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Article ; Online: Allergological reappraisal of the Annex to the European Commission guideline on excipients (SANTE-2017-11,668).

Caballero, María Luisa / Quirce, Santiago

2023 Volume 79, Issue 3, Page(s) 735–739

MeSH term(s)	Humans ; Excipients/adverse effects
Chemical Substances	Excipients
Language	English
Publishing date	2023-10-10
Publishing country	Denmark
Document type	Letter
ZDB-ID	391933-x
ISSN	1398-9995 ; 0105-4538
ISSN (online)	1398-9995
ISSN	0105-4538
DOI	10.1111/all.15913
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Article ; Online: Anti-IL-5 and anti-IL-5R biologics for severe asthma. Are there any differences in their effects?

Granda, Paula / Villamañán, Elena / Carpio, Carlos / Laorden, Daniel / Quirce, Santiago / Álvarez-Sala, Rodolfo

The Journal of asthma : official journal of the Association for the Care of Asthma

2024 , Page(s) 1–10

Abstract: Objective: The aim of this retrospective multicentre study is to describe the clinical characteristics of patients diagnosed with severe eosinophilic asthma receiving anti-IL-5/anti-IL-5Rα therapies and to compare their effectiveness.: Methods: We ... ...

Abstract	Objective: The aim of this retrospective multicentre study is to describe the clinical characteristics of patients diagnosed with severe eosinophilic asthma receiving anti-IL-5/anti-IL-5Rα therapies and to compare their effectiveness. Methods: We collected and analysed results separately for anti-IL-5 and anti-IL-5Rα therapies from January 2016 until December 2021 in multidisciplinary severe asthma units. We collected demographic and clinical data, treatment with previous anti-IgE and/or anti-IL-5 agents, and comorbidities. We compared the number of exacerbations and admissions to the hospital, daily oral corticosteroid intake, pulmonary function tests, and Asthma Control Test scores before and after 12 months of therapy. 261 patients were included: 176 patients in the anti-IL-5 group and 85 in the anti-IL-5Rα group. Results: Both groups led to statistically significant reductions in asthma exacerbations, hospital admissions, and visits to the Emergency Room. Although both groups showed a significant reduction in blood eosinophiliccount, we found a difference, although not significant, in the magnitude of reduction as benralizumab was able to decrease eosinophil counts to zero. Patients in the anti-IL-5 group achieved higher ACT scores after treatment, although this improvement was seen in both treatment groups. Conclusion: The anti-IL-5 and anti-IL-5Rα biologics have shown similar effectiveness despite having different mechanisms of action. The anti-IL-5 group appeared to be better than benralizumab at improving ACT scores and FEV1/FVC and at reducing the number of inhalers. Although these differences were not statistically significant, it is not clear whether they may have clinical relevance and they might highlight the need for further head-to-head studies comparing these treatments.
Language	English
Publishing date	2024-01-24
Publishing country	England
Document type	Journal Article
ZDB-ID	603816-5
ISSN	1532-4303 ; 0277-0903
ISSN (online)	1532-4303
ISSN	0277-0903
DOI	10.1080/02770903.2024.2308684
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Article ; Online: Respiratory Diseases Associated With Organic Dust Exposure.

Poole, Jill A / Zamora-Sifuentes, Jose L / De Las Vecillas, Leticia / Quirce, Santiago

The journal of allergy and clinical immunology. In practice

2024

Abstract: Organic dusts are complex bioaerosol mixtures comprised of dust and par ticulate matter of organic origin. These include components from bacteria, fungi, pollen, and viruses to fragments of animals and plants commonplace to several environmental/ ... ...

Abstract	Organic dusts are complex bioaerosol mixtures comprised of dust and par ticulate matter of organic origin. These include components from bacteria, fungi, pollen, and viruses to fragments of animals and plants commonplace to several environmental/occupational settings encompassing agriculture/farming, grain processing, waste/recycling, textile, cotton, woodworking, bird breeding, and more. Organic dust exposures are linked to development of chronic bronchitis, chronic obstructive pulmonary disease, asthma, asthma-like syndrome, byssinosis, hypersensitivity pneumonitis, and idiopathic pulmonary fibrosis. Risk factors of disease development include cumulative dust exposure, smoking, atopy, timing/duration, and nutritional factors. The immunopathogenesis predominantly involves Toll-like receptor signaling cascade, T-helper 1/T-helper 17 lymphocyte responses, neutrophil influx, and potentiation of manifestations associated with allergy. The true prevalence of airway disease directly attributed to organic dust, especially in a workplace setting, remains challenging. Diagnostic confirmation can be difficult and complicated by hesitancy from workers to seek medical care, driven by fears of potential labor-related consequence. Clinical respiratory and systemic presentations coupled with allergy testing, lung function patterns of obstructive versus restrictive disease, and radiological characteristics are typically utilized to delineate these various organic dust-associated respiratory diseases. Prevention, risk reduction, and management primarily focus on reducing exposure to the offending dust, managing symptoms, and preventing disease progression.
Language	English
Publishing date	2024-02-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	2843237-X
ISSN	2213-2201 ; 2213-2198
ISSN (online)	2213-2201
ISSN	2213-2198
DOI	10.1016/j.jaip.2024.02.022
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Article ; Online: Landscape of short-acting beta-agonists (SABA) overuse in Europe.

