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CME

A Tale of Two Cases in Allergic Diseases: How Will You Treat These Patients With Asthma and Chronic Spontaneous Urticaria?

  • Authors: Anil Nanda, MD, FAAAAI
  • CME Released: 1/27/2023
  • Valid for credit through: 1/27/2024
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  • Credits Available

    Physicians - maximum of 1.00 AMA PRA Category 1 Credit(s)™

    You Are Eligible For

    • Letter of Completion

Target Audience and Goal Statement

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:

  • Have greater competence related to
    • Identifying patients with uncontrolled allergic disease
    • Selecting appropriate treatment for uncontrolled allergic disease


Disclosures

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: 

  • Employment. Name of employer and job title. 
  • Financial interests. All organizations, other than the employer, from which the faculty member receives annual remuneration in any amount (including grants, honoraria and consulting fees). 
  • Research interests. All organizations which support research projects for which the faculty member serves as an investigator. 
  • Legal Consultation Services/Expert Witness Testimony: All topics on which the faculty member provided legal consultation and/or expert witness testimony during the previous calendar year. 
  • Organizational interests: All organizations, other than the AAAAI, for which the faculty member holds volunteer positions. 
  • Gifts. All organizations from which the faculty member have received a gift of any amount in the last year. 
  • Other interests. All interests of the faculty member that would be judged by a majority of his/her peers to be more than casual and/or likely to impact his/her ability to exercise independent judgment. This includes any financial interest in or relationship with any manufacturer of a commercial product, and any financial interest or relationship with any organization that provides commercial support to AAAAI-sponsored educational activities. 

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.


Faculty

  • Anil Nanda, MD, FAAAAI

    Asthma and Allergy Center
    Lewisville, Texas

    Disclosures

    Anil Nanda, MD, FAAAAI, has no relevant financial relationships.

Editor

  • Briana Betz, PhD

    Medical Education Director, Medscape, LLC

    Disclosures

    Briana Betz, PhD, has no relevant financial relationships.

Compliance Reviewer

  • Stephanie Corder, ND, RN, CHCP

    Associate Director, Accreditation and Compliance, Medscape, LLC

    Disclosures

    Stephanie Corder, ND, RN, CHCP, has no relevant financial relationships.

  • Robert Corriel, MD, FAAAA

    Lake Success Allergy and Clinical Immunology, Lake Success, NY

    Disclosures: Robert Corriel, MD, FAAAAI, has no relevant financial relationships.

    Disclosures

    Disclosures: Robert Corriel, MD, FAAAAI, has no relevant financial relationships.


Accreditation Statements

Developed through a partnership between Medscape and American Academy of Allergy Asthma & Immunology (AAAAI).


The American Academy of Allergy, Asthma and Immunology (AAAAI) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

    For Physicians

  • 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.

    Contact this provider

For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]


Instructions for Participation and Credit

There are no fees for participating in or receiving credit for this online educational activity. For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board.

This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period that is noted on the title page. To receive AMA PRA Category 1 Credit™, you must receive a minimum score of 70% on the post-test.

Follow these steps to earn CME/CE credit*:

  1. Read about the target audience, learning objectives, and author disclosures.
  2. Study the educational content online or print it out.
  3. Online, choose the best answer to each test question. To receive a certificate, you must receive a passing score as designated at the top of the test. We encourage you to complete the Activity Evaluation to provide feedback for future programming.

You may now view or print the certificate from your CME/CE Tracker. You may print the certificate, but you cannot alter it. Credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period, you can print out the tally as well as the certificates from the CME/CE Tracker.

*The credit that you receive is based on your user profile.

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​To verify your participation in educational activities, you may be asked to provide your name, contact information, and/or other descriptors. The AAAAI will not release this information to outside entities. It may be used internally to inform you of other AAAAI educational activities. If you wish to have your information excluded from this process, please contact us at [email protected]

CME

A Tale of Two Cases in Allergic Diseases: How Will You Treat These Patients With Asthma and Chronic Spontaneous Urticaria?

