current immunosuppressive therapies. The goal of immunosuppressive therapies is to prevent graft rejection; however, they prevent optimal vaccine responses as well. At the center of acute and chronic antibody mediated rejection and vaccine responses is the B lymphocyte. This review will highlight the role of B cells in alloimmune responses including the dependency on T cells for antibody production. We will discuss the need to improve vaccination rates in transplant recipients and present data on B cell populations and SARS-CoV-2 vaccine response rates in pediatric kidney transplant recipients.
MeSH term(s)	Allografts ; Antibodies ; B-Lymphocytes ; COVID-19/prevention & control ; COVID-19 Vaccines ; Child ; Humans ; SARS-CoV-2 ; T-Lymphocytes ; Vaccination
Chemical Substances	Antibodies ; COVID-19 Vaccines
Language	English
Publishing date	2022-07-27
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2606827-8
ISSN	1664-3224 ; 1664-3224
ISSN (online)	1664-3224
ISSN	1664-3224
DOI	10.3389/fimmu.2022.948379
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Article: A novel case of chronic spontaneous urticaria associated chronic myelogenous leukemia with rapid resolution upon treatment with imatinib.

Tracy, Alexis / Kahn, Julia / Geng, Bob / Russo, Marian / Safai, Bijan

JAAD case reports

2022 Volume 30, Page(s) 21–23

Language	English
Publishing date	2022-10-04
Publishing country	United States
Document type	Case Reports
ZDB-ID	2834220-3
ISSN	2352-5126
ISSN	2352-5126
DOI	10.1016/j.jdcr.2022.09.025
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Article ; Online: Primary immunodeficiency diseases treated with immunoglobulin and associated comorbidities.

Dilley, Michelle / Wangberg, Hannah / Noone, Joshua / Geng, Bob

Allergy and asthma proceedings

2021 Volume 42, Issue 1, Page(s) 78–86

Abstract: Background: ...

Abstract	Background:
MeSH term(s)	Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Comorbidity ; Female ; Humans ; Immunoglobulins, Intravenous/therapeutic use ; Infant ; Infant, Newborn ; Insurance Claim Review ; Male ; Middle Aged ; Primary Immunodeficiency Diseases/epidemiology ; Primary Immunodeficiency Diseases/therapy ; Sex Factors ; United States/epidemiology ; Young Adult
Chemical Substances	Immunoglobulins, Intravenous
Language	English
Publishing date	2021-02-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	1312445-6
ISSN	1539-6304 ; 1088-5412
ISSN (online)	1539-6304
ISSN	1088-5412
DOI	10.2500/aap.2021.42.200113
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Article ; Online: Biologic Therapies for Allergic Rhinitis and Nasal Polyposis.

Geng, Bob / Dilley, Michelle / Anterasian, Christine

Current allergy and asthma reports

2021 Volume 21, Issue 6, Page(s) 36

Abstract: Purpose of review: There is an emerging body of research on targeted biologic therapies for the treatment of severe inflammatory nasal disorders, especially chronic rhinosinusitis with nasal polyposis (CRSwNP). This paper will evaluate the efficacy of ... ...

