Atopic Dermatitis

Key clinical point: Safety is the most valued treatment attribute for adults with moderate-to-severe atopic dermatitis (AD), followed by the mode of administration, whereas monitoring requirements is the least critical attribute.

Major finding: The risk for severe adverse events emerged as the most important attribute (coefficient 0.42; 95% CI 0.36-0.49), followed by the ease of treatment administration with daily oral pills vs biweekly injections (coefficient 0.41, 95% CI 0.35-0.48). Avoiding monitoring for severe adverse events was the least critical attribute (coefficient 0.02; 95% CI −0.03 to 0.07).

Study details: This study included 713 adults with moderate-to-severe AD having Patient-Oriented Eczema Measure scores > 7 or current or prior exposure to systemic treatment who completed the online discrete choice experiment survey for treatment preferences in AD.

Disclosures: This study was sponsored by LEO Pharma. Five authors declared being employees of LEO Pharma or EY Economics Denmark, a paid vendor of LEO Pharma. Some authors declared serving as advisors, consultants, etc., for or receiving research grants, etc., from LEO Pharma and others.

Source: Ameen M, Alhusayen R, Brandi H, et al. Patient preferences in the treatment of moderate-to-severe atopic dermatitis. Acta Derm Venereol. 2024 (Feb 21). doi: 10.2340/actadv.v104.19454 Source

Key clinical point: Safety is the most valued treatment attribute for adults with moderate-to-severe atopic dermatitis (AD), followed by the mode of administration, whereas monitoring requirements is the least critical attribute.

Major finding: The risk for severe adverse events emerged as the most important attribute (coefficient 0.42; 95% CI 0.36-0.49), followed by the ease of treatment administration with daily oral pills vs biweekly injections (coefficient 0.41, 95% CI 0.35-0.48). Avoiding monitoring for severe adverse events was the least critical attribute (coefficient 0.02; 95% CI −0.03 to 0.07).

Study details: This study included 713 adults with moderate-to-severe AD having Patient-Oriented Eczema Measure scores > 7 or current or prior exposure to systemic treatment who completed the online discrete choice experiment survey for treatment preferences in AD.

Disclosures: This study was sponsored by LEO Pharma. Five authors declared being employees of LEO Pharma or EY Economics Denmark, a paid vendor of LEO Pharma. Some authors declared serving as advisors, consultants, etc., for or receiving research grants, etc., from LEO Pharma and others.

Source: Ameen M, Alhusayen R, Brandi H, et al. Patient preferences in the treatment of moderate-to-severe atopic dermatitis. Acta Derm Venereol. 2024 (Feb 21). doi: 10.2340/actadv.v104.19454 Source

Key clinical point: Safety is the most valued treatment attribute for adults with moderate-to-severe atopic dermatitis (AD), followed by the mode of administration, whereas monitoring requirements is the least critical attribute.

Major finding: The risk for severe adverse events emerged as the most important attribute (coefficient 0.42; 95% CI 0.36-0.49), followed by the ease of treatment administration with daily oral pills vs biweekly injections (coefficient 0.41, 95% CI 0.35-0.48). Avoiding monitoring for severe adverse events was the least critical attribute (coefficient 0.02; 95% CI −0.03 to 0.07).

Study details: This study included 713 adults with moderate-to-severe AD having Patient-Oriented Eczema Measure scores > 7 or current or prior exposure to systemic treatment who completed the online discrete choice experiment survey for treatment preferences in AD.

Disclosures: This study was sponsored by LEO Pharma. Five authors declared being employees of LEO Pharma or EY Economics Denmark, a paid vendor of LEO Pharma. Some authors declared serving as advisors, consultants, etc., for or receiving research grants, etc., from LEO Pharma and others.

Source: Ameen M, Alhusayen R, Brandi H, et al. Patient preferences in the treatment of moderate-to-severe atopic dermatitis. Acta Derm Venereol. 2024 (Feb 21). doi: 10.2340/actadv.v104.19454 Source

Key clinical point: Abrocitinib is safe and effective in patients with atopic dermatitis (AD) in daily practice, regardless of their previous inadequate response to upadacitinib or dupilumab.

Major finding: At week 28, 57.6% of patients achieved a ≥75% reduction in the Eczema Area and Severity Index (EASI) scores. At week 16, no significant difference was observed in the EASI scores between nonresponders and patients naive or responsive to upadacitinib or dupilumab (all P > .05). Most adverse events (81.6%) were mild in severity.

