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- Patient‐centered digital biomarkers for allergic respiratory diseases and asthma: The ARIA‐EAACI approach – ARIA‐EAACI Task Force ReportPublication . Bousquet, Jean; Shamji, Mohamed; Anto, Josep M.; Schünemann, Holger; Canonica, Giorgio Walter; Jutel, Marek; Del Giacco, Stafano; Zuberbier, Torsten; Pfaar, Oliver; Fonseca, Joao A; Pinto, Bernardo Sousa; Pétré, Benoit; Pham‐Thi, Nhân; Puggioni, Francesca; Quirce, Santiago; Roche, Nicolas; Rouadi, Philip; Sousa, Ana Sá; Sagara, Hironori; Sastre, Joaquin; Scichilone, Nicola; Sheikh, Aziz; Sova, Milan; Ulrik, Charlotte Suppli; Taborda Barata, Luis; Todo-Bom, Ana; Torres, María Jose; Tsiligianni, Ioanna; Usmani, Omar; Valovirta, Erkka; Vasankari, Tuula; Vieira, Rafael José; Wallace, Dana; Waserman, Susan; Zidarn, Mihaela; Yorgancıoglu, Arzu; Zhang, Luo; Chivato, Tomás; Ollert, Markus; Klimek, Ludger; Czarlewski, Wienczyslawa; Bedbrook, Anna; Amaral, Rita; Ansotegui Zubeldia, Ignacio Javier; Bosnic-Anticevich, Sinthia; Braido, Fulvio; Loureiro, Cláudia Chaves; Gemicioglu, Bilun; Haahtela, Tari; Kulus, Marek; Kuna, Piotr; Kupczyk, Maciej; Matricardi, Paolo Maria; Regateiro, Frederico S.; Samoliński, Bolesław; Sofiev, Mikhail; Toppila-Salmi, Sanna; Valiulis, Arunas; Ventura, Maria Teresa; Bárbara, Cristina; Bergmann, Karl-Christian; Bewick, Michael; Blain, Hubert; Bonini, Matteo; Boulet, Louis-Philippe; Bourret, Rodolphe; Brusselle, Guy; Brussino, Luisa; Buhl, Roland; Cardona, Victoria; Casale, Thomas; Cecchi, Lorenzo; Charpin, Denis; Cherrez Ojeda, Ivan; Chu, Derek K; Cing, Cemal; Costa, Elísio; Cruz, Álvaro A.; Devillier, Philippe; Dramburg, Stephanie; Fokkens, Wytske; Gotua, Maia; Heffler, Enrico; Ispayeva, Zhanat; Ivancevich, Juan Carlos; Joos, Guy; Kaidashev, Igor; Kraxner, Helga; Kvedarienė, Violeta; Larenas Linnemann, Désirée; Laune, Daniel; Lourenço, Olga; Louis, Renaud; Mäkelä, Mika J.; Makris, Michael; Maurer, Marcus; Melén, Erik; Micheli, Yann; Almeida, Mário Morais; Mullol, Joaquim; Niedoszytko, Marek; O'Hehir, Robyn; Okamoto, Yoshitaka; Olze, Heidi; Papadopoulos, Nikolaos G.; Papi, Alberto; Patella, VincenzoBiomarkers for the diagnosis, treatment and follow-up of patients with rhinitis and/ or asthma are urgently needed. Although some biologic biomarkers exist in specialist care for asthma, they cannot be largely used in primary care. There are no validated biomarkers in rhinitis or allergen immunotherapy (AIT) that can be used in clinical practice. The digital transformation of health and health care (including mHealth) places the patient at the center of the health system and is likely to optimize the practice of allergy. Allergic Rhinitis and its Impact on Asthma (ARIA) and EAACI (European Academy of Allergy and Clinical Immunology) developed a Task Force aimed at proposing patient-reported outcome measures (PROMs) as digital biomarkers that can be easily used for different purposes in rhinitis and asthma. It first defined control digital biomarkers that should make a bridge between clinical practice, randomized controlled trials, observational real-life studies and allergen challenges. Using the MASK-air app as a model, a daily electronic combined symptom-medication score for allergic diseases (CSMS) or for asthma (e-DASTHMA), combined with a monthly control questionnaire, was embedded in a strategy similar to the diabetes approach for disease control. To mimic real-life, it secondly proposed quality-of- life digital biomarkers including daily EQ-5D visual analogue scales and the bi-weekly RhinAsthma Patient Perspective (RAAP). The potential implications for the management of allergic respiratory diseases were proposed.
