Friday, September 22, 2023
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Pursuant to the Code of Ethics for the American Academy of Allergy, Asthma & Immunology (AAAAI) and the Standards for Commercial Support of Continuing Medical Education of the Accreditation Council for Continuing Medical Education, the AAAAI requires disclosure of certain information from faculty members of educational activities designated for CME credit by the AAAAI. Prior to the activity, authors and reviewers are required to disclose all relationships that meet the following parameters:
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Asthma and Allergy Center
Lewisville, Texas
Physicians - maximum of 1.00 AMA PRA Category 1 Credit(s)™
This activity is intended for allergists, clinical immunologists, primary care physicians, and dermatologists.
The goal of this activity is for learners to be better able to integrate understanding of advances in treatment for allergic asthma and CSU into treatment decisions for patients with refractory symptoms.
Upon completion of this activity, participants will:
AAAAI Disclosure Policy
Pursuant to the Code of Ethics for the American Academy of Allergy, Asthma & Immunology (AAAAI) and the Standards for Commercial Support of Continuing Medical Education of the Accreditation Council for Continuing Medical Education, the AAAAI requires disclosure of certain information from faculty members of educational activities designated for CME credit by the AAAAI. Prior to the activity, authors and reviewers are required to disclose all relationships that meet the following parameters:
The information disclosed by the speakers, planning committee, and reviewers was reviewed in accordance with the AAAAI Disclosure Policy. All potential conflicts of interest were mitigated by the planners, faculty, and reviewers prior to their participation in the development of this activity.
Medscape, LLC requires every individual in a position to control educational content to disclose all financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
All relevant financial relationships for anyone with the ability to control the content of this educational activity are listed below and have been mitigated. Others involved in the planning of this activity have no relevant financial relationships.
Asthma and Allergy Center
Lewisville, Texas
Developed through a partnership between Medscape and American Academy of Allergy Asthma & Immunology (AAAAI).
The American Academy of Allergy, Asthma & Immunology designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit ™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
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CME Released: 1/27/2023
Valid for credit through: 1/27/2024, 11:59 PM EST
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The first patient case in this series is a 26-year-old woman with a history of comorbid allergic asthma, eczema, and allergic rhinitis.
The patient was diagnosed with allergic asthma when she was 6 years old following an emergency department visit for an exacerbation. She had not been previously diagnosed with the condition, but her parents had reported a history of frequent nighttime coughing, which worsened with respiratory infections. Following discharge from the emergency department, she was prescribed medium-dose inhaled corticosteroids (ICS) together with a long-acting β-agonist (LABA). Symptoms were stable on this treatment combination throughout childhood. This treatment was switched during adolescence to montelukast in response to improved symptoms. However, montelukast was subsequently ineffective, and the patient was reverted to low-dose ICS plus LABA, which controlled her symptoms until approximately 1 year ago.
Allergy testing performed approximately 15 years ago was positive for tree pollens, grass pollens, dog dander, and dust mites, leading to the diagnosis of comorbid allergic rhinitis. Her allergic rhinitis is treated with topical fluticasone nasal spray and oral cetirizine daily. Eczema has also been present since childhood and is considered mild. It is currently managed with topical steroids and moisturizers, as required. She is a non-smoker (never smoked), works as an administrative assistant in an office, lives alone with 2 cats, and does not take any other medications.
The patient is attending the clinic because she has been experiencing frequent asthma exacerbations. In total, she has experienced 3 exacerbations in the past year, of which 2 were in the last 6 months. She currently uses rescue medications approximately 3 to 4 times per week and wakes up due to her asthma at least once a week. Her ICS dose was increased to a medium dose about 10 months ago and then a high dose approximately 5 months ago. A physical exam of the nasal cavity revealed mild edema, pale mucosa, and no polyps. A lung exam was normal, but pulmonary function tests revealed a mild obstruction.