Study details: This multicenter prospective study included 103 patients with AD from the BioDay registry who did or did not exhibit adequate response to previous dupilumab or upadacitinib treatment and received abrocitinib for ≤28 weeks.

Disclosures: The BioDay registry was sponsored by Eli Lilly, Sanofi Genzyme, Leo Pharma, AbbVie, and Pfizer. Seven authors reported being consultants, speakers, etc., for or having other ties with various sources, including the aforementioned organizations. The other authors had nothing to disclose.

Source: Kamphuis E, Boesjes CM, Loman L, et al. Real-world experience of abrocitinib treatment in patients with atopic dermatitis and hand eczema: Up to 28-week results from the BioDay Registry. Acta Derm Venereol. 2024 (Feb 7). Doi: 10.2340/actadv.v104.19454 Source

Key clinical point: Abrocitinib is safe and effective in patients with atopic dermatitis (AD) in daily practice, regardless of their previous inadequate response to upadacitinib or dupilumab.

Major finding: At week 28, 57.6% of patients achieved a ≥75% reduction in the Eczema Area and Severity Index (EASI) scores. At week 16, no significant difference was observed in the EASI scores between nonresponders and patients naive or responsive to upadacitinib or dupilumab (all P > .05). Most adverse events (81.6%) were mild in severity.

Study details: This multicenter prospective study included 103 patients with AD from the BioDay registry who did or did not exhibit adequate response to previous dupilumab or upadacitinib treatment and received abrocitinib for ≤28 weeks.

Disclosures: The BioDay registry was sponsored by Eli Lilly, Sanofi Genzyme, Leo Pharma, AbbVie, and Pfizer. Seven authors reported being consultants, speakers, etc., for or having other ties with various sources, including the aforementioned organizations. The other authors had nothing to disclose.

Source: Kamphuis E, Boesjes CM, Loman L, et al. Real-world experience of abrocitinib treatment in patients with atopic dermatitis and hand eczema: Up to 28-week results from the BioDay Registry. Acta Derm Venereol. 2024 (Feb 7). Doi: 10.2340/actadv.v104.19454 Source

Key clinical point: Abrocitinib is safe and effective in patients with atopic dermatitis (AD) in daily practice, regardless of their previous inadequate response to upadacitinib or dupilumab.

Major finding: At week 28, 57.6% of patients achieved a ≥75% reduction in the Eczema Area and Severity Index (EASI) scores. At week 16, no significant difference was observed in the EASI scores between nonresponders and patients naive or responsive to upadacitinib or dupilumab (all P > .05). Most adverse events (81.6%) were mild in severity.

Study details: This multicenter prospective study included 103 patients with AD from the BioDay registry who did or did not exhibit adequate response to previous dupilumab or upadacitinib treatment and received abrocitinib for ≤28 weeks.

Disclosures: The BioDay registry was sponsored by Eli Lilly, Sanofi Genzyme, Leo Pharma, AbbVie, and Pfizer. Seven authors reported being consultants, speakers, etc., for or having other ties with various sources, including the aforementioned organizations. The other authors had nothing to disclose.

Source: Kamphuis E, Boesjes CM, Loman L, et al. Real-world experience of abrocitinib treatment in patients with atopic dermatitis and hand eczema: Up to 28-week results from the BioDay Registry. Acta Derm Venereol. 2024 (Feb 7). Doi: 10.2340/actadv.v104.19454 Source

Key clinical point: Atopic dermatitis (AD) does not have a significant association with the development of photodermatoses, including photosensitivity, photoallergy, and contact allergy.

Major finding: Of the phototested patients, 23 had a history of AD, of whom 52.2% were photosensitive and 34.8% were photopatch test-positive. Phototested patients with and without AD showed no significant differences in terms of the development of photosensitivity (P = .61), photoallergy (P = .25), or contact allergy (P = .74).

Study details: Findings are from a 10-year retrospective cohort study including 101 patients with or without a history of AD who were tested for sensitivity to UV-A, UV-B, and visible light, followed by photopatch or contact patch testing if photoallergy or simple contact dermatitis was suspected.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Afvari S and Zippin JH. Photodermatoses in patients with atopic dermatitis: A 10-year retrospective cohort study. J Am Acad Dermatol. 2024 (Feb 18). doi: 10.1016/j.jaad.2024.01.032 Source

Key clinical point: Atopic dermatitis (AD) does not have a significant association with the development of photodermatoses, including photosensitivity, photoallergy, and contact allergy.