- Digitally‐enabled, patient‐centred care in rhinitis and asthma multimorbidity: The ARIA‐MASK‐air® approachPublication . Bousquet, Jean; Anto, Josep M.; Sousa-Pinto, Bernardo; Czarlewski, Wienczyslawa; Bedbrook, Anna; Haahtela, Tari; Klimek, Ludger; Pfaar, Oliver; Kuna, Piotr; Kupczyk, Maciej; Regateiro, Frederico S.; Palamarchuk, Yuliia; Pépin, Jean‐Louis; Pétré, Benoit; Picard, Robert; Pitsios, Constantinos; Puggioni, Francesca; Quirce, Santiago; Raciborski, Filip; Reitsma, Sietze; Roche, Nicolas; Samolinski, Boleslaw; Rodriguez‐Gonzalez, Monica; Romantowski, Jan; Sousa, Ana Sá; Serpa, Faradiba S.; Savouré, Marine; Shamji, Mohamed H.; Sova, Milan; Sperl, Annette; Stellato, Cristiana; Todo‐Bom, Ana; Valiulis, Arunas; Tomazic, Peter Valentin; Vandenplas, Olivier; Van Eerd, Michiel; Vasankari, Tuula; Viart, Frédéric; Waserman, Susan; Fonseca, Joao A; Zuberbier, Torsten; Yorgancioglu, Arzu; Arnavielhe, Sylvie; Basagaña, Xavier; Bergmann, Karl C.; Bosnic‐Anticevich, Sinthia; Brussino, Luisa; Canonica, Giorgio Walter; Cardona, Victoria; Cecchi, Lorenzo; Loureiro, Cláudia Chaves; Costa, Elísio; Cruz, Alvaro A.; Gemicioglu, Bilun; Fokkens, Wytske; Ivancevich, Juan Carlos; Kraxner, Helga; Kvedariene, Violeta; Linnemann, Désirée E. Larenas; Laune, Daniel; Louis, Renaud; Makris, Michael; Maurer, Marcus; Melén, Erik; Micheli, Yann; Almeida, Mário Morais; Mullol, Joaquim; Niedoszytko, Marek; Okamoto, Yoshitaka; Papadopoulos, Nikolaos G.; Patella, Vincenzo; Pham‐Thi, Nhân; Rouadi, Philip W.; Sastre, Joaquin; Scichilone, Nicola; Sheikh, Aziz; Sofiev, Mikhail; Barata, Luís Taborda; Salmi, Sanna Toppila; Tsiligianni, Ioanna; Valovirta, Erkka; Ventura, Maria Teresa; Vieira, Rafael José; Zidarn, Mihaela; Amaral, Rita; Ansotegui, Ignacio J.; Bédard, Annabelle; Benveniste, Samuel; Bewick, Michael; Jensen, Carsten Bindslev; Blain, Hubert; Bonini, Matteo; Bourret, Rodolphe; Braido, Fulvio; Martins, Pedro Carreiro; Charpin, Denis; Cherrez‐Ojeda, Ivan; Chivato, Tomas; Chu, Derek K.; Cingi, Cemal; Del Giacco, Stefano; de Blay, Frédéric; Devillier, Philippe; De Vries, Govert; Doulaptsi, Maria; Doyen, Virginie; Dray, Gérard; Fontaine, Jean‐François; Gomez, R. Maximiliano; Hagemann, Jan; Heffler, Enrico; Hofmann, Maja; Jassem, Ewa; Jutel, Marek; Keil, Thomas; Kritikos, Vicky; Kull, Inger; Kulus, Marek; Lourenço, Olga; Mathieu‐Dupas, Eve; Menditto, Enrica; Mösges, Ralph; Murray, Ruth; Nadif, Rachel; Neffen, Hugo; Nicola, Stefania; O’Hehir, Robyn; Olze, HeidiMASK‐air®, a validated mHealth app (Medical Device regulationClass IIa) has enabled large observational implementation studies in over 58,000 people with allergic rhinitis and/or asthma. It can help to address unmet patient needs in rhinitis and asthma care. MASK‐air® is a Good Practice of DG Santé on digitally‐enabled, patient‐centred care. Itis also a candidate Good Practice ofOECD (Organisation for EconomicCo‐operation and Development). MASK‐air® data has enabled novel phenotype discovery and characterisation, as well as novel insights into the management of allergic rhinitis. MASK‐air® data show that most rhinitis patients (i) are not adherent and do notfollow guidelines, (ii) use as‐needed treatment, (iii) do not take medication when they are well, (iv) increase their treatment based on symptoms and (v) do not use the recom mended treatment. The data also show that control (symptoms, work productivity, educational performance) is not always improved by medications. A combined symptom‐medication score (ARIA‐EAACI‐CSMS) has been validated for clinical practice and trials. The implications of the novel MASK‐air® results should lead to change management in rhinitis and asthma.