de Las Vecillas, Leticia / Quirce, Santiago

Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology

2022 Volume 53, Issue 2, Page(s) 132–144

Abstract: This review article provides an overview of short-acting beta-agonist (SABA) use and prescribing trends in Europe, summarizing updated data on the results from the industry-funded SABINA program (SABA use IN asthma) and other studies on this matter. SABA ...

Abstract	This review article provides an overview of short-acting beta-agonist (SABA) use and prescribing trends in Europe, summarizing updated data on the results from the industry-funded SABINA program (SABA use IN asthma) and other studies on this matter. SABA use continues to increase worldwide. Overuse has been defined as ≥3 canisters/year. Almost a third of European patients with asthma, at all severity levels, overuse SABA. Guidelines recommend close monitoring of patients who overuse SABA and avoiding over-reliance on SABA monotherapy. SABA overuse is associated with increased risk of asthma exacerbations and mortality, increased use of health services and negative physical and mental health outcomes. Reliance on SABA monotherapy can be unsafe and therefore it is necessary to change asthma treatment approaches and policies. Changes in physician and patient behaviours towards SABA use are required to ensure that patients with asthma are not over-reliant on SABA monotherapy. Notwithstanding, the limitations of the studies on the use of SABA should be considered, taking into account that the prescription/purchase of medication canisters does not always represent the actual use of the medication and that associations between SABA overuse and poor asthma outcomes may not be directly causal. National health systems and asthma guidelines must align asthma management with global recommendations and adjust them to local needs.
MeSH term(s)	Humans ; Asthma/drug therapy ; Asthma/epidemiology ; Asthma/chemically induced ; Europe/epidemiology ; Administration, Inhalation ; Anti-Asthmatic Agents/adverse effects
Chemical Substances	Anti-Asthmatic Agents
Language	English
Publishing date	2022-12-05
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	645204-8
ISSN	1365-2222 ; 0954-7894 ; 0960-2178
ISSN (online)	1365-2222
ISSN	0954-7894 ; 0960-2178
DOI	10.1111/cea.14250
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Article ; Online: Impact of Identification of Clinical Phenotypes in Occupational Asthma.

Tarlo, Susan M / Quirce, Santiago

The journal of allergy and clinical immunology. In practice

2020 Volume 8, Issue 10, Page(s) 3277–3282

Abstract: Phenotypic differences and similarities in the spectrum of occupational asthma (OA) subtypes reflect the underlying mechanisms of the diverse forms of the disease, and these phenotypes provide information as to diagnostic steps and approaches to ... ...

Abstract	Phenotypic differences and similarities in the spectrum of occupational asthma (OA) subtypes reflect the underlying mechanisms of the diverse forms of the disease, and these phenotypes provide information as to diagnostic steps and approaches to management. In large part, the phenotype reflects the existence of immunologic mechanisms and the presence or absence of a specific IgE-antibody response to a work sensitizer. However, further differences occur between OA from high- and low-molecular-weight sensitizers (chemical sensitizers), which potentially might be relevant for nonoccupational asthma. Chemical sensitizers cause a specific response that is more likely to be a late asthmatic response and specific IgE can be identified only in a minority. Irritant-induced asthma is most easily recognized when it occurs with 1 or more high-level respiratory irritant exposure(s) but is also possible with chronic low-level exposures as in cleaners, farmers, and woodworkers, as suggested from epidemiologic studies. OA chronic obstructive pulmonary disease overlap is more common in older patients and with OA from low-molecular-weight sensitizers. Removal from exposure to the causative agent is currently advised for those with OA from sensitization: further studies with omalizumab and other biologic agents are needed to determine whether these might allow return to the same exposure.
MeSH term(s)	Aged ; Asthma, Occupational/diagnosis ; Asthma, Occupational/epidemiology ; Humans ; Irritants ; Occupational Diseases/diagnosis ; Occupational Diseases/epidemiology ; Occupational Exposure/adverse effects ; Phenotype
Chemical Substances	Irritants
Language	English
Publishing date	2020-06-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	2843237-X
ISSN	2213-2201 ; 2213-2198
ISSN (online)	2213-2201
ISSN	2213-2198
DOI	10.1016/j.jaip.2020.06.003
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Article ; Online: IgE antibodies in occupational asthma: are they causative or an associated phenomenon?