Major finding: Of the phototested patients, 23 had a history of AD, of whom 52.2% were photosensitive and 34.8% were photopatch test-positive. Phototested patients with and without AD showed no significant differences in terms of the development of photosensitivity (P = .61), photoallergy (P = .25), or contact allergy (P = .74).

Study details: Findings are from a 10-year retrospective cohort study including 101 patients with or without a history of AD who were tested for sensitivity to UV-A, UV-B, and visible light, followed by photopatch or contact patch testing if photoallergy or simple contact dermatitis was suspected.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Afvari S and Zippin JH. Photodermatoses in patients with atopic dermatitis: A 10-year retrospective cohort study. J Am Acad Dermatol. 2024 (Feb 18). doi: 10.1016/j.jaad.2024.01.032 Source

Key clinical point: Atopic dermatitis (AD) does not have a significant association with the development of photodermatoses, including photosensitivity, photoallergy, and contact allergy.

Major finding: Of the phototested patients, 23 had a history of AD, of whom 52.2% were photosensitive and 34.8% were photopatch test-positive. Phototested patients with and without AD showed no significant differences in terms of the development of photosensitivity (P = .61), photoallergy (P = .25), or contact allergy (P = .74).

Study details: Findings are from a 10-year retrospective cohort study including 101 patients with or without a history of AD who were tested for sensitivity to UV-A, UV-B, and visible light, followed by photopatch or contact patch testing if photoallergy or simple contact dermatitis was suspected.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Afvari S and Zippin JH. Photodermatoses in patients with atopic dermatitis: A 10-year retrospective cohort study. J Am Acad Dermatol. 2024 (Feb 18). doi: 10.1016/j.jaad.2024.01.032 Source

Key clinical point: Dupilumab led to rapid and significant improvements in atopic dermatitis (AD) signs and symptoms in children, including those who failed to attain clear or almost clear skin according to Investigator's Global Assessment (IGA).

Major finding: At week 16, the composite endpoint, including ≥50% improvement in Eczema Area and Severity Index scores, was achieved by significantly more children receiving dupilumab vs placebo in the overall group (77.7% vs 24.6%; P < .0001) and the subgroup with an IGA score > 1 (68.9% vs 21.5%; P < .0001). Significant improvements were observed as early as week 2.

Study details: This post hoc analysis of LIBERTY AD PRESCHOOL (Part B) included 162 children age 6 months to 5 years with moderate-to-severe AD who were randomized to receive dupilumab or placebo and low-potency topical corticosteroids, of whom 136 had an IGA score > 1.

Disclosures: This study was sponsored by Sanofi and Regeneron Pharmaceuticals Inc. Three authors reported being employees of or owning stocks or stock options in Sanofi or Regeneron. The remaining authors reported receiving grants from or having other ties with Sanofi, Regeneron, or others.

Source: Cork MJ, Lockshin B, Pinter A, et al. Clinically meaningful responses to dupilumab among children aged 6 months to 5 years with moderate-to-severe atopic dermatitis who did not achieve clear or almost clear skin according to the investigator's global assessment: A post hoc analysis of a phase 3 trial. Acta Derm Venereol. 2024 (Feb 12). doi: 10.2340/actadv.v104.13467 Source

Key clinical point: Dupilumab led to rapid and significant improvements in atopic dermatitis (AD) signs and symptoms in children, including those who failed to attain clear or almost clear skin according to Investigator's Global Assessment (IGA).

Major finding: At week 16, the composite endpoint, including ≥50% improvement in Eczema Area and Severity Index scores, was achieved by significantly more children receiving dupilumab vs placebo in the overall group (77.7% vs 24.6%; P < .0001) and the subgroup with an IGA score > 1 (68.9% vs 21.5%; P < .0001). Significant improvements were observed as early as week 2.

Study details: This post hoc analysis of LIBERTY AD PRESCHOOL (Part B) included 162 children age 6 months to 5 years with moderate-to-severe AD who were randomized to receive dupilumab or placebo and low-potency topical corticosteroids, of whom 136 had an IGA score > 1.

Disclosures: This study was sponsored by Sanofi and Regeneron Pharmaceuticals Inc. Three authors reported being employees of or owning stocks or stock options in Sanofi or Regeneron. The remaining authors reported receiving grants from or having other ties with Sanofi, Regeneron, or others.