- ARIA 2019: Um Percurso Assistencial Integrado para a Rinite Alérgica em PortugalPublication . Fonseca, Joao A; Gomes, Tiago Taveira; Pereira, Ana Margarida; Ferreira, Manuel Branco; Martins, Pedro Carreiro; Correia, Magna Alves; Sousa, Jaime Correia de; Costa, Elísio; Lourenço, Olga; Almeida, Mário Morais; Morête, Ana; Regateiro, Frederico; Bom, Ana Todo; Bachert, Claus; Pfaar, Oliver; Wallace, Dana; Bedbrook, Anna; Czarlewski, Wienczyslawa; Bousquet, JeanA iniciativa Allergic Rhinitis and Its Impact on Asthma (ARIA) teve início há mais de 20 anos e tem elaborado e disseminado orientações baseadas em evidência, e desenvolvido projetos na área da rinite alérgica. Esta iniciativa está atualmente focada em proporcionar orientações centradas no doente que contribuam para um percurso integrado entre os vários níveis de cuidados e que tirem partido de soluções digitais, tendo sido recomendada a introdução na prática clínica de percursos assistenciais integrados. Neste artigo descrevemos a adaptação para Portugal do documento ARIA Integrated Care Pathways. Após breve revisão sobre a epidemiologia e o impacto da rinite alérgica em Portugal e das atividades realizadas em Portugal no âmbito da iniciativa ARIA, é descrito o conjunto alargado de conhecimento utilizado para o desenvolvimento das recomendações para o tratamento farmacológico da rinite alérgica, recomendações essas baseadas na metodologia GRADE, evidência do mundo real adquirida por tecnologia móvel (mHealth) e resultante de estudos de câmara de exposição alergénica. Em seguida, são resumidos os percursos assistenciais integrados para imunoterapia com alergénios produzidas em 2019. Considera-se a imunoterapia com alergénios um exemplo de medicina de precisão e em que a utilização de tecnologias mHealth permitirá melhorar a estratificação para seleção dos doentes e monitorização da resposta. Estas recomendações foram consideradas como ‘boas práticas’ dos cuidados integrados centrados no doente apoiados por sistemas digitais da DG Santé (Direção Geral de Saúde e de Segurança Alimentar da União Europeia) e representam a estratégia de gestão da mudança da fase 4 do ARIA.
- Concepts for the Development of Person-Centered, Digitally Enabled, Artificial Intelligence–Assisted ARIA Care Pathways (ARIA 2024)Publication . Bousquet, Jean; Schünemann, Holger; Sousa-Pinto, Bernardo; Zuberbier, Torsten; Togias, Alkis; Samoliński, Bolesław; Bedbrook, Anna; Czarlewski, Wienczyslawa; Hofmann-Apitius, Martin; Litynska, Justyna; Vieira, Rafael José; Giuliano, Antonio F.M.; Gotua, Maia; Gradauskiene, Brigita; Guzman, Maria Antonieta; Hossny, Elham; Hrubiško, Martin; Iinuma, Tomohisa; Irani, Carla; Ispayeva, Zhanat; Ivancevich, Juan Carlos; Anto, Josep M.; Jartti, Tuomas; Jesenak, Milos; Julge, Kaja; Jutel, Marek; Kaidashev, Igor; Bennoor, Kazi Saifuddin; Khaltaev, Nicolai; Kirenga, Bruce; Kraxner, Helga; Kull, Inger; Fonseca, Joao A; Kulus, Marek; Kuna, Piotr; Kupczyk, Maciej; Kurchenko, Andriy; La Grutta, Stefania; Lane, Stephen; Miculinic, Neven; Lee, Sang Min; Le Thi Tuyet, Lan; Lkhagvaa, Battur; Brozek, Jan; Louis, Renaud; Mahboub, Bassam; Mäkelä, Mika J.; Makris, Michael; Maurer, Marcus; Melén, Eric; Milenkovic, Branislava; Mohammad, Yousser; Moniuszko, Marcin; Montefort, Stephen; Bognanni, Antonio; Moreira, Andre; Moreno, Pablo; Mullol, Joaquim; Nadif, Rachel; Nakonechna, Alla; Navarro-Locsin, Cecilia Gretchen; Neffen, Hugo; Nekam, Kristof; Niedoszytko, Marek; Nunes, Elizabete; Brussino, Luisa; Nyembue Tshipukane, Dieudonne; O’Hehir, Robyn; Ollert, Markus; Ohta, Ken; Okamoto, Yoshitaka; Okubo, Kimihiro; Olze, Heidi; Padukudru, Mahesh Anand; Palomares, Oscar; Pali-Schöll, Isabella; Canonica, Giorgio Walter; Panzner, Petr; Palosuo, Kati; Park, Hae-Sim; Passalacqua, Giovanni; Patella, Vincenzo; Pawankar, Ruby; Pétré, Benoît; Pitsios, Constantinos; Plavec, Davor; Popov, Todor A.; Cherrez Ojeda, Ivan; Puggioni, Francesca; Quirce, Santiago; Raciborski, Filip; Ramonaité, Agné; Recto, Marysia; Repka- Ramirez, María Susana; Roberts, Graham; Robles-Velasco, Karla; Roche, Nicolas; Rodriguez-Gonzalez, Monica; Cruz, Alvaro; Romualdez, Joel A.; Rottem, Menachem; Rouadi, Philip; Salapatas, Marianella; Sastre, Joaquin; Serpa, Faradiba; Sayah, Zineb; Scichilone, Nicola; Senna, Gianenrico; Sisul, Juan; Vecillas, Leticia De Las; Solé, Dirceu; Soto-Martinez, Manuel E.; Sova, Milan; Sozinova, Olga; Stevanovic, Katarina; Suppli Ulrik, Charlotte; Szylling, Anna; Tan, Frances M.; Tantilipikorn, Pongsakorn; Bom, Ana Todo; Dykewicz, Mark; Tomic Spiric, Vesna; Tsaryk, Vladyslav; Tsiligianni, Ioanna; Urrutia-Pereira, Marilyn; Valentin Rostan, Marylin; Sofiev, Mikhail; Valovirta, Erkka; Van Eerd, Michiel; Van Ganse, Eric; Vasankari, Tuula; Gemicioglu, Bilun; Vichyanond, Pakit; Viegi, Giovanni; Wallace, Dana; Wang, De Yun; Waserman, Susan; Wong, Gary; Worm, Margitta; Yusuf, Osman; Zaitoun, Fares; Zidarn, Mihaela; Giovannini, Mattia; Haahtela, Tari; Jacobs, Marc; Jacomelli, Cristina; Klimek, Ludger; Kvedarienė, Violeta; Linnemann, Désirée Larenas; Louis, Gilles; Lourenço, Olga; Leemann, Lucas; Almeida, Mario