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1. Perceptions of the impact of individual allergic rhinitis symptoms: A survey of ARIA clinical experts

Author

Sara Gil-Mata, MD, Tatiana Teixeira, MD, Anna Bedbrook, BSc, Jean Bousquet, PhD, Bernardo Sousa-Pinto, PhD, Rafael José Vieira, MD, Julijana Asllani, Habib Douagui, Estrella Asayag, Castro Maria Elizabeth, Carlos D. Crisci, René Maximiliano Gomez, Juan Carlos Ivancevich, Edgardo Jares, Jorge Fernando Máspero, Pablo Moreno, Hugo Eduardo Neffen, Mario Emilio Zernotti, Sinthia Bosnic-Anticevich, Kristin Chahhoud Carson, Biljana Cvetkovski, Janet M. Davies, Vicky Kritikos, Robyn O'Hehir, Brian Oliver, House Rachel Tan, Jessica Tattersall, Celia Zubrinich, Werner Aberer, Verena Niederberger-Leppin, Isabella Pali-Schöll, Virginie Doyen, Didier Ebo, Renaud Louis, Philippe Rombaux, Sophie Scheire, Kazi Bennoor, Bruno A. Barreto, Paulo Camargos, Herberto Jose Chong-Neto, Alvaro A. Cruz, Jane da Silva, Guidacci Marta, José Angelo Rizzo, Nelson Rosario Filho, Sarquis Serpa Faradiba, Dirceu Solé, Marilyn Urrutia-Pereira, George Christoff, Mandazhieva-Pepelanova Mariana, Odjakova Cvetanka, Todor A. Popov, Dilyana Vicheva, do Ceu Teixeira Maria, Jacques Bouchard, Jan Brozek, Derek K. Chu, Judah Denburg, Thomas Eiwegger, Paul K. Keith, Teresa To, Susan Waserman, Nancy Abusada, Emilio Alvarez Cuesta, Mario A. Calvo-Gil, Maria Antonieta Guzmán, Tamara Pérez Gomez, Wing Kin Wong Gary, Luo Zhang, Luis Caraballo, Alfonso Cepeda Sarabia, Dieudonné Nyembue, Manuel Soto-Martinez, Neven Miculinic, Davor Plavec, Constantinos Pitsios, Panayiotis Yiallouros, Petr Panzner, Milan Sova, Martina Vachova, Carsten Bindslev-Jensen, Ronald Dahl, Hans-Jorgen Malling, Lars Münter, Lars K. Poulsen, Suppli Ulrik Charlotte, Line Kring Tannert, Bassam Mahboub, Laila Salameh, Ivan Cherrez-Ojeda, de Guevara Karla Robles, Rasha Hassan El-Owaidy, Zeinab A. El-Sayed, Shereen Saad El-Sayed, Elham Hossny, Badr Eldin Mostafa, Kaja Julge, Nils Eric Billo, Patrik Eklund, Marina Erhola, Tari Haahtela, Jussi Karjalainen, Mika Makela, Sanna Toppila-Salmi, Erkka Valovirta, Tuula Vasankari, Isabella Annesi-Maesano, Isabelle Bossé, Melisande Bourgoin-Heck, Denis Charpin, André Coste, Frédéric de Blay, Philippe Devillier, Alain Didier, Anh Tuan Dinh-Xuan, Jean-François Fontaine, Jocelyne Just, Rachel Nadif, Nhân Pham-Thi, Bernard Pigearias, Nicolas Roche, Van Ganse Eric, Ekaterine Chkhartishvili, Amiran Gamkrelidze, Maia Gotua, Sven Becker, Karl-Christian Bergmann, Thomas Bieber, Randolf Brehler, Roland Buhl, Adam