Dust mite allergy and perennial allergic rhinitis

The most significant contributor to perennial allergic rhinitis (PAR) is dust mite allergy. Reducing exposure to house dust mite seems like an obvious strategy to minimize symptoms in PAR patients, but does it work? In a 2010 update to a Cochrane Review, Sheikh et al. (Cochrane Database of Systematic Reviews 2010, Issue 7. Art. No.: CD001563. DOI: 10.1002/14651858.CD001563.pub3) re-examine the literature to see if anyone else is trying to add more insight into this question. The authors searched the same 4 databases, two Cochrane, Medline and EMBASE, for newly published, randomized trials that evaluate air filtration, pesticides, and barrier bedding as mitigation.

Nine trials of varying quality met inclusion criteria. They didn’t find sufficient numbers and/or rigorously designed trials to permit a meta-analysis, so the authors provide a narrative of their findings. Overall the studies’ results suggest that acaricides along with extensive environmental control via air filtration seem to offer some benefit, but it’s uncertain which method is most effective and to what degree. Sheikh and colleagues are able to state that the evidence is strong that the single intervention of barrier bedding in the patient’s room is not likely to be helpful.

Tell us what you think. Please feel free to post your own comments and/or predictions below. Topics and articles that you think would be of interest in our NBOP section and/or this blog can be sent to the JACI Editorial Office at jaci@njhealth.org.

CoFAR program renewed, expanded

The National Institutes of Health (NIH) announced this week that not only has funding for the Consortium of Food Allergy Research (CoFAR) program been extended for an additional five years, but CoFAR’s scope has also been expanded to include research on eosinophilic gastrointestinal diseases (EGID), which are frequently comorbid with food allergies.

Like food allergies, EGIDs are IgE-mediated. The most common EGID presentation is eosinophilic esophagitis. The EGID studies will be led by Dr. Marc Rothenberg (Cincinnati Children’s Hospital), the co-editor of this section, and include researchers from the University of Colorado, Denver, and Children’s Hospital, Philadelphia.

An additional clinical trial for treatment of peanut allergy has been added to the research program. The new treatment delivers peanut protein transdermally. Further program expansion includes two sites to examine food allergy genetics.

Tell us what you think. Please feel free to post your own comments and/or predictions below. Topics and articles that you think would be of interest in our NBOP section and/or this blog can be sent to the JACI Editorial Office at jaci@njhealth.org.

A new combo product approved for asthma

Last week, Merck & Co.’s Schering Corp. announced that they have received approval from the US Food and Drug Administration for DULERA®, a fixed-dose combination product of mometasone and formoterol, indicated for controller treatment of asthma in patients 12 years and older.

Two controlled studies comparing DULERA® with mometasone and placebo support the FDA’s decision. Merck reports significant increases in FEV1 for the AUC0-12hrs in both trials at week 12, with demonstrated persistence at week 26 in one trial. Side effects were similar to other combination products and include headache, nasopharyngeal irritation, and sinusitis. The black box warning for long-acting β-2 agonists is included in the FDA approval. (For the DULERA® medication guide, click here.) The medication comes in two fixed dose strengths and is expected to be available in the US by the end of this month.

Tell us what you think. Please feel free to post your own comments and/or predictions below. Topics and articles that you think would be of interest in our NBOP section and/or this blog can be sent to the JACI Editorial Office at jaci@njhealth.org.