Morais; Neves, Ana Luisa; Nadeau, Kari; Nowak, Artur; Palamarchuk, Yuliia; Palkonen, Susanna; Papadopoulos, Nikolaos G.; Parmelli, Elena; Pereira, Ana Margarida; Pfaar, Oliver; Regateiro, Frederico S.; Savouré, Marine; Barata, Luís Taborda; Toppila-Salmi, Sanna Katriina; Torres, María Jose; Valiulis, Arunas; Ventura, Maria Teresa; Williams, Siân; Yepes-Nuñez, Juan J.; Yorgancıoglu, Arzu; Zhang, Luo; Zuberbier, Jaron; Abdul Latiff, Amir; Abdullah, Baharudin; Agache, Ioana; Al-Ahmad, Mona; Al-Nesf, Maryam A Y; Al Shaikh, A.; Amaral, Rita; Ansotegui Zubeldia, Ignacio Javier; Asllani, Julijana; Balotro-Torres, Maria Cristina; Bergmann, Karl-Christian; Bernstein, Jonathan; Bindslev-Jensen, Carsten; Blaiss, Michael S.; Bonaglia, Cristina; Bonini, Matteo; Bossé, Isabelle; Braido, Fulvio; Caballero-Fonseca, Fernan; Camargos, Paulo; Martins, Pedro Carreiro; Casale, Thomas; Castillo-Vizuete, José-Antonio; Cecchi, Lorenzo; Teixeira, Maria Do Céu; Chang, Yoon-Seok; Loureiro, Cláudia Chaves; Christoff, George; Ciprandi, Giorgio; Cirule, Ieva; Sousa, Jaime Correia De; Costa, Elísio; Cvetkovski, Biljana; De Vries, Govert; Del Giacco, Stefano; Devillier, Philippe; Dokic, Dejan; Douagui, Habib; Durham, Stephen; Enecilla, Maria Lourdes; Fiocchi, Alessandro; Fokkens, Wytske; Fontaine, Jean-François; Gawlik, Radoslaw; Gereda, Jose E.; Mata, Sara GilAbstract The traditional healthcare model is focused on diseases (medicine and natural science) and does not acknowledge patients' resources and abilities to be experts in their own lives based on their lived experiences. Improving healthcare safety, quality, and coordination, as well as quality of life, is an important aim in the care of patients with chronic conditions. Person-centered care needs to ensure that people's values and preferences guide clinical decisions. This paper reviews current knowledge to develop (1) digital care pathways for rhinitis and asthma multimorbidity and (2) digitally enabled, person-centered care.1 It combines all relevant research evidence, including the so-called real-world evidence, with the ultimate goal to develop digitally enabled, patient-centered care. The paper includes (1) Allergic Rhinitis and its Impact on Asthma (ARIA), a 2-decade journey, (2) Grading of Recommendations, Assessment, Development and Evaluation (GRADE), the evidence-based model of guidelines in airway diseases, (3) mHealth impact on airway diseases, (4) From guidelines to digital care pathways, (5) Embedding Planetary Health, (6) Novel classification of rhinitis and asthma, (7) Embedding real-life data with population-based studies, (8) The ARIA-EAACI (European Academy of Allergy and Clinical Immunology) strategy for the management of airway diseases using digital biomarkers, (9) Artificial intelligence, (10) The development of digitally enabled, ARIA person-centered care, and (11) The political agenda. The ultimate goal is to propose ARIA 2024 guidelines centered around the patient to make them more applicable and sustainable.
- Heterogeneity of the pharmacologic treatment of allergic rhinitis in Europe based on MIDAS and OTCims platformsPublication . Bousquet, Jean; Schröder-Bernhardi, Detlef; Bachert, Claus; Canonica, G Walter; Cardona, Victoria; Costa, Elísio; Czarlewski, Wienczyslawa; Devillier, Philippe; Fonseca, Joao A; Klimek, Ludger; Kuna, Piotr; Lourenço, Olga; Mullol, Joaquim; Pfaar, Oliver; Pham-Thi, Nhân; Samolinski, Boleslaw; Saueressig, Julia; Scadding, Glenis K; Stroh, Ann-Kathrin; Scheire, Sophie; Van Ganse, Eric; Zuberbier, TorstenBackground: The practice of allergology varies widely between countries, and the costs and sales for the treatment of rhinitis differ depending on practices and health systems. To understand these differences and their implications, the rhinitis market was studied in some of the EU countries. Methods: We conducted a pharmaco-epidemiological database analysis to assess the medications that were being prescribed for allergic rhinitis in the years 2016, 2017 and 2018. We used the IQVIA platforms for prescribed medicines (MIDAS®- Meaningful Integration of Data, Analytics and Services) and for OTC medicines (OTC International Market Tracking-OTCims). We selected the five most important markets in the EU (France, Germany, Italy, Poland and Spain). Results: Intranasal decongestants were excluded from the analyses because they are rarely prescribed for allergic rhinitis. For both Standard Units (SU) and costs, France is leading the other countries. In terms of SU, the four other countries are similar. For costs, Poland is lower than the three others. However, medication use differs largely. For 2018, in SU, intranasal corticosteroid is the first treatment in Poland (70.0%), France (51.3%), Spain (51.1%) and Germany (50.3%), whereas the Italian market is dominated by systemic antihistamines (41.4%) followed by intranasal corticosteroids (30.1%). Results of other years were similar. Discussion: There are major differences between countries in terms of rhinoconjunctivitis medication usage.
