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  • Diagnosis and Management of Asthma in Adults: A Review

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    JAMA. 2017; 318(3):279-290. doi: 10.1001/jama.2017.8372

    This review describes the characteristics of asthma and presents an evidence-based approach to the diagnosis and management of mild to moderate stable asthma in adults.

  • Reducing Exposure to Mouse Allergen Among Children and Adolescents With Asthma Is Achievable, but Is It Enough?

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    JAMA. 2017; 317(10):1023-1025. doi: 10.1001/jama.2016.21181
  • Effect of an Integrated Pest Management Intervention on Asthma Symptoms Among Mouse-Sensitized Children and Adolescents With Asthma: A Randomized Clinical Trial

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    JAMA. 2017; 317(10):1027-1036. doi: 10.1001/jama.2016.21048

    This randomized clinical trial compares the effects of an integrated pest management intervention vs pest management education alone on asthma symptoms among mouse-sensitized and exposed children and adolescents with asthma living in Baltimore, Maryland, and Boston, Massachusetts.

  • JAMA February 14, 2017

    Figure 4: Time Course of Early and Late Skin Responses to Intradermal Allergen, Changes in Serum Grass Pollen Allergen–Specific Immunoglobulin E, and Immunoglobulin G4

    Data are once-yearly mean values for all participants. Early skin response was recorded at 15 minutes and late skin response was recorded at 8 hours. Skin responses were analyzed using analysis of covariance with adjustment for baseline values in the modified intent-to-treat population of 33 sublingual immunotherapy (SLIT) participants, 33 placebo participants, and 34 subcutaneous immunotherapy (SCIT) participants at year 1; 31 SLIT participants, 32 placebo participants, and 32 SCIT participants at year 2; 30 SLIT participants, 31 placebo participants, and 31 SCIT participants at year 3 (eTable 4a and eTable 4b in Supplement 1). Serum allergen–specific immunoglobulin parameters were analyzed in the per-protocol population of 27 SLIT, 30 placebo, and 27 SCIT participants at all time points using a linear mixed model with adjustment for baseline values. Serum allergen–specific immunoglobulin responses were plotted after log transformation for normalization of these variables. The per-protocol sample included participants who were adherent with study medications (taking ≥50% of study medication for study duration) and who had an assessment of the primary end point. All comparisons for skin and serum allergen–specific immunoglobulin responses between treatment groups at years 1, 2, and 3 have P values less than .01, with the following exceptions: early skin responses between SLIT and SCIT at year 2 (P = .02) and year 3 (P = .94), specific immunoglobulin E between SLIT and placebo at year 2 (P = .04) and year 3 (P = .32), and between SCIT and placebo at year 1 (P = .10) (eTable 5a and eTable 5b in Supplement 1).
  • JAMA February 14, 2017

    Figure 2: Time Course of Changes After Nasal Allergen Challenge for Total Nasal Symptom Scores and Peak Nasal Inspiratory Flow

    Data are reported as mean values for all participants. Total Nasal Symptom Scores (TNSS) and peak nasal inspiratory flow (PNIF) were analyzed in the modified intent-to-treat population of 34 sublingual immunotherapy (SLIT) participants, 33 placebo participants, and 33 subcutaneous immunotherapy (SCIT) participants at year 1; 31 SLIT participants, 32 placebo participants, and 32 SCIT participants at year 2; and 30 SLIT participants, 31 placebo participants, and 31 SCIT participants at year 3. A, A higher TNSS indicates a higher burden of symptoms during the nasal challenge (range, 0 [best] to 12 [worst]). Mean scores for the TNSS are reported in Table 2. The P values compare the TNSS area under the curve (AUC) between treatment groups (calculated using an analysis of covariance [ANCOVA] model at at the 0.05 level of significance adjusted for pretreatment baseline AUC measures [minimal clinically important difference for this measure within a participant was 1.08]). B, A larger change in PNIF indicates a higher burden of symptoms during the nasal challenge. Change (liters/min) was defined relative to the 0 time point in the challenge. Mean values for the change in PNIF are reported in eTable 1 (in Supplement 1). The P values compare the delta PNIF AUC between treatment groups (calculated using an ANCOVA model at the 0.05 level of significance adjusted for pretreatment baseline AUC measures [minimal clinically important difference for this measure within a participant was 33.9]).
  • Effect of 2 Years of Treatment With Sublingual Grass Pollen Immunotherapy on Nasal Response to Allergen Challenge at 3 Years Among Patients With Moderate to Severe Seasonal Allergic Rhinitis: The GRASS Randomized Clinical Trial

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    JAMA. 2017; 317(6):615-625. doi: 10.1001/jama.2016.21040

    This randomized clinical trial compares the effects of 2 years of sublingual grass pollen immunotherapy vs placebo on nasal symptom scores in adults with moderate to severe seasonal allergic rhinitis.