Quirce, Santiago

Current opinion in allergy and clinical immunology

2014 Volume 14, Issue 2, Page(s) 100–105

Abstract: Purpose of review: To evaluate recent data on the causative role of specific IgE antibodies, as well as the performance of IgE diagnostic tests, in allergic occupational asthma induced by high (HMW) or low-molecular-weight (LMW) agents.: Recent ... ...

Abstract	Purpose of review: To evaluate recent data on the causative role of specific IgE antibodies, as well as the performance of IgE diagnostic tests, in allergic occupational asthma induced by high (HMW) or low-molecular-weight (LMW) agents. Recent findings: Skin prick testing (SPT) and specific IgE assays are useful to document allergy to most HMW allergens and some LMW agents. These tests, however, are limited by the lack of standardized and commercially available reagents. There is a wide variability among the quality of occupational allergen extracts used for SPT and the sensitivity of several SPT solutions is low. In addition, many individuals with allergen-specific serum IgE and/or positive SPT to specific HMW allergens do not have clinical symptoms. Sensitization or allergenic cross-reactivity to allergens or epitopes from unrelated sources may interfere in the diagnosis of IgE-mediated allergy, giving rise to false-positive results, particularly when cross-reactive carbohydrate determinants (CCDs) are involved. The immune responses to these ubiquitous structures may interfere with the diagnosis of occupational allergy. Component-resolved diagnosis of IgE-mediated allergic diseases (occupational and nonoccupational) using panels of native or recombinant allergens, or micro-arrayed allergens, have been proposed to identify specific molecules responsible for these disorders and to overcome false-positive in-vitro test results. Summary: Improvement and standardization of SPT solutions for occupational allergens are highly recommended. More refined diagnostic tools than specific IgE measurements are being developed, such as inhibition assays of IgE binding to CCDs with specific carbohydrate molecules, and component-resolved diagnosis.
MeSH term(s)	Allergens/immunology ; Animals ; Antibody Specificity ; Asthma, Occupational/diagnosis ; Asthma, Occupational/immunology ; Cross Reactions ; Humans ; Immunoglobulin E/blood ; Immunoglobulin E/immunology ; Skin Tests
Chemical Substances	Allergens ; Immunoglobulin E (37341-29-0)
Language	English
Publishing date	2014-04
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	2088710-3
ISSN	1473-6322 ; 1528-4050
ISSN (online)	1473-6322
ISSN	1528-4050
DOI	10.1097/ACI.0000000000000041
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Article ; Online: Cost-effectiveness and resource use analysis of patients with asthma before and after treatment with mepolizumab in a real-life setting.

Domínguez-Ortega, Javier / Laorden, Daniel / Vílchez-Sánchez, Francisca / Bañas-Conejero, David / Quirce, Santiago

The Journal of asthma : official journal of the Association for the Care of Asthma

2023 Volume 61, Issue 1, Page(s) 39–47

Abstract: Objective: To define the cost-effectiveness and health resource use of mepolizumab in a cohort of patients with severe eosinophilic asthma in real-life conditions in Spain.: Methods: This was an observational, retrospective, single-center study. ... ...