- ARIA-EAACI care pathways for allergen immunotherapy in respiratory allergyPublication . Bousquet, Jean; Pfaar, Oliver; Agache, Ioana; Bedbrook, Anna; Akdis, Cezmi; Canonica, Giorgio Walter; Chivato, Tomas; Al-Ahmad, Mona; Rasib, A. H. Abdul; Ansotegui Zubeldia, Ignacio Javier; Bachert, Claus; Ispayeva, Zhanat; Bosnic-Anticevich, Sinthia; Recto, Marysia; Valiulis, Arunas; Durham, Stephen L; Gereda, Jose E; Schünemann, Holger; Levin, Michael; Zernotti, Mario; Fauquert, Jean-Luc; Sofiev, Mikhail; Kowalski, Marek; Chkhartishvili, Ekaterine; Bindslev-Jensen, Carsten; Wagenmann, Martin; Fontaine, Jean-François; Heffler, Enrico; Soto-Martinez, Manuel; Mahboub, Bassam; Jutel, Marek; Gerth Van Wijk, Roy; Lauerma, Antti; Ebisawa, Motohiro; Casale, Thomas; Bosse, Isabelle; Grisle, Ineta; Julge, Kaja; Barata, Luís Taborda; Meltzer, Eli O; Caraballo, Luis; Hoffmann-Sommergruber, Karin; Gawlik, Radoslaw; Devillier, Philippe; Chu, Derek K; Irani, Carla; Kraxner, Helga; Toppila-Salmi, Sanna; Montefort, Stephen; Nekam, Kristof; Kaidashev, Igor; Guzman, Maria Antonieta; El-Gamal, Yehia; Klimek, Ludger; Lau, Susanne; Valovirta, Erkka; Mullol, Joaquim; Palomares, Oscar; Ollert, Markus; O'Hehir, Robyn; Gelincik, Asli; Kvedarienė, Violeta; Wallace, Dana; Okubo, Kimihiro; Bergmann, Karl-Christian; Park, Hae-Sim; Papadopoulos, Nikolaos G.; Haahtela, Tari; Linnemann, Désirée Larenas; Wong, Gary Wk; Pham-Thi, Nhân; Martins, Pedro Carreiro; Regateiro, Frederico S.; Ivancevich, Juan Carlos; Malling, Hans-Jørgen; Zhang, Luo; Rottem, Menachem; Demoly, Pascal; Samoliński, Bolesław; Knol, Edward; Miculinic, Neven; Brough, Helen; Fiocchi, Alessandro; Sheikh, Aziz; Kritikos, Vicky; Almeida, Mário Morais; Cirule, Ieva; Gomez, R Maximiliano; Soto-Quiros, Manuel; Lodrup Carlsen, Karin C; Namazova-Baranova, Leyla; Ėmužytė, Regina; Bom, Ana Todo; Manning, Patrick; Pajno, Giovanni B; Gemicioglu, Bilun; Tsiligianni, Ioanna; Milenkovic, Branislava; Plavec, Davor; Halken, Susanne; Skypala, Isabel; O'Mahony, Liam; Fokkens, Wytske J; Lombardi, Carlo; Riggioni, Carmen; Shamji, Mohamed; Hossny, Elham; Vandenplas, Olivier; Mortz, Charlotte G; Rouadi, Philip; Tomazic, Peter Valentin; Passalacqua, Giovanni; Odemyr, Mikaëla; Marshall, Gailen D; Sanchez-Borges, Mario; Solé, Dirceu; Kalayci, Omer; Walusiak-Skorupa, Jolanta; Neffen, Hugo; Schmid-Grendelmeier, Peter; Roberts, Graham; Panzner, P.; Ohta, Ken; Scichilone, Nicola; Suppli-Ulrik, Charlotte; Kull, Inger; Yorgancıoglu, Arzu; Baharuddin, Abdullah; Sooronbaev, Talant; Serpa, Faradiba S; Patella, Vincenzo; Sova, Milan; Valero, Antonio; Laune, Daniel; Zidarn, Mihaela; Cardona, Victoria; Bonini, Matteo; Bjermer, Leif; Rodriguez-Gonzales, Monica; Torres, Maria J; Lourenço, Olga; Brussino, Luisa; Del Giacco, Stefano; Cepeda Sarabia, Alfonso M; Cecchi, Lorenzo; Sastre, Joaquin; Untersmayr, Eva; Melén, Erik; Cruz, Alvaro A; Niedoszytko, Marek; Dokic, Dejan; Sisul, Juan; Ventura, Maria Teresa; Moin, Mostafa; Gamkrelidze, Amiran; Palkonen, Susanna; Fonseca, Joao A; Schwarze, Jürgen; Wang, De Yun; Mösges, Ralph; Popov, Todor A; Gotua, Maia; Valentin Rostan, Marylin; Yusuf, Osman; Okamoto, Yoshitaka; Ryan, Dermot; Hrubiško, Martin; Urrutia-Pereira, Marilyn; Zuberbier, Torsten; Pawankar, Ruby; Khaitov, Musa; Vichyanond, Pakit; Calderon, Moises A; Rosário, Nelson; Kuna, Piotr; Waserman, Susan; Czarlewski, Wienczyslawa; Scadding, Glenis KAllergen immunotherapy (AIT), the gradually increasing repeated administration of high doses of allergens to allergic patients, offers the potential for immune tolerance against reactions to the natural exposures to specific allergens. AIT may lead to the long‐lasting remission of allergic symptoms and is the only disease‐modifying intervention in IgE‐mediated allergic respiratory diseases. [...]