Abstract	Purpose of review: There is an emerging body of research on targeted biologic therapies for the treatment of severe inflammatory nasal disorders, especially chronic rhinosinusitis with nasal polyposis (CRSwNP). This paper will evaluate the efficacy of biologic therapies for severe nasal inflammation by summarizing key preclinical trials of biologics for animal models of allergic rhinitis and the recent phase 2 and 3 clinical trials of biologic therapies for CRSwNP. Recent findings: Biologics that target the IL-4 receptor (dupilumab), IgE (omalizumab), and IL-5 (mepolizumab, reslizumab, and benralizumab) in patients with CRSwNP have shown improvement of various metrics including Sino-Nasal Outcome Test (SNOT-22) scores, Nasal Polyp Scores (NPS), Nasal Congestion Scores (NCS), and Lund-Mackay sinus opacification scores. The efficacy demonstrated through the dupilumab phase 3 trials (LIBERTY NP SINUS-24 and SINUS-52) led to approval of the first biologic for the treatment of CRSwNP. Phase 3 trials for omalizumab (POLYP 1 and 2) and mepolizumab (SYNAPSE study) and post hoc analyses of phase 3 asthma studies for reslizumab and benralizumab have also demonstrated positive results for the use of biologics for patients with CRSwNP. Future efficacy studies and risk/benefit and cost analyses of these biologics and other cytokine targets for allergic rhinitis with and without nasal polyposis need to be performed.
MeSH term(s)	Biological Therapy ; Chronic Disease ; Humans ; Nasal Polyps/complications ; Nasal Polyps/drug therapy ; Omalizumab ; Rhinitis ; Rhinitis, Allergic/drug therapy ; Sinusitis/complications ; Sinusitis/drug therapy
Chemical Substances	Omalizumab (2P471X1Z11)
Language	English
Publishing date	2021-06-10
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2057370-4
ISSN	1534-6315 ; 1529-7322
ISSN (online)	1534-6315
ISSN	1529-7322
DOI	10.1007/s11882-021-01013-y
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Article ; Online: Multidisciplinary atopic dermatitis program: A novel approach to managing difficult-to-control atopic dermatitis patients.

Tracy, Alexis / Loop, Lauren / Bhatti, Safiyyah / Anterasian, Christine / Kellogg, Caitlyn / Smiley, Kathryn / Wu, Alyssa / Geng, Bob / Eichenfield, Lawrence

Pediatric dermatology

2024 Volume 41, Issue 2, Page(s) 210–214

Abstract: Background/objectives: Disease improvement for difficult-to-control pediatric atopic dermatitis may be more challenging to achieve when directed by single specialties due to disjointed and conflicting dialogue with patients.: Methods: The ... ...

Abstract	Background/objectives: Disease improvement for difficult-to-control pediatric atopic dermatitis may be more challenging to achieve when directed by single specialties due to disjointed and conflicting dialogue with patients. Methods: The Multidisciplinary Atopic Dermatitis Program (MADP) was developed through collaborations with the Rady Children's Hospital and UC San Diego Health Divisions of Dermatology, Allergy & Immunology and Clinical Pharmacy, to create team-based evaluation and management of children and adolescents with atopic dermatitis (AD). The MADP allows concurrent, comprehensive evaluations by multiple specialists to develop treatment plans. The program includes extensive patient education to support shared decision making, incorporating patient and family's perspectives along with those of clinical experts into their care. Objective severity measures and patient reported outcome data were collected, along with assessment of patient and family satisfaction with the MADP. Results: Data showed significant improvement in AD severity as assessed by providers, patients and families by the first follow-up visit. BSA mean percentage decreased by up to 56% by the 7th visit, and pruritus (NRS), CLDQI and POEM mean scores decreased by more than 4 points, 12 points, and over 11 points, respectively. After management was initiated in the MADP, 72.73% of patients achieved an EASI 50 and 47.73% achieved an EASI 75 from a baseline mean of 21.7. Patients who continued in clinic beyond the second visit showed further clinically significant decreases in disease measures. Conclusions: The multidisciplinary approach shows success in the treatment of difficult-to-control AD patients with improvements in clinician and patient reported outcome measures.
MeSH term(s)	Adolescent ; Humans ; Child ; Dermatitis, Atopic/drug therapy ; Severity of Illness Index ; Pruritus ; Patient Reported Outcome Measures ; Hospitals, Pediatric ; Treatment Outcome ; Quality of Life
Language	English
Publishing date	2024-01-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	605539-4
ISSN	1525-1470 ; 0736-8046
ISSN (online)	1525-1470
ISSN	0736-8046
DOI	10.1111/pde.15533
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