M. Chaker, Ulf Darsow, Eckard Hamelmann, Joachim Heinrich, Thomas Keil, Ludger Klimek, Pavel Kolkhir, Susanne Lau, Marcus Maurer, Ralph Mösges, Angelos Neou, Oliver Pfaar, Johannes Ring, Martin Wagenmann, Torsten Zuberbier, Aiste Ramanauskaite, Anja Lingnau, Demetrios Christou, Sophia Neisinger, Xenophon Aggelidis, Jannis Constantinidis, Maria Dimou, Christos Grigoreas, Trisevgeni Kapsali, Michael Katotomichelakis, Stelios Loukides, Michael Makris, Emmanouil Manousakis, Nikolaos Mikos, Aris Pagkalos, Nikolaos G. Papadopoulos, Vasileios Papanikolaou, Giannis Paraskevopoulos, Konstantina Piskou, Emmanuel Prokopakis, Fotios Psarros, Konstantinos Samitas, Sofia Stamataki, Evangelia Stefanaki Lina, Ekaterini Syrigou, Ioanna Tsiligianni, Mina Vallianatou, Dimitrios Vourdas, Paraskevi Xepapadaki, Aspasia Karavelia, Fanny Wai San Ko, Gary Wong, Andor Hirschberg, Helga Kraxner, Kristof Nekam, Stephen Lane, Menachem Rottem, Cristina Artesani Maria, Simona Barbaglia, Bianca Beghé, Beatrice Bilo Maria, Attilio Boner, Matteo Bonini, Sergio Bonini, Fulvio Braido, Luisa Brussino, G Walter Canonica, Lorenzo Cecchi, Giorgio Ciprandi, Enrico Compalati, Gennaro D'Amato, Giulia De Feo, Stefano Del Giacco, Alessandro Fiocchi, Enrico Heffler, Carlo Lombardi, Riccardo Monti, Antonella Muraro, Eustachio Nettis, Stefania Nicola, Giovanni Passalacqua, Vincenzo Patella, Francesca Puggioni, Giovanni Rolla, Antonino Romano, Nicola Scichilone, Massimo Triggiani, Teresa Ventura Maria, Giovanni Viegi, Cristina Boccabella, Mattia Giovannini, Anand Mahesh Padukudru, Tomohisa Iinuma, Ken Ohta, Yoshitaka Okamoto, Kimihiro Okubo, Ruby Pawankar, Daiju Sakurai, Maho Suzukawa, Masao Yamaguchi, Zhanat Ispayeva, Yoon-Seok Chang, Hae-Sim Park, Mona Al-Ahmad, Ieva Cirule, Ineta Grisle, Carla Irani, Philip Rouadi, Fares Zaitoun, Ruta Dubakiene, Regina Emuzyte, Violeta Kvedariene, Brigita Gradauskiene, Arunas Valiulis, Markus Ollert, Farah Hannachi, Dejan Dokic, Amir Hamzah Abdul Latiff, Baharudin Abdullah, S.P. Palaniappan, Kent Woo, Stephen Montefort, Martín Bedolla Barajas, María del Carmen Costa Domínguez, Jesús Guillermo Espinoza Contreras, Jose Miguel Fuentes Pèrez, José Luis Gálvez Romero, María de la Luz Hortensia García Cruz, Sandra González Diaz, Yunuen Rocío Huerta Villalobos, Désiree E. Larenas-Linnemann, Jorge Agustin Luna-Pech, Juan José Matta Campos, Daniela Rivero Yeverino, Mónica Rodríguez González, Eréndira Rodríguez Zagal, Battur Lkhagvaa, Sandra Mavale-Manuel, Abrantes Nunes Elizabete, Niels Chavannes, Wytske J. Fokkens, Gerard Koppelman, Anke-Hilse