Abstract	Objective: To define the cost-effectiveness and health resource use of mepolizumab in a cohort of patients with severe eosinophilic asthma in real-life conditions in Spain. Methods: This was an observational, retrospective, single-center study. Patients included were diagnosed with severe eosinophilic asthma and treated with mepolizumab 100 mg subcutaneous (SC) 4-weekly for 12 months. Outcomes evaluated: incremental cost-effectiveness ratio (ICER), number of exacerbations, disease control with the Asthma Control Test (ACT), Asthma Quality of Life Questionnaire (AQLQ), and direct and indirect cost per patient. Results: 12 months after mepolizumab initiation, a significant decrease in exacerbations was shown, from a mean (standard deviation [SD]) of 3.1 (2.6) to 0.7 (1.5), an increase from 4.9 (0.4) to 6.1 (0.5) in AQLQ, and from 14.9 (5.7) to 21.5 (3.9) in ACT scores. The number of cortico-dependent patients significantly decreased from 53.3% to 13.3% during this period. There was a significant decrease of 94% in the cost of hospitalization, from a mean (SD) of €4063.9 (5423.9) pretreatment to €238.6 (1306.9) post-treatment ( Conclusions: Mepolizumab improves control of asthma and quality of life in patients with severe diseases in a cost-effectiveness range. The number of exacerbations decreased, and there was a clear reduction in primary care visits and hospitalizations. Further economic analyses of biological therapies for asthma are required.
MeSH term(s)	Humans ; Asthma/therapy ; Anti-Asthmatic Agents/therapeutic use ; Cost-Benefit Analysis ; Quality of Life ; Retrospective Studies ; Pulmonary Eosinophilia
Chemical Substances	mepolizumab (90Z2UF0E52) ; Anti-Asthmatic Agents
Language	English
Publishing date	2023-08-12
Publishing country	England
Document type	Observational Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	603816-5
ISSN	1532-4303 ; 0277-0903
ISSN (online)	1532-4303
ISSN	0277-0903
DOI	10.1080/02770903.2023.2241905
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Article ; Online: Occupational asthma: clinical phenotypes, biomarkers, and management.

Quirce, Santiago / Sastre, Joaquín

Current opinion in pulmonary medicine

2018 Volume 25, Issue 1, Page(s) 59–63

Abstract: Purpose of review: This review focuses on new findings in the clinical and inflammatory aspects that can help to better identify the different phenotypes of work-related asthma and the development of specific biomarkers useful in diagnosis and follow-up. ...

Abstract	Purpose of review: This review focuses on new findings in the clinical and inflammatory aspects that can help to better identify the different phenotypes of work-related asthma and the development of specific biomarkers useful in diagnosis and follow-up. Recent findings: Studies on phenotyping of occupational asthma, a subtype of work-related asthma, have mainly compared the clinical, physiological, and inflammatory patterns associated with the type of agent causing occupational asthma, namely, high-molecular-weight and low-molecular-weight agents. Most of this research has found that patients with occupational asthma due to high-molecular-weight agents have an associated presence of rhinitis, conjunctivitis, atopy, and a pattern of early asthmatic reactions during specific inhalation challenge. The inflammatory profile (blood eosinophils, sputum cell count, or exhaled nitric oxide) may be similar when occupational asthma is caused by either type of agent. In some studies, severity of asthma and exacerbations have been associated with exposure to low-molecular-weight agents. The most reliable biomarkers in diagnosis and follow-up are eosinophilia in induced sputum and exhaled nitric oxide. Summary: There are several phenotypes, characterized by its pathogenesis and inflammatory profile. Avoidance of the causative agents does not warrant complete recovery of occupational asthma. Treatment with biologic agents may be considered in severe occupational asthma.
MeSH term(s)	Asthma, Occupational/blood ; Asthma, Occupational/complications ; Asthma, Occupational/diagnosis ; Biomarkers ; Breath Tests ; Conjunctivitis/complications ; Eosinophils ; Humans ; Molecular Weight ; Nitric Oxide/analysis ; Occupational Exposure/adverse effects ; Phenotype ; Rhinitis/complications ; Sputum/cytology
Chemical Substances	Biomarkers ; Nitric Oxide (31C4KY9ESH)
Language	English
Publishing date	2018-10-14
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	1285505-4
ISSN	1531-6971 ; 1070-5287 ; 1078-1641
ISSN (online)	1531-6971
ISSN	1070-5287 ; 1078-1641
DOI	10.1097/MCP.0000000000000535
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Article ; Online: Novel approaches in occupational asthma diagnosis and management.

Quirce, Santiago / Domínguez-Ortega, Javier / Luna, Juan A

Current opinion in pulmonary medicine

2020 Volume 27, Issue 1, Page(s) 9–14

Abstract: Purpose of review: To describe the recent findings of the last 2 years on the epidemiology and phenotypes of occupational asthma, as well as new developments in its diagnosis and management.: Recent findings: Data from nine longitudinal studies ... ...