Source: Cork MJ, Lockshin B, Pinter A, et al. Clinically meaningful responses to dupilumab among children aged 6 months to 5 years with moderate-to-severe atopic dermatitis who did not achieve clear or almost clear skin according to the investigator's global assessment: A post hoc analysis of a phase 3 trial. Acta Derm Venereol. 2024 (Feb 12). doi: 10.2340/actadv.v104.13467 Source

Key clinical point: Dupilumab led to rapid and significant improvements in atopic dermatitis (AD) signs and symptoms in children, including those who failed to attain clear or almost clear skin according to Investigator's Global Assessment (IGA).

Major finding: At week 16, the composite endpoint, including ≥50% improvement in Eczema Area and Severity Index scores, was achieved by significantly more children receiving dupilumab vs placebo in the overall group (77.7% vs 24.6%; P < .0001) and the subgroup with an IGA score > 1 (68.9% vs 21.5%; P < .0001). Significant improvements were observed as early as week 2.

Study details: This post hoc analysis of LIBERTY AD PRESCHOOL (Part B) included 162 children age 6 months to 5 years with moderate-to-severe AD who were randomized to receive dupilumab or placebo and low-potency topical corticosteroids, of whom 136 had an IGA score > 1.

Disclosures: This study was sponsored by Sanofi and Regeneron Pharmaceuticals Inc. Three authors reported being employees of or owning stocks or stock options in Sanofi or Regeneron. The remaining authors reported receiving grants from or having other ties with Sanofi, Regeneron, or others.

Source: Cork MJ, Lockshin B, Pinter A, et al. Clinically meaningful responses to dupilumab among children aged 6 months to 5 years with moderate-to-severe atopic dermatitis who did not achieve clear or almost clear skin according to the investigator's global assessment: A post hoc analysis of a phase 3 trial. Acta Derm Venereol. 2024 (Feb 12). doi: 10.2340/actadv.v104.13467 Source

Key clinical point: Both the age of onset and persistence of atopic dermatitis (AD) are differentially associated with the expression and progression of other atopic diseases during childhood.

Major finding: Children who developed AD at 1 year of age (persistent AD) showed significantly higher rates of food allergy (P = .004), asthma (P < .001), and self-reported rhinitis (P < .001) during childhood compared with children without AD at age 1 year (none/intermittent AD [never had AD or had an intermittent course] or late-onset AD [onset from 4-6 years of age]).

Study details: This study included 285 children from the Childhood Origins of ASThma cohort with a history of physician-diagnosed asthma or respiratory allergies who were followed up to 18 years of age and categorized based on AD phenotypes into none/intermittent (n = 180), late-onset (n = 38), or persistent (n = 67) AD groups.

Disclosures: This study was funded by the US National Institutes of Health (NIH) and the US National Heart, Lung, and Blood Institute. Two authors declared receiving funding from or having other ties with various sources, including NIH.

Source: Taki MH, Lee KE, Gangnon R, et al. Atopic dermatitis phenotypes impact expression of atopic diseases despite similar mononuclear cell cytokine responses. J Allergy Clin Immunol. 2024 (Mar 2). doi: 10.1016/j.jaci.2024.02.015 Source

Key clinical point: Both the age of onset and persistence of atopic dermatitis (AD) are differentially associated with the expression and progression of other atopic diseases during childhood.

Major finding: Children who developed AD at 1 year of age (persistent AD) showed significantly higher rates of food allergy (P = .004), asthma (P < .001), and self-reported rhinitis (P < .001) during childhood compared with children without AD at age 1 year (none/intermittent AD [never had AD or had an intermittent course] or late-onset AD [onset from 4-6 years of age]).

Study details: This study included 285 children from the Childhood Origins of ASThma cohort with a history of physician-diagnosed asthma or respiratory allergies who were followed up to 18 years of age and categorized based on AD phenotypes into none/intermittent (n = 180), late-onset (n = 38), or persistent (n = 67) AD groups.

Disclosures: This study was funded by the US National Institutes of Health (NIH) and the US National Heart, Lung, and Blood Institute. Two authors declared receiving funding from or having other ties with various sources, including NIH.

Source: Taki MH, Lee KE, Gangnon R, et al. Atopic dermatitis phenotypes impact expression of atopic diseases despite similar mononuclear cell cytokine responses. J Allergy Clin Immunol. 2024 (Mar 2). doi: 10.1016/j.jaci.2024.02.015 Source

Key clinical point: Both the age of onset and persistence of atopic dermatitis (AD) are differentially associated with the expression and progression of other atopic diseases during childhood.