Maitland-van der Zee, Sietze Reitsma, Ramanathan Chandrasekharan, Osman Yusuf, Maria Susana Repka-Ramirez, Juan Carlos Sisul, José E. Gereda, Marysia T. Recto, Slawomir Bialek, Artur Bialoszewski, Marta Chelminska, Radoslaw Gawlik, Ewa Jassem, Marek Jutel, Piotr Kuna, Maciej Kupczyk, Marcin Moniuszko, Marek Niedoszytko, Filip Raciborski, Jan Romantowski, Boleslaw Samolinski, Krzysztof Specjalski, Pedro Carreiro Martins, Jaime Correia de Sousa, Elisio Costa, Joao A. Fonseca, Olga Lourenço, Mario Morais-Almeida, Margarida Pereira Ana, Frederico Regateiro, Carlos Robalo Cordeiro, Jose Rosado Pinto, Bernardo Sousa-Pinto, Luis Taborda Barata, Ana Maria Todo-Bom, José Vieira Rafael, Daniela Carvalho, Maryam Ali Al-Nesf, Ioana Agache, Camelia Berghea Elena, Roxana Bumbacea, Diana Deleanu, Florin Mihaltan, Carmen Panaitescu Bunu, Musa Khaitov, Leyla Namazova-Baranova, Elena Vishneva, Ali Alshaikh Nada, Sanja Dimic-Janjic, Branislava Milenkovic, De Yun Wang, Martin Hrubiško, Natalija Edelbaher, Maja Jošt, Peter Kopac, Mitja Košnik, Nika Lalek, Antonija Poplas Susic, Irma Rozman Sinur, Tanja Soklic Košak, Nadja Triller, Katja Triller, Jure Urbancic, Mihaela Zidarn, Michael Levin, Paul Potter, Heather Zar, Isam Alobid, Aram Anto, Joan Bartra, Irina Bobolea, Paloma Campo, Vicky Cardona, Maria Carriazo Ana, José Antonio Castillo Vizuete, Tomas Chivato, Ignacio Jesus Davila Gonzalez, Joaquim Mullol, Antonio Nieto Garcia, César Picado, Santiago Quirce, Joaquin Sastre, Leticia de las Vecillas, Mikael Benson, Inger Kull, Marianne van Hage, Magnus Wickman, Nikolai Khaltaev, Yousser Mohammad, Pongsakorn Tantilipikorn, Pakit Vichyanond, Cemal Cingi, Bilun Gemicioglu, Ozlem Goksel, Omer Kalayci, Ali Fuat Kalyoncu, Cem Meço, Koyuncu Ilgim Vardaloglu, Arzu Yorgancioglu, Deniz Eyice Karabacak, Bruce Kirenga, Ian Michael Adcock, Hasan S. Arshad, Mike Bewick, Christine Bond, Christopher Brightling, Andrew Bush, Moïses Calderon, Kian Fan Chung, Adnan Custovic, Ratko Djukanovic, Stephen Durham, John Farrell, David Halpin, Michael Hyland, Sebastian Johnston, Brian Lipworth, Alla Nakonechna, David Price, Graham Roberts, Dermot Ryan, Jürgen Schwarze, Aziz Sheikh, Mike Shields, Samantha Walker, Sian Williams, Igor Kaidashev, Andrii Igorevich Kurchenko, Vladyslav Tsaryk, David Bernstein, Jonathan A. Bernstein, Thomas B. Casale, Sharon Chinthrajah, Mark Dykewicz, Gailen D. Marshall, Eli O. Meltzer, Robert M. Naclerio, Alkis Togias, Elina Toskala, Dana Wallace, Dennis M. Williams, Barbara Yawn, Fernan Caballero-Fonseca, Lan Le Thi Tuyet, and Tran Thien Quan Vu