- 2019 ARIA Care pathways for allergen immunotherapyPublication . Bousquet, Jean; Pfaar, Oliver; Togias, Alkis; Schünemann, Holger J; Ansotegui, Ignacio; Papadopoulos, Nikolaos G; Tsiligianni, Ioanna; Agache, Ioana; Anto, Josep M.; Bachert, Claus; Bedbrook, Anna; Bergmann, Karl-Christian; Bosnic-Anticevich, Sinthia; Bosse, Isabelle; Brozek, Jan; Calderon, Moises A; Canonica, Giorgio W; Caraballo, Luigi; Cardona, Victoria; Casale, Thomas; Cecchi, Lorenzo; Chu, Derek; Costa, Elísio; Cruz, Alvaro A; Czarlewski, Wienczyslawa; Durham, Stephen R; Du Toit, George; Dykewicz, Mark; Ebisawa, Motohiro; Fauquert, Jean Luc; Fernandez-Rivas, Montserrat; Fokkens, Wytske J; Fonseca, João; Fontaine, Jean-François; Gerth van Wijk, Roy; Haahtela, Tari; Halken, Susanne; Hellings, Peter; Ierodiakonou, Despo; Iinuma, Tomohisa; Ivancevich, Juan Carlos; Jacobsen, Lars; Jutel, Marek; Kaidashev, Igor; Khaitov, Musa; Kalayci, Omer; Kleine Tebbe, Jörg; Klimek, Ludger; Kowalski, Marek L; Kuna, Piotr; Kvedarienė, Violeta; La Grutta, Stefania; Larenas Linnemann, Désirée; Lau, Susanne; Laune, Daniel; Le Thi Tuyet, Lan; Lodrup Carlsen, Karin; Lourenço, Olga; Malling, Hans-Jørgen; Marien, Gert; Menditto, Enrica; Mercier, Gregoire; Mullol, Joaquim; Muraro, Antonella; O'Hehir, Robyn; Okamoto, Yoshitaka; Pajno, Giovanni B; Park, Hae-Sim; Panzner, Petr; Passalacqua, Giovanni; Pham-Thi, Nhan; Roberts, Graham; Pawankar, Ruby; Rolland, Christine; Rosario, Nelson; Ryan, Dermot; Samolinski, Boleslaw; Sanchez-Borges, Mario; Scadding, Glenis; Shamji, Mohamed H; Sheikh, Aziz; Sturm, Gunter J; Todo-Bom, Ana; Toppila-Salmi, Sanna; Valentin Rostan, Marylin; Valiulis, Arunas; Valovirta, Erkka; Ventura, Maria Teresa; Wahn, Ulrich; Walker, Samantha; Wallace, Dana; Waserman, Susan; Yorgancioglu, Arzu; Zuberbier, TorstenAllergen immunotherapy (AIT) is a proven therapeutic option for the treatment of allergic rhinitis and/or asthma. Many guidelines or national practice guidelines have been produced but the evidence-based method varies, many are complex and none propose care pathways. This paper reviews care pathways for AIT using strict criteria and provides simple recommendations that can be used by all stakeholders including healthcare professionals. The decision to prescribe AIT for the patient should be individualized and based on the relevance of the allergens, the persistence of symptoms despite appropriate medications according to guidelines as well as the availability of good-quality and efficacious extracts. Allergen extracts cannot be regarded as generics. Immunotherapy is selected by specialists for stratified patients. There are no currently available validated biomarkers that can predict AIT success. In adolescents and adults, AIT should be reserved for patients with moderate/severe rhinitis or for those with moderate asthma who, despite appropriate pharmacotherapy and adherence, continue to exhibit exacerbations that appear to be related to allergen exposure, except in some specific cases. Immunotherapy may be even more advantageous in patients with multimorbidity. In children, AIT may prevent asthma onset in patients with rhinitis. mHealth tools are promising for the stratification and follow-up of patients.
- Next-generation Allergic Rhinitis and Its Impact on Asthma (ARIA) guidelines for allergic rhinitis based on Grading of Recommendations Assessment, Development and Evaluation (GRADE) and real-world evidencePublication . Bousquet, Jean; Schünemann, Holger J; Togias, Akdis; Bachert, Claus; Erhola, Martina; Hellings, Peter; Klimek, Ludger; Pfaar, Oliver; Wallace, Dana; Ansotegui, Ignacio; Agache, Ioana; Devillier, Philippe; Dykewicz, Mark; Ebisawa, Motohiro; Fauquert, Jean-Louis; Fokkens, Wytske J; Fonseca, Joao A; Fontaine, Jean-François; Gemicioglu, Bilun; van Wijk, Roy Gerth; Haahtela, Tari; Halken, Susanne; Ierodiakonou, Despo; Iinuma, Tomohisa; Ivancevich, Juan-Carlos; Jutel, Marek; Kaidashev, Igor; Khaitov, Musa; Kalayci, Omer; Kleine Tebbe, Jorg; Kowalski, Marek L; Kuna, Piotr; Kvedarienė, Violeta; La Grutta, Stefania; Linnemann, Désirée Larenas; Lau, Susanne; Laune, Daniel; Le Thi Tuyet, Lan; Lieberman, Philipp; Lodrup Carlsen, Karin C; Lourenço, Olga; Marien, Gert; Carreiro-Martins, Pedro; Melén, Erik; Menditto, Enrica; Neffen, Hugo; Mercier, Gregoire; Mosgues, Ralph; Mullol, Joaquim; Muraro, Antonella; Namazova-Baranova, Leyla; Novellino, Ettore; O'Hehir, Robyn; Okamoto, Yoshitaka; Ohta, Ken; Park, Hae-Sim; Panzner, Petr; Passalacqua, Giovanni; Pham-Thi, Nhan; Price, David; Roberts, Graham; Roche, Nicolas; Rolland, Christine; Rosario, Nelson; Ryan, Dermot; Samolinski, Boleslaw; Sanchez-Borges, Mario; Scadding, Glenis K; Shamji, Mohamed H; Sheikh, Aziz; Todo-Bom, Ana; Toppila-Salmi, Sanna; Tsiligianni, Ioana; Valentin Rostan, Marylin; Valiulis, Arunas; Valovirta, Erkka; Ventura, Maria Teresa; Walker, Samantha; Waserman, Susan; Yorgancioglu, Arzu; Zuberbier, Torsten; Bedbrook, Anna; Bergmann, Karl-Christian; Bewick, Mike; Bonniaud, Philippe; Bosnic-Anticevich, Sinthia; Bossé, Isabelle; Bouchard, Jacques; Boulet, Louis-Philippe; Brozek, Jan; Brusselle, Guy; Calderon, Moises A; Canonica, Walter G; Caraballo, Luis; Cardona, Vicky; Casale, Thomas; Cecchi, Lorenzo; Chu, Derek K; Costa, Elísio; Cruz, Alvaro A; Czarlewski, Wienczyslawa; D'Amato, GennaroThe selection of pharmacotherapy for patients with allergic rhinitis aims to control the disease and depends on many factors. Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines have considerably improved the treatment of allergic rhinitis. However, there is an increasing trend toward use of real-world evidence to inform clinical practice, especially because randomized controlled trials are often limited with regard to the applicability of results. The Contre les Maladies Chroniques pour un Vieillissement Actif (MACVIA) algorithm has proposed an allergic rhinitis treatment by a consensus group. This simple algorithm can be used to step up or step down allergic rhinitis treatment. Next-generation guidelines for the pharmacologic treatment of allergic rhinitis were developed by using existing GRADE-based guidelines for the disease, real-world evidence provided by mobile technology, and additive studies (allergen chamber studies) to refine the MACVIA algorithm.