Major finding: Children who developed AD at 1 year of age (persistent AD) showed significantly higher rates of food allergy (P = .004), asthma (P < .001), and self-reported rhinitis (P < .001) during childhood compared with children without AD at age 1 year (none/intermittent AD [never had AD or had an intermittent course] or late-onset AD [onset from 4-6 years of age]).

Study details: This study included 285 children from the Childhood Origins of ASThma cohort with a history of physician-diagnosed asthma or respiratory allergies who were followed up to 18 years of age and categorized based on AD phenotypes into none/intermittent (n = 180), late-onset (n = 38), or persistent (n = 67) AD groups.

Disclosures: This study was funded by the US National Institutes of Health (NIH) and the US National Heart, Lung, and Blood Institute. Two authors declared receiving funding from or having other ties with various sources, including NIH.

Source: Taki MH, Lee KE, Gangnon R, et al. Atopic dermatitis phenotypes impact expression of atopic diseases despite similar mononuclear cell cytokine responses. J Allergy Clin Immunol. 2024 (Mar 2). doi: 10.1016/j.jaci.2024.02.015 Source

Key clinical point: Children who later developed atopic dermatitis (AD) had a delayed maturation of the skin microbiome and increased levels of proinflammatory stratum corneum biomarkers before AD onset.

Major finding: Children who did vs did not develop AD later had significantly increased levels of stratum corneum biomarkers (thymus and activation-regulated chemokine, interleukin-18, monocyte chemoattractant protein-1, interleukin-22, etc.; all P ≤ .01) and greater variance over time in the most abundant 14 core amplicon sequence variants (P = .04), indicating delayed establishment of a stable skin microbiome.

Study details: This study longitudinally analyzed the epidermal biomarker levels and microbiome profiles of 50 children who were at a high risk for AD from a previous randomized study, of whom 26% of children developed AD up to month 24.

Disclosures: This study was supported by the BIOMAP project, LA ROCHE-POSAY Laboratoire Pharmaceutique, France, and others. Four authors declared receiving institutional research grants, honoraria for consulting, etc., from or having other ties with various sources.

Source: Fonfara M, Hartmann J, Stölzl D, et al. Stratum corneum and microbial biomarkers precede and characterize childhood atopic dermatitis. J Eur Acad Dermatol Venereol. 2024 (Feb 29). doi: 10.1111/jdv.19932 Source

Key clinical point: Children who later developed atopic dermatitis (AD) had a delayed maturation of the skin microbiome and increased levels of proinflammatory stratum corneum biomarkers before AD onset.

Major finding: Children who did vs did not develop AD later had significantly increased levels of stratum corneum biomarkers (thymus and activation-regulated chemokine, interleukin-18, monocyte chemoattractant protein-1, interleukin-22, etc.; all P ≤ .01) and greater variance over time in the most abundant 14 core amplicon sequence variants (P = .04), indicating delayed establishment of a stable skin microbiome.

Study details: This study longitudinally analyzed the epidermal biomarker levels and microbiome profiles of 50 children who were at a high risk for AD from a previous randomized study, of whom 26% of children developed AD up to month 24.

Disclosures: This study was supported by the BIOMAP project, LA ROCHE-POSAY Laboratoire Pharmaceutique, France, and others. Four authors declared receiving institutional research grants, honoraria for consulting, etc., from or having other ties with various sources.

Source: Fonfara M, Hartmann J, Stölzl D, et al. Stratum corneum and microbial biomarkers precede and characterize childhood atopic dermatitis. J Eur Acad Dermatol Venereol. 2024 (Feb 29). doi: 10.1111/jdv.19932 Source

Key clinical point: Children who later developed atopic dermatitis (AD) had a delayed maturation of the skin microbiome and increased levels of proinflammatory stratum corneum biomarkers before AD onset.

Major finding: Children who did vs did not develop AD later had significantly increased levels of stratum corneum biomarkers (thymus and activation-regulated chemokine, interleukin-18, monocyte chemoattractant protein-1, interleukin-22, etc.; all P ≤ .01) and greater variance over time in the most abundant 14 core amplicon sequence variants (P = .04), indicating delayed establishment of a stable skin microbiome.