Subjects
Allergic rhinitis, Survey, Professional-patient relation, Immunologic diseases. Allergy, RC581-607
Abstract

Background: Allergic rhinitis (AR) is a highly prevalent disease. We aimed to assess the symptoms that physicians who see patients with AR perceive as the most bothersome in their patients. Methods: We performed a cross-sectional study based on an online questionnaire sent to all members of the Allergic Rhinitis and its Impact on Asthma (ARIA) initiative. The survey included questions on the physicians' perceptions of patients’ AR symptoms as well as of their own AR symptoms. Results: Among 401 respondents, 155 (38.7%) reported having AR. ARIA members reported nasal symptoms to be the most frequent (89.7%) and bothersome (80.0%) symptoms experienced by themselves. Likewise, nasal symptoms were reported by ARIA members as the most frequent (94.8% in members with AR vs 96.0% in members without AR) and bothersome (57.0% in members with AR vs 67.9% in members without AR) in their patients. We found a significant association (p = 0.001) between physicians’ own symptoms and those perceived as the most bothersome in their patients. Conclusion: Physicians perceive nasal symptoms to be the most frequent and the most bothersome symptoms in AR patients. The physicians' personal experiences with AR may influence their perception of patients’ symptoms.

Published
2024
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2. PRevalence of the Eosinophilic Phenotype Among SeveRE asthma patients in Lebanon: results of the PREPARE study

Author

Wajdi Abi Saleh, Zuhair Alameh, Zeina Aoun Bacha, Joudy Bahous, Pierre Bou Khalil, Zahia Chahine, Hassan Chami, Georges Dabar, Hassan Dheiny, Alfred Dib, Dany farhat, Carla Irani, Georges Juvelekian, Nadim Kanj, Bassam Mansour, Moussa Riachi, Mirna Waked, Mohamad Yassine, Carole Youakim, Salah Zeinedine, and Fares Zaitoun

Subjects
Severe asthma, Eosinophilic phenotype, Prevalence, Lebanon, Immunologic diseases. Allergy, RC581-607
Abstract

Abstract Background The prevalence of eosinophilic asthma in Lebanon, one of the most severe phenotypes among severe asthma, is not known. This study aimed at determining the prevalence of the eosinophilic phenotype defined as an eosinophil count ≥ 300 cells/mm3 among severe asthma patients in Lebanon. Methods The Lebanese Chapter of the PREPARE study was a national, multicenter, cross-sectional observational study. Patients aged ≥ 12 years with severe asthma were identified and prospectively enrolled during clinic visits and completed the Global Initiative for Asthma (GINA) assessment of asthma control questionnaire. Patients’ health characteristics were collected from medical records and blood samples were obtained for measurement of serum IgE levels and blood eosinophils count. Results Overall, 101 patients (with mean age of 46.3 ± 17.0 years and 73.27% females) with severe asthma were included and, among them, 37% had eosinophilic phenotype, 67.3% had atopic phenotype with IgE > 100 IU/mL and 25.7% patients had overlapping atopic and eosinophilic phenotypes. Close to 80% had late-onset asthma, beyond 12 years of age, and around 85% had at least one severe exacerbation in the 12 months prior to study enrolment. The majority of participants [64.4%] had uncontrolled asthma, 24.7% had partially controlled symptoms and 10.9% had controlled symptoms. 19.8% of participants were on chronic oral corticosteroids, 78.2% had short course treatment of corticosteroids and all were prescribed a combination of inhaled corticosteroids and long-acting beta-agonist. Conclusions The majority of patients with severe asthma were uncontrolled of which 37% present with an eosinophilic phenotype, which should be taken into consideration for better management of these patients in view of the novel phenotype-specific therapeutic options.

Published
2023
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3. Consensus on diagnosis and management of Hereditary Angioedema in the Middle East: A Delphi initiative

Author

Marcus Maurer, MD, Mohamed Abuzakouk, MD, PhD, Mona Al-Ahmad, MD, Waleed Al-Herz, MD, Hassan Alrayes, MD, Salem Al-Tamemi, MD, Rand Arnaout, MD, Hend Binghadeer, MD, Ravi Gutta, MD, Carla Irani, MD, Hassan Mobayed, MD, Iman Nasr, MD, Hiba Shendi, MD, and Fares Zaitoun, MD, FACAAI

Subjects
Hereditary angioedema, Middle east, Delphi consensus, Immunologic diseases. Allergy, RC581-607
Abstract

Background: Hereditary angioedema (HAE), a potentially life-threatening genetic disorder due to C1 inhibitor deficiency in most cases, is characterized by sudden and/or recurrent attacks of angioedema (subcutaneous/submucosal swellings). The global World Allergy Organization (WAO)/European Academy of Allergy and Clinical Immunology (EAACI) International guideline for HAE management is comprehensive, but the implementation of this guideline may require regional adaptation considering the diversity in disease awareness, type of medical care systems, and access to diagnostics and treatment. The aim of this Delphi initiative was to build on the global guideline and provide regional adaptation to address the concerns and specific needs in the Middle East. Methods: The Consensus panel comprised 13 experts from the Middle East (3 from the United Arab Emirates, 3 from Saudi Arabia, 2 from Lebanon, 2 from Kuwait, 2 from Oman and 1 from Qatar) who have more than 2 decades of experience in allergy and immunology and are actively involved in managing HAE patients. The process that was carried out to reach the consensus recommendation included: 1.) A systematic literature review for articles related to HAE management using Ovid MEDLINE. 2.) The development of a questionnaire by an internationally acclaimed expert, with 10 questions specific to HAE management in the Middle East. 3.) Experts received the questionnaire via email individually and their answers were recorded (email/interview). 4.) A virtual consensus meeting was organized to discuss the questionnaire, make amends if needed, vote, and achieve consensus. Results: The questionnaire comprised 10 questions, each with 2 or more statements/recommendations on which the regional experts voted. A consensus was reached based on a 70% agreement between the participants. The key highlights include: 1) HAE experts in the Middle East emphasized the importance of a positive family history for arriving at a diagnosis of HAE. 2) The number of episodes per month or per 6-month period and severity should be used, together with other markers, to determine the need for prophylaxis. 3) Disease status should be monitored by periodic visits and the use of patient-reported outcome measures such as the angioedema activity score and the angioedema control test. 4) Attenuated androgens and tranexamic acid may be considered for long-term prophylaxis, if lanadelumab, C1-Inhibitor or berotralstat are not available. Conclusion: This consensus recommendation may help to educate healthcare practitioners in the Middle East and unify their approach to the diagnosis and management of HAE.

Published
2023
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4. Digital tools in allergy and respiratory care

Author

Elisabeth Verhoeven, MD, Philip Rouadi, MD, Eliane Abou Jaoude, MD, Mohamed Abouzakouk, MD, Ignacio Ansotegui, MD, Mona Al-Ahmad, MD, Maryam Ali Al-Nesf, MD, Cecilio Azar, MD, Sami Bahna, MD, Lyda Cuervo-Pardo, MD, Zuzana Diamant, MD, Habib Douagui, MD, R. Maximiliano Gómez, MD, Sandra González Díaz, MD, Joseph K. Han, MD, Samar Idriss, MD, Carla Irani, MD, Marilyn Karam, MD, Ludger Klimek, MD, Talal Nsouli, MD, Glenis Scadding, MD, Brent Senior, MD, Pete Smith, MD, Anahí Yáñez, MD, Fares Zaitoun, MD, and Peter W. Hellings, MD

Subjects
E-health, Allergy, Rhinitis, Asthma, Chronic rhinosinusitis, Digital tools, Immunologic diseases. Allergy, RC581-607
Abstract

Patient care in the allergy and respiratory fields is advancing rapidly, offering the possibility of the inclusion of a variety of digital tools that aim to improve outcomes of care. Impaired access to several health care facilities during the COVID-19 pandemic has considerably increased the appetite and need for the inclusion of e-health tools amongst end-users. Consequently, a multitude of different e-health tools have been launched worldwide with various registration and access options, and with a wide range of offered benefits. From the perspective of both patients and healthcare providers (HCPs), as well as from a legal and device-related perspective, several features are important for the acceptance, effectiveness,and long-term use of e-health tools. Patients and physicians have different needs and expectations of how digital tools might be of help in the care pathway. There is a need for standardization by defining quality assurance criteria. Therefore, the Upper Airway Diseases Committee of the World Allergy Organization (WAO) has taken the initiative to define and propose criteria for quality, appeal, and applicability of e-health tools in the allergy and respiratory care fields from a patient, clinician, and academic perspective with the ultimate aim to improve patient health and outcomes of care.

Published
2022
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