Efficacité du dupilumab dans l’asthme sévère non contrôlé : étude multicentrique de vraie vie en France

Introduction De septembre 2017 a janvier 2018, l’ouverture d’une autorisation temporaire d’utilisation (ATU) a permis de traiter par dupilumab (anticorps monoclonal anti-IL4/13R) des patients asthmatiques severes non controles en impasse therapeutique. L’objectif de ce travail est d’evaluer l’effet du traitement sur le controle de l’asthme. Methodes Une etude retrospective multicentrique a ete conduite dans les 13 hopitaux francais ayant fait une demande d’ATU nominative pour du dupilumab. Les caracteristiques demographiques, cliniques et fonctionnelles des patients ont ete recueillies a l’inclusion et a 12 mois de traitement. Les Resultats sont exprimes en tant que medianes avec ecarts int…

Organisation des structures de soins transversales en allergologie en France en 2020

Resume Introduction Les allergies touchent 25 % de la population generale avec une augmentation des allergies severes. Le developpement en France de structures de soins transversales en allergologie pour une prise en charge pluridisciplinaire des patients repond a un besoin de sante publique. Notre travail a pour but de faire un etat des lieux de ces structures. Methodes Enquete descriptive par questionnaire envoye aux chefs de services de structures de soins soit avec une activite principale en allergologie, soit avec une activite variee en allergologie. L’enquete portait sur l’organisation administrative, les equipes medicales et paramedicales, l’offre de soins et les moyens techniques de…

Integrated care pathways for airway diseases (AIRWAYS-ICPs)

International audience; The objective of Integrated Care Pathways for Airway Diseases (AIRWAYS-ICPs) is to launch a collaboration to develop multi-sectoral care pathways for chronic respiratory diseases in European countries and regions. AIRWAYS-ICPs has strategic relevance to the European Union Health Strategy and will add value to existing public health knowledge by: 1) proposing a common framework of care pathways for chronic respiratory diseases, which will facilitate comparability and trans-national initiatives; 2) informing cost-effective policy development, strengthening in particular those on smoking and environmental exposure; 3) aiding risk stratification in chronic disease patien…

SQ HDM SLIT-tablet (ALK) in treatment of asthma – Post hoc results from a randomised trial

SummaryIntroductionIn a double-blind, placebo-controlled trial (EudraCT identifier: 2006-001795-20), the standardised quality (SQ) house dust mite (HDM) sublingual immunotherapy (SLIT)-tablet (ALK, Denmark) was investigated.MethodThe trial included 604 subjects, ≥14 years, with mild-moderate HDM allergic asthma. Subjects were randomised 1:1:1:1 to 1, 3 or 6 SQ-HDM or placebo once daily. The primary endpoint was reduction in inhaled corticosteroid (ICS) after one year. ICS reduction, asthma quality of life questionnaire (AQLQ) and asthma control questionnaire (ACQ) score was analysed post hoc in a subgroup with daily ICS use of 400–800 μg and ACQ score of 1–1.5, corresponding to partly contr…

WITHDRAWN: Scaling up strategies of the Chronic Respiratory Disease programme of the European Innovation Partnership on Active and Healthy Ageing (Action Plan B3 – Area 5)

MACVIA-ARIA Sentinel NetworK for allergic rhinitis (MASK-rhinitis): the new generation guideline implementation

Accepted Article

Technical standards in allergen exposure chambers worldwide - an EAACI Task Force Report

Allergen exposure chambers (AECs) can be used for controlled exposure to allergenic and non-allergenic airborne particles in an enclosed environment, in order to (i) characterize the pathological features of respiratory diseases and (ii) contribute to and accelerate the clinical development of pharmacological treatments and allergen immunotherapy for allergic disease of the respiratory tract (such as allergic rhinitis, allergic rhinoconjunctivitis, and allergic asthma). In the guidelines of the European Medicines Agency for the clinical development of products for allergen immunotherapy (AIT), the role of AECs in determining primary endpoints in dose-finding Phase II trials is emphasized. A…

Scaling up strategies of the chronic respiratory disease programme of the European Innovation Partnership on Active and Healthy Ageing (Action Plan B3: Area 5)

Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) focuses on the integrated care of chronic diseases. Area 5 (Care Pathways) was initiated using chronic respiratory diseases as a model. The chronic respiratory disease action plan includes (1) AIRWAYS integrated care pathways (ICPs), (2) the joint initiative between the Reference site MACVIA-LR (Contre les MAladies Chroniques pour un VIeillissement Actif) and ARIA (Allergic Rhinitis and its Impact on Asthma), (3) Commitments for Action to the European Innovation Partnership on Active and Healthy Ageing and the AIRWAYS ICPs network. It is deployed in collaboration with the World Health Organizatio…

Guidance to 2018 good practice: ARIA digitally-enabled, integrated, person-centred care for rhinitis and asthma

AIMS: Mobile Airways Sentinel NetworK (MASK) belongs to the Fondation Partenariale MACVIA-LR of Montpellier, France and aims to provide an active and healthy life to rhinitis sufferers and to those with asthma multimorbidity across the life cycle, whatever their gender or socio-economic status, in order to reduce health and social inequities incurred by the disease and to improve the digital transformation of health and care. The ultimate goal is to change the management strategy in chronic diseases. METHODS: MASK implements ICT technologies for individualized and predictive medicine to develop novel care pathways by a multi-disciplinary group centred around the patients. STAKEHOLDERS: Incl…

Le comprimé d’immunothérapie sublinguale acariens SQ est efficace dans le traitement de l’asthme allergique ; résultats de l’essai de phase III MITRA

Introduction Les allergenes d’acariens domestiques sont associes a une pathologie respiratoire persistante. La rhinite allergique et l’asthme allergique (AA) coexistent frequemment. L’immunotherapie a le potentiel de modifier la cause de la maladie sous-jacente. Nous rapportons ici l’efficacite du comprime acarien d’immunotherapie sublinguale (ITSL) SQ-HDM (ALK, Danemark) sur le controle de l’asthme allergique aux acariens (AAA). Methodes L’essai europeen randomise en double aveugle controle par placebo MITRA (EudraCT 2010-018621-19) a inclus 834 sujets de 13 pays, ayant a l’inclusion un asthme allergique depuis plus d’un an, des tests de sensibilisation aux acariens positifs et un asthme m…

Correlation between work impairment, scores of rhinitis severity and asthma using the MASK-air ® App

Background: In allergic rhinitis, a relevant outcome providing information on the effectiveness of interventions is needed. In MASK-air (Mobile Airways Sentinel Network), a visual analogue scale (VAS) for work is used as a relevant outcome. This study aimed to assess the performance of the work VAS work by comparing VAS work with other VAS measurements and symptom-medication scores obtained concurrently. Methods: All consecutive MASK-air users in 23 countries from 1 June 2016 to 31 October 2018 were included (14 189 users; 205 904 days). Geolocalized users self-assessed daily symptom control using the touchscreen functionality on their smart phone to click on VAS scores (ranging from 0 to 1…

Allergic Rhinitis and its Impact on Asthma (ARIA) Phase 4 (2018): Change management in allergic rhinitis and asthma multimorbidity using mobile technology

Allergic Rhinitis and its Impact on Asthma (ARIA) has evolved from a guideline by using the best approach to integrated care pathways using mobile technology in patients with allergic rhinitis (AR) and asthma multimorbidity. The proposed next phase of ARIA is change management, with the aim of providing an active and healthy life to patients with rhinitis and to those with asthma multimorbidity across the lifecycle irrespective of their sex or socioeconomic status to reduce health and social inequities incurred by the disease. ARIA has followed the 8-step model of Kotter to assess and implement the effect of rhinitis on asthma multimorbidity and to propose multimorbid guidelines. A second c…

Allergy immunotherapy across the life cycle to promote active and healthy ageing: from research to policies: An AIRWAYS Integrated Care Pathways (ICPs) programme item (Action Plan B3 of the European Innovation Partnership on active and healthy ageing) and the Global Alliance against Chronic Respiratory Diseases (GARD), a World Health Organization GARD research demonstration project.

Allergic diseases often occur early in life and persist throughout life. This life-course perspective should be considered in allergen immunotherapy. In particular it is essential to understand whether this al treatment may be used in old age adults. The current paper was developed by a working group of AIRWAYS integrated care pathways for airways diseases, the model of chronic respiratory diseases of the European Innovation Partnership on active and healthy ageing (DG CONNECT and DG Santé). It considered (1) the political background, (2) the rationale for allergen immunotherapy across the life cycle, (3) the unmet needs for the treatment, in particular in preschool children and old age adu…