  • New Horizons in Allergen Immunotherapy

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    JAMA. 2016; 315(16):1711-1712. doi: 10.1001/jama.2016.4078
  • Efficacy of a House Dust Mite Sublingual Allergen Immunotherapy Tablet in Adults With Allergic Asthma: A Randomized Clinical Trial

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    JAMA. 2016; 315(16):1715-1725. doi: 10.1001/jama.2016.3964

    This randomized clinical trial compares the efficacy and adverse events of house dust mite sublingual allergen immunotherapy vs placebo for asthma exacerbations in adults with allergic asthma during an inhaled corticosteroid reduction period.

  • JAMA April 26, 2016

    Figure 1: Participant Disposition Throughout the Trial

    ACQ indicates Asthma Control Questionnaire; FEV1, forced expiratory volume in the first second of expiration; ICS, inhaled corticosteroids; IgE, immunoglobulin E; SPT, skin prick test. The biological activity of the house dust mite sublingual allergen immunotherapy tablet is related to the activity of the allergens and is expressed in the unit SQ-HDM.aMore than 1 criterion could apply to each individual.bPeriod 2, in which participants received the intervention as an add-on to ICS, lasted 7 to 12 months; period 3, in which participants began ICS reduction/withdrawal, lasted 6 months.cThe protocol defined that, following an asthma exacerbation, participants were offered to continue in the trial at an adjusted ICS dose and provide data to secondary end points. The participants discontinuing the trial following an exacerbation were considered to have completed the trial (26 participants in the 6 SQ-HDM group, 22 in the 12 SQ-HDM group, and 28 in the placebo group).
  • JAMA April 26, 2016

    Figure 2: Probability of Having the First Moderate or Severe Asthma Exacerbation in the Full Analysis Set

    ICS indicates inhaled corticosteroid. The biological activity of the house dust mite sublingual allergen immunotherapy tablet is related to the activity of the allergens and is expressed in the unit SQ-HDM. At the end of the 6-month efficacy assessment period, the 6 SQ-HDM and 12 SQ-HDM tablets significantly reduced the risk of a moderate or severe asthma exacerbation compared with placebo (hazard ratios: 0.69 [95% CI, 0.49-0.96] for the 6 SQ-HDM group, P = .03, and 0.66 [95% CI, 0.47-0.93] for the 12 SQ-HDM group, P = .02; absolute risk for first exacerbation: 24% for the 6 SQ-HDM group [n = 62], 24% for the 12 SQ-HDM group [n = 59], 33% for the placebo group [n = 83]; risk difference vs placebo: 9% [95% CI, 1%-15%] for the 6 SQ-HDM group and 10% [95% CI, 2%-16%] for the 12 SQ-HDM group). There was no significant difference between the 2 active groups (hazard ratio, 0.96 [95% CI, 0.68-1.37], P = .84).
  • FDA Approves First Sublingual Therapies for Allergic Rhinitis

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    JAMA. 2014; 311(20):2057-2057. doi: 10.1001/jama.2014.5757
  • Selections From News@JAMA and JAMA Forum

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    JAMA. 2013; 309(19):1983-1983. doi: 10.1001/jama.2013.5120
  • Sublingual Immunotherapy for the Treatment of Allergic Rhinoconjunctivitis and Asthma: A Systematic Review

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    JAMA. 2013; 309(12):1278-1288. doi: 10.1001/jama.2013.2049
    Lin and coauthors report on the use of sublingual immunotherapy as a treatment for allergic rhinoconjunctivitis and asthma. In an accompanying Editorial, Nelson discusses whether sublingual immuotherapy is ready for use in the United States.
  • JAMA January 25, 2012

    Figure: Treatment Rather Than Avoidance May Be Within Reach for Children With Food Allergies

    Scientists studying allergies to foods such as peanuts, tree nuts, milk, eggs, wheat, shellfish, and fish are investigating ways to induce tolerance to food allergens in affected individuals.
  • JAMA February 10, 2010

    Figure: New Item on Pediatric Menu: Food Allergy

    Most physicians know that peanuts are among the 3 most common food allergens in children. Yet many feel they are not adequately trained to care for children with food allergies.
  • JAMA April 12, 2006

    Figure: NIH Initiatives to Probe Contribution of Genes, Environment in Disease

    Two new initiatives aim to speed research into how such environmental factors as allergens (pictured above), pollution, metals, and diet contribute to common human diseases.
  • Food Allergens

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    JAMA. 2006; 295(8):880-880. doi: 10.1001/jama.295.8.880-b
  • Pet Allergens in Homes

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    JAMA. 2004; 292(8):916-916. doi: 10.1001/jama.292.8.916-c
  • Exposure to Dogs and Cats in the First Year of Life and Risk of Allergic Sensitization at 6 to 7 Years of Age

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    JAMA. 2002; 288(8):963-972. doi: 10.1001/jama.288.8.963
  • Detection of Peanut Allergens in Breast Milk of Lactating Women

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    JAMA. 2001; 285(13):1746-1748. doi: 10.1001/jama.285.13.1746