Authors: Anil Nanda, MD, FAAAAIFaculty and Disclosures

CME Released: 1/27/2023

Valid for credit through: 1/27/2024

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References

  1. Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention. Accessed September 22, 2022. https://ginasthma.org/gina-reports/
  2. Yaghoubi M, et al. The projected economic and health burden of uncontrolled asthma in the United States. Am J Respir Crit Care Med. 2019;200:1102-1112.
  3. Czira A, et al. A systematic literature review of burden of illness in adults with uncontrolled moderate/severe asthma. Respir Med. 2022;191:106670.
  4. Ding B, et al. Disease burden of mild asthma: findings from a cross-sectional real-world survey. Adv Ther. 2017;34:1109-1127.
  5. Chapman KR. Impact of 'mild' asthma on health outcomes: findings of a systematic search of the literature. Respir Med. 2005;99:1350-1362.
  6. Van Herck M, et al. Fatigue is highly prevalent in patients with asthma and contributes to the burden of disease. J Clin Med. 2018;7:471.
  7. Schatz M, et al. Asthma control test: reliability, validity, and responsiveness in patients not previously followed by asthma specialists. J Allergy Clin Immunol. 2006;117:549-556.
  8. Juniper EF, et al. Development and validation of a questionnaire to measure asthma control. Eur Respir J. 1999;14:902-907.
  9. Juniper EF, et al. Evaluation of impairment of health related quality of life in asthma: development of a questionnaire for use in clinical trials. Thorax. 1992;47:76-83.
  10. Beasley R, et al. Inhaled corticosteroid therapy in adult asthma. Time for a new therapeutic dose terminology. Am J Respir Crit Care Med. 2019;199:1471-1477.
  11. Lapi F, et al. The use of inhaled corticosteroids and the risk of adrenal insufficiency. Eur Respir J. 2013;42:79-86.
  12. Heffler E, et al. Inhaled corticosteroids safety and adverse effects in patients with asthma. J Allergy Clin Immunol Pract. 2018;6:776-781.
  13. Dahl R. Systemic side effects of inhaled corticosteroids in patients with asthma. Respir Med. 2006;100:1307-1317.
  14. Bleecker ER, et al. Systematic literature review of systemic corticosteroid use for asthma management. Am J Respir Crit Care Med. 2020;201:276-293.
  15. Sullivan PW, et al. Oral corticosteroid exposure and adverse effects in asthmatic patients. J Allergy Clin Immunol. 2018;141:110-116.e7.
  16. Abramson MJ, et al. Allergen immunotherapy for asthma. Cochrane Database Syst Rev. 2003;(4):Cd001186.
  17. Klimek L, et al. SCIT with a high-dose house dust mite allergoid is well tolerated: safety data from pooled clinical trials and more than 10 years of daily practice analyzed in different subgroups. Allergo J Int. 2018;27:131-139.
  18. Aue A, et al. Systemic reactions to subcutaneous allergen immunotherapy: real-world cause and effect modelling. Allergy Asthma Clin Immunol. 2021;17:65.
  19. Chow TG, et al. Safety of subcutaneous immunotherapy in patients with severe asthma. Ann Allergy Asthma Immunol. 2022;129:585-591.e3.
  20. Corren J, et al. Short-term subcutaneous allergy immunotherapy and dupilumab are well tolerated in allergic rhinitis: a randomized trial. J Asthma Allergy. 2021;14:1045-1063.
  21. Canonica GW, et al. Sublingual immunotherapy: World Allergy Organization position paper 2013 update. World Allergy Organ J. 2014;7:6.
  22. Menzies-Gow A, et al. Tezepelumab in adults and adolescents with severe, uncontrolled asthma. N Engl J Med. 2021;384:1800-1809.
  23. Tezepelumab [prescribing information]. Approved 2021. Revised December 2021.
  24. Omalizumab [prescribing information]. Approved 2006. Revised July 2016.
  25. Hanania NA, et al. Exploring the effects of omalizumab in allergic asthma: an analysis of biomarkers in the EXTRA study. Am J Respir Crit Care Med. 2013;187:804-811.
  26. Humbert M, et al. Omalizumab effectiveness in patients with severe allergic asthma according to blood eosinophil count: the STELLAIR study. Eur Respir J. 2018;51:1702523.
  27. Casale TB, et al. Omalizumab effectiveness by biomarker status in patients with asthma: evidence from PROSPERO, a prospective real-world study. J Allergy Clin Immunol Pract. 2019;7:156-164.e1.
  28. Bleecker ER, et al. Baseline patient factors impact on the clinical efficacy of benralizumab for severe asthma. Eur Respir J. 2018;52:1800936.
  29. Harvey ES, et al. Mepolizumab effectiveness and identification of super-responders in severe asthma. Eur Respir J. 2020;55:1902420.
  30. Castro M, et al. Reslizumab for inadequately controlled asthma with elevated blood eosinophil counts: results from two multicentre, parallel, double-blind, randomised, placebo-controlled, phase 3 trials. Lancet Respir Med. 2015;3:355-366.
  31. Dupilumab [prescribing information]. Approved 2017. Revised March 2017.
  32. Corren J, et al. Dupilumab efficacy in patients with uncontrolled, moderate-to-severe allergic asthma. J Allergy Clin Immunol Pract. 2020;8:516-526.
  33. Khan A, et al. Type 2 inflammation-related comorbidities among patients with asthma, chronic rhinosinusitis with nasal polyps, and atopic dermatitis. Eur Respir J. 2020;56(suppl 64):232.
  34. Mepolizumab [prescribing information]. Approved 2015. Revised June 2019.
  35. Zuberbier T, et al. The international EAACI/GA²LEN/EuroGuiDerm/APAAACI guideline for the definition, classification, diagnosis, and management of urticaria. Allergy. 2022;77:734-766.
  36. Church MK, et al. The role and relevance of mast cells in urticaria. Immunol Rev. 2018;282:232-247.
  37. Asero R. Clinical management of adult patients with a history of nonsteroidal anti-inflammatory drug-induced urticaria/angioedema: update. Allergy Asthma Clin Immunol. 2007;3:24.
  38. Puhl V, et al. A novel histopathological scoring system to distinguish urticarial vasculitis from chronic spontaneous urticaria. Clin Transl Allergy. 2021;11:e12031.
  39. Kaplan AP, et al. Mechanisms of action that contribute to efficacy of omalizumab in chronic spontaneous urticaria. Allergy. 2017;72:519-533.
  40. Grattan CE, et al. Randomized double-blind study of cyclosporin in chronic 'idiopathic' urticaria. Br J Dermatol. 2000;143:365-372.
  41. Kulthanan K, et al. Cyclosporine for chronic spontaneous urticaria: a meta-analysis and systematic review. J Allergy Clin Immunol Pract. 2018;6:586-599.
  42. Vena GA, et al. Cyclosporine in chronic idiopathic urticaria: a double-blind, randomized, placebo-controlled trial. J Am Acad Dermatol. 2006;55:705-709.
  43. Kolkhir P, et al. New treatments for chronic urticaria. Ann Allergy Asthma Immunol. 2020;124:2-12.
  44. Maurer M, et al. Efficacy and safety of ligelizumab in patients with chronic spontaneous urticaria: results of two phase 3 randomized controlled trials. Presented at: European Association of Dermatology and Venereology Congress; September 7-10, 2022; Milan, Italy. Presentation 10.
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