Abstract	Purpose of review: To describe the recent findings of the last 2 years on the epidemiology and phenotypes of occupational asthma, as well as new developments in its diagnosis and management. Recent findings: Data from nine longitudinal studies showed a population attributable fraction for the occupational contribution to incident asthma of 16%. The main phenotypes of occupational asthma are: occupational asthma caused by high-molecular-weight (HMW) or low-molecular-weight (LMW) agents, irritant-induced asthma and occupational asthma-chronic obstructive pulmonary disease overlap. Among the variety of causative agents of occupational asthma, food-derived components are increasingly being reported, accounting for up to 25% cases of occupational asthma and/or occupational rhinitis. Recently, a specific inhalation challenge (SIC)-independent model has been developed to calculate the probability of occupational asthma diagnosis in workers exposed to HMW agents. In this model, work-specific sensitization, bronchial hyperresponsiveness, inhaled corticosteroid use, rhinoconjunctivitis and age 40 years or less were the most relevant predictive factors. Specific IgE measurements showed a pooled sensitivity of 0.74 and a specificity of 0.71 in the diagnosis of occupational asthma for HMW agents, while a lower sensitivity (0.28) and a higher specificity (0.89) was shown for LMW agents. Cessation of exposure to workplace sensitizers is the cornerstone of management of work-related conditions. Summary: An early and precise diagnosis of occupational asthma is crucial, allowing appropriate management and implementation of preventive strategies.
MeSH term(s)	Adult ; Air Pollutants, Occupational/adverse effects ; Asthma, Occupational/diagnosis ; Asthma, Occupational/physiopathology ; Bronchial Hyperreactivity/diagnosis ; Bronchial Hyperreactivity/physiopathology ; Humans ; Occupational Exposure/adverse effects ; Respiratory Function Tests ; Risk Factors
Chemical Substances	Air Pollutants, Occupational
Language	English
Publishing date	2020-12-07
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1285505-4
ISSN	1531-6971 ; 1070-5287 ; 1078-1641
ISSN (online)	1531-6971
ISSN	1070-5287 ; 1078-1641
DOI	10.1097/MCP.0000000000000737
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Article ; Online: Food allergy as an asthma comorbidity in children and adolescents: a practical approach through a real-world study.

Esteban-Gorgojo, Ignacio / Gorgojo, María Puy / Sastre, Joaquin / Quirce, Santiago

Allergologia et immunopathologia

2021 Volume 49, Issue 1, Page(s) 68–78

Abstract: Introduction: Several studies have shown interactions between food allergy (FA) and asthma, but the influence of FA in asthma traits has been scarcely studied.: Methods: A real-world retrospective observational study was conducted among patients ... ...

Abstract	Introduction: Several studies have shown interactions between food allergy (FA) and asthma, but the influence of FA in asthma traits has been scarcely studied. Methods: A real-world retrospective observational study was conducted among patients between 3 and 18 years old referred to our Asthma Clinic from November 2014 to November 2017. Data were obtained from daily clinical practice. Only patients properly diagnosed with asthma and FA were included. Results: 815 patients were included: 483 asthmatics and 332 non-asthmatics and 180 FA and 635 no FA. Food allergy was statistically more prevalent among asthma patients (p = 0.014). In a high pollen exposure area, Madrid, among subjects with asthma (121 FA, 362 no-FA), sensitization to lipid transfer protein (LTP) (p = 0.016, OR: 3.064, RR: 2.512) and pollen (p = 0.016, OR: 3.064, RR: 2.512) are risk factors to have a concomitant FA diagnosis, whereas sensitization to profilin is not. Peripheral blood eosinophils were higher in subjects with asthma and FA (≥450 eos/µL) than in asthmatics without FA (≤300 eos/µL) (p = 0.031). Blood eosinophilia, using a cut-off >300 eos/µL, was only present in the FA group. Therefore, this trait should be considered when phenotyping a patient as eosinophilic asthma. Sex had an impact on several variables: height, weight, BMI, blood eosinophils count, sensitization profile, and early-onset asthma. Conclusions: Asthma and FA are closely related and the presence of FA should be investigated in every asthma patient. This study shows an association between asthma with concomitant FA and sensitization to pollen and LTP, blood eosinophilia, and growth alterations. Differences between boys and girls were also described, so a sex-specific approach is recommended.
MeSH term(s)	Adolescent ; Allergens/immunology ; Asthma/epidemiology ; Asthma/immunology ; Carrier Proteins/immunology ; Child ; Child, Preschool ; Comorbidity ; Eosinophils/cytology ; Female ; Food Hypersensitivity/epidemiology ; Food Hypersensitivity/immunology ; Humans ; Leukocyte Count ; Male ; Pollen/immunology ; Prevalence ; Retrospective Studies ; Risk Factors ; Spain/epidemiology
Chemical Substances	Allergens ; Carrier Proteins ; lipid transfer protein
Language	English
Publishing date	2021-01-02
Publishing country	Singapore
Document type	Journal Article ; Observational Study
ZDB-ID	193144-1
ISSN	1578-1267 ; 0301-0546
ISSN (online)	1578-1267
ISSN	0301-0546
DOI	10.15586/aei.v49i1.19
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