- Next-generation care pathways for allergic rhinitis and asthma multimorbidity: a model for multimorbid non-communicable diseases-Meeting Report (Part 2)Publication . Bousquet, Jean; Pham-Thi, Nhân; Bedbrook, Anna; Agache, Ioana; Annesi-Maesano, Isabella; Ansotegui, Ignacio; Anto, Josep M.; Bachert, Claus; Benveniste, Samuel; Bewick, Mike; Billo, Nils; Bosnic-Anticevich, Sinthia; Bosse, Isabelle; Brusselle, Guy; Calderon, Moïses A; Canonica, G Walter; Caraballo, Luis; Cardona, Victoria; Carriazo, Ana Maria; Cash, Eugene; Cecchi, Lorenzo; Chu, Derek K; Colgan, Elaine; Costa, Elísio; Cruz, Alvaro A; Czarlewski, Wienczyslawa; Durham, Stephen; Ebisawa, Motohiro; Erhola, Marina; Fauquert, Jean-Luc; Fokkens, Wytske J; Fonseca, Joao A; Guldemond, Nick; Iinuma, Tomohisa; Illario, Maddalena; Klimek, Ludger; Kuna, Piotr; Kvedarienė, Violeta; Linnemann, Désirée Larenas; Laune, Daniel; Le Thi Tuyet, Lan; Lourenço, Olga; Malva, Joao O; Marien, Gert; Menditto, Enrica; Mullol, Joaquim; Münter, Lars; Okamoto, Yoshitaka; Onorato, Gabrielle L; Papadopoulos, Nikos G; Perala, Maritta; Pfaar, Oliver; Phillips, Abigail; Phillips, Jim; Pinnock, Hilary; Portejoie, Fabienne; Quinones-Delgado, Pablo; Rolland, Christine; Rodts, Ulysse; Samolinski, Boleslaw; Sanchez-Borges, Mario; Schünemann, Holger J; Shamji, Mohamed; Somekh, David; Togias, Alkis; Toppila-Salmi, Sanna; Tsiligianni, Ioanna; Usmani, Omar; Walker, Samantha; Wallace, Dana; Valiulis, Arunas; van der Kleij, Rianne; Ventura, Maria Teresa; Williams, Sian; Yorgancioglu, Arzu; Zuberbier, TorstenIn all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system into integrated care with organizational health literacy. MASK (Mobile Airways Sentinel NetworK) (1), a new development of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative (2), and POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EIT Health) (3), in collaboration with professional and patient organizations in the field of allergy and airway diseases, are proposing real-life ICPs—centred around the patient with rhinitis and using mHealth monitoring of environmental exposure. An expert meeting took place at the Pasteur Institute in Paris, December 3, 2018. The aim was to discuss nextgeneration care pathways following an ongoing political agenda (4,5): (I) patient participation, health literacy and self-care through technology-assisted “patient activation”; (II) implementation of care pathways by pharmacists and (III) Next-generation guidelines assessing the recommendations of GRADE guidelines in rhinitis and asthma using real-world evidence (RWE) assessed by mobile technology. The present document reviews the workshop report and follows on from Part 1.
- Next-generation care pathways for allergic rhinitis and asthma multimorbidity: a model for multimorbid non-communicable diseases-Meeting Report (Part 1)Publication . Bousquet, Jean; Pham-Thi, Nhân; Bedbrook, Anna; Agache, Ioana; Annesi-Maesano, Isabella; Ansotegui, Ignacio; Anto, Josep M; Bachert, Claus; Benveniste, Samuel; Bewick, Mike; Billo, Nils; Bosnic-Anticevich, Sinthia; Bosse, Isabelle; Brusselle, Guy; Calderon, Moïses A; Canonica, Giorgio W; Caraballo, Luis; Cardona, Victoria; Carriazo, Ana Maria; Cash, Eugene; Cecchi, Lorenzo; Chu, Derek K; Colgan, Elaine; Costa, Elísio; Cruz, Alvaro A; Czarlewski, Wienczyslawa; Durham, Stephen; Ebisawa, Motohiro; Erhola, Marina; Fauquert, Jean-Luc; Fokkens, Wytske J; Fonseca, Joao A; Guldemond, Nick; Iinuma, Tomohisa; Illario, Maddalena; Klimek, Ludger; Kuna, Piotr; Kvedarienė, Violeta; Linnemann, Désirée Larenas; Laune, Daniel; Le Thi Tuyet, Lan; Lourenço, Olga; Malva, Joao O; Marien, Gert; Menditto, Enrica; Mullol, Joaquim; Münter, Lars; Okamoto, Yoshitaka; Onorato, Gabrielle L; Papadopoulos, Nikos G; Perala, Maritta; Pfaar, Oliver; Phillips, Abigail; Phillips, Jim; Pinnock, Hilary; Portejoie, Fabienne; Quinones-Delgado, Pablo; Rolland, Christine; Rodts, Ulysse; Samolinski, Boleslaw; Sanchez-Borges, Mario; Schünemann, Holger J; Shamji, Mohamed; Somekh, David; Togias, Alkis; Toppila-Salmi, Sanna; Tsiligianni, Ioanna; Usmani, Omar; Walker, Samantha; Wallace, Dana; Valiulis, Arunas; Van Der Kleij, Rianne; Ventura, Maria Teresa; Williams, Sian; Yorgancioglu, Arzu; Zuberbier, TorstenIn all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system for integrated care with organizational health literacy. MASK (Mobile Airways Sentinel NetworK) (1), a new development of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, and POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EIT Health) (2), in collaboration with professional and patient organizations in the field of allergy and airway diseases, are proposing reallife integrated care pathways (ICPs) (3)-centred around the patient with rhinitis and using mHealth monitoring of environmental exposure (4). An expert meeting took place at the Pasteur Institute in Paris, December 3, 2018. The aim was to discuss nextgeneration care pathways: (I) Patient participation, health literacy and self-care through technology-assisted “patient activation”; (II) Implementation of care pathways by pharmacists and (III) Next-generation guidelines assessing the recommendations of GRADE guidelines in rhinitis and asthma using real-world evidence (RWE) assessed by mobile technology. The EU (5) and global political agendas are of great importance in supporting health care transformation. MASK has been recognized by DG Santé as a Good Practice (6) in the field of digitally-enabled, integrated, person-centred care. The one-day meeting objectives were clear (Figure 1). The meeting was followed by a workshop. The present paper reports the background of the two-day meeting. [...]