Study details: This study longitudinally analyzed the epidermal biomarker levels and microbiome profiles of 50 children who were at a high risk for AD from a previous randomized study, of whom 26% of children developed AD up to month 24.

Disclosures: This study was supported by the BIOMAP project, LA ROCHE-POSAY Laboratoire Pharmaceutique, France, and others. Four authors declared receiving institutional research grants, honoraria for consulting, etc., from or having other ties with various sources.

Source: Fonfara M, Hartmann J, Stölzl D, et al. Stratum corneum and microbial biomarkers precede and characterize childhood atopic dermatitis. J Eur Acad Dermatol Venereol. 2024 (Feb 29). doi: 10.1111/jdv.19932 Source

Key clinical point: The presence of atopic dermatitis (AD) symptoms in children during early life is associated with increased likelihood of pain at 10 years of age, suggesting a prospective influence of AD on pain experiences in children.

Major finding: Children with AD-like symptoms at 6 and 15 months of age had a significantly higher risk of reporting any pain (relative risk [RR] 1.75; 95% CI 1.15-2.66) and multisite pain (RR 1.67; 95% CI 1.18-2.37), respectively, at age 10 years.

Study details: This prospective study analyzed the data of 1302 and 874 children from the Generation XXI birth cohort for AD-like symptoms at ages 6 months and 15 months, respectively, by interviewing parents; data on pain history in the last 3 months at age 10 years was collected using structured questionnaires for parents and children.

Disclosures: This study was funded by the European Regional Development Fund, through COMPETE 2020 Operational Programme 'Competitiveness and Internationalization,' projects at the Univeridade do Porto, Portugal, and others. The authors declared no conflicts of interest.

Source: Gorito V, Brandão M, Azevedo I, et al. Atopic dermatitis in early life and pain at 10 years of age: An exploratory study. Eur J Pediatr. 2024 (Feb 24). doi: 10.1007/s00431-024-05439-0 Source

Key clinical point: The presence of atopic dermatitis (AD) symptoms in children during early life is associated with increased likelihood of pain at 10 years of age, suggesting a prospective influence of AD on pain experiences in children.

Major finding: Children with AD-like symptoms at 6 and 15 months of age had a significantly higher risk of reporting any pain (relative risk [RR] 1.75; 95% CI 1.15-2.66) and multisite pain (RR 1.67; 95% CI 1.18-2.37), respectively, at age 10 years.

Study details: This prospective study analyzed the data of 1302 and 874 children from the Generation XXI birth cohort for AD-like symptoms at ages 6 months and 15 months, respectively, by interviewing parents; data on pain history in the last 3 months at age 10 years was collected using structured questionnaires for parents and children.

Disclosures: This study was funded by the European Regional Development Fund, through COMPETE 2020 Operational Programme 'Competitiveness and Internationalization,' projects at the Univeridade do Porto, Portugal, and others. The authors declared no conflicts of interest.

Source: Gorito V, Brandão M, Azevedo I, et al. Atopic dermatitis in early life and pain at 10 years of age: An exploratory study. Eur J Pediatr. 2024 (Feb 24). doi: 10.1007/s00431-024-05439-0 Source

Key clinical point: The presence of atopic dermatitis (AD) symptoms in children during early life is associated with increased likelihood of pain at 10 years of age, suggesting a prospective influence of AD on pain experiences in children.

Major finding: Children with AD-like symptoms at 6 and 15 months of age had a significantly higher risk of reporting any pain (relative risk [RR] 1.75; 95% CI 1.15-2.66) and multisite pain (RR 1.67; 95% CI 1.18-2.37), respectively, at age 10 years.

Study details: This prospective study analyzed the data of 1302 and 874 children from the Generation XXI birth cohort for AD-like symptoms at ages 6 months and 15 months, respectively, by interviewing parents; data on pain history in the last 3 months at age 10 years was collected using structured questionnaires for parents and children.

Disclosures: This study was funded by the European Regional Development Fund, through COMPETE 2020 Operational Programme 'Competitiveness and Internationalization,' projects at the Univeridade do Porto, Portugal, and others. The authors declared no conflicts of interest.

Source: Gorito V, Brandão M, Azevedo I, et al. Atopic dermatitis in early life and pain at 10 years of age: An exploratory study. Eur J Pediatr. 2024 (Feb 24). doi: 10.1007/s00431-024-05439-0 Source

Key clinical point: Topical Streptococcus postbiotic emollient (strain CX) demonstrated superior efficacy in improving disease activity outcomes and a tolerable safety profile in patients with mild-to-moderate atopic dermatitis (AD).

Major finding: At week 8, a higher percentage of patients in the topical Streptococcus postbiotic emollient vs placebo group (41.5% vs 12.1%; P = .005) achieved an Investigator’s Global Assessment score of 0 or 1 and a reduction of ≥1 point from baseline. No significant safety issues were identified during the study.

Study details: Findings are from a proof-of-concept trial including 98 patients with mild-to-moderate AD (age 12-70 years) who were randomly assigned 2:1 to receive daily topical 1.0% Strain CX postbiotic emollient (n = 65) or placebo (n = 33) for 8 weeks.

Disclosures: This study was supported by the National Research Foundation of Korea grant funded by the Korea government and Cosmax BTI. The authors declared no conflicts of interest.

Source: Kim MS, Kim HJ, Kang SM, Heo YM, Kang J, et al. Efficacy and safety of topical Streptococcus postbiotic emollient in adolescents and adults with mild-to-moderate atopic dermatitis: A randomized, double-blind, vehicle-controlled trial. Allergy. 2024 (Mar 4). doi: 10.1111/all.16077 Source

Key clinical point: Topical Streptococcus postbiotic emollient (strain CX) demonstrated superior efficacy in improving disease activity outcomes and a tolerable safety profile in patients with mild-to-moderate atopic dermatitis (AD).

Major finding: At week 8, a higher percentage of patients in the topical Streptococcus postbiotic emollient vs placebo group (41.5% vs 12.1%; P = .005) achieved an Investigator’s Global Assessment score of 0 or 1 and a reduction of ≥1 point from baseline. No significant safety issues were identified during the study.

Study details: Findings are from a proof-of-concept trial including 98 patients with mild-to-moderate AD (age 12-70 years) who were randomly assigned 2:1 to receive daily topical 1.0% Strain CX postbiotic emollient (n = 65) or placebo (n = 33) for 8 weeks.

Disclosures: This study was supported by the National Research Foundation of Korea grant funded by the Korea government and Cosmax BTI. The authors declared no conflicts of interest.

Source: Kim MS, Kim HJ, Kang SM, Heo YM, Kang J, et al. Efficacy and safety of topical Streptococcus postbiotic emollient in adolescents and adults with mild-to-moderate atopic dermatitis: A randomized, double-blind, vehicle-controlled trial. Allergy. 2024 (Mar 4). doi: 10.1111/all.16077 Source

Key clinical point: Topical Streptococcus postbiotic emollient (strain CX) demonstrated superior efficacy in improving disease activity outcomes and a tolerable safety profile in patients with mild-to-moderate atopic dermatitis (AD).

Major finding: At week 8, a higher percentage of patients in the topical Streptococcus postbiotic emollient vs placebo group (41.5% vs 12.1%; P = .005) achieved an Investigator’s Global Assessment score of 0 or 1 and a reduction of ≥1 point from baseline. No significant safety issues were identified during the study.

Study details: Findings are from a proof-of-concept trial including 98 patients with mild-to-moderate AD (age 12-70 years) who were randomly assigned 2:1 to receive daily topical 1.0% Strain CX postbiotic emollient (n = 65) or placebo (n = 33) for 8 weeks.

Disclosures: This study was supported by the National Research Foundation of Korea grant funded by the Korea government and Cosmax BTI. The authors declared no conflicts of interest.

Source: Kim MS, Kim HJ, Kang SM, Heo YM, Kang J, et al. Efficacy and safety of topical Streptococcus postbiotic emollient in adolescents and adults with mild-to-moderate atopic dermatitis: A randomized, double-blind, vehicle-controlled trial. Allergy. 2024 (Mar 4). doi: 10.1111/all.16077 Source

Key clinical point: Atopic dermatitis (AD) is associated with a higher likelihood of cognitive impairment symptoms involving difficulties in learning or memory, especially in children with neurodevelopmental comorbidities, such as attention-deficit/hyperactivity disorder (ADHD) or learning disability.

Major finding: A significantly greater number of children with vs without AD experienced difficulties with learning (10.8% vs 5.9%) and memory (11.1% vs 5.8%; both P < .001). However, this association was observed only in children with neurodevelopmental disorders (adjusted odds ratio 2.26; 95% CI 1.43-3.57) including ADHD or learning disabilities.

Study details: This cross-sectional study analyzed the data of 7957 children, representing a weighted total of 69,732,807 children without intellectual disabilities from the 2021 US National Health Interview Survey who did (n = 9,223,013) or did not (n = 60,509,794) have AD. The survey randomly selects 1 child per surveyed household for whom a parent or adult caregiver provides information.

Disclosures: This study was supported by a grant to Joy Wan from the US National Institutes of Health. Joy Wan also declared receiving a grant and personal fees from various pharmaceutical companies. The other authors declared no conflicts of interest.

Source: Ma EZ, Chang HR, Radtke S, Wan J. Symptoms of cognitive impairment among children with atopic dermatitis. JAMA Dermatol. 2024 (Mar 6). doi: 10.1001/jamadermatol.2024.0015 Source

Key clinical point: Atopic dermatitis (AD) is associated with a higher likelihood of cognitive impairment symptoms involving difficulties in learning or memory, especially in children with neurodevelopmental comorbidities, such as attention-deficit/hyperactivity disorder (ADHD) or learning disability.

Major finding: A significantly greater number of children with vs without AD experienced difficulties with learning (10.8% vs 5.9%) and memory (11.1% vs 5.8%; both P < .001). However, this association was observed only in children with neurodevelopmental disorders (adjusted odds ratio 2.26; 95% CI 1.43-3.57) including ADHD or learning disabilities.

Study details: This cross-sectional study analyzed the data of 7957 children, representing a weighted total of 69,732,807 children without intellectual disabilities from the 2021 US National Health Interview Survey who did (n = 9,223,013) or did not (n = 60,509,794) have AD. The survey randomly selects 1 child per surveyed household for whom a parent or adult caregiver provides information.

Disclosures: This study was supported by a grant to Joy Wan from the US National Institutes of Health. Joy Wan also declared receiving a grant and personal fees from various pharmaceutical companies. The other authors declared no conflicts of interest.

Source: Ma EZ, Chang HR, Radtke S, Wan J. Symptoms of cognitive impairment among children with atopic dermatitis. JAMA Dermatol. 2024 (Mar 6). doi: 10.1001/jamadermatol.2024.0015 Source

Key clinical point: Atopic dermatitis (AD) is associated with a higher likelihood of cognitive impairment symptoms involving difficulties in learning or memory, especially in children with neurodevelopmental comorbidities, such as attention-deficit/hyperactivity disorder (ADHD) or learning disability.

Major finding: A significantly greater number of children with vs without AD experienced difficulties with learning (10.8% vs 5.9%) and memory (11.1% vs 5.8%; both P < .001). However, this association was observed only in children with neurodevelopmental disorders (adjusted odds ratio 2.26; 95% CI 1.43-3.57) including ADHD or learning disabilities.

Study details: This cross-sectional study analyzed the data of 7957 children, representing a weighted total of 69,732,807 children without intellectual disabilities from the 2021 US National Health Interview Survey who did (n = 9,223,013) or did not (n = 60,509,794) have AD. The survey randomly selects 1 child per surveyed household for whom a parent or adult caregiver provides information.

Disclosures: This study was supported by a grant to Joy Wan from the US National Institutes of Health. Joy Wan also declared receiving a grant and personal fees from various pharmaceutical companies. The other authors declared no conflicts of interest.

Source: Ma EZ, Chang HR, Radtke S, Wan J. Symptoms of cognitive impairment among children with atopic dermatitis. JAMA Dermatol. 2024 (Mar 6). doi: 10.1001/jamadermatol.2024.0015 Source

Sublingual immunotherapy (SLIT) is as safe and effective for high-risk older children and adolescents as oral immunotherapy (OIT) is for infants and preschoolers, according to new research.

Preliminary data from a study of more than 180 pediatric patients with multiple food allergies showed that while most patients had mild symptoms, none experienced a severe grade 4 reaction during the buildup and maintenance phase of SLIT.

In addition, 70% of those tested at the end of the treatment protocol were able to tolerate 300 mg of their allergen, a success rate nearly as high as that for OIT.

The study was published in The Journal of Allergy and Clinical Immunology: In Practice.

SLIT has been used successfully in the treatment of environmental allergens such as grass and tree pollen and dust mites. In this study, researchers decided to test SLIT’s effectiveness and safety in the treatment of food allergies in older children.

“We knew that OIT is very effective and safe in infants and toddlers, but there was literature illustrating that for older, school-age kids and adolescents, OIT is not safe enough, as those older age groups tend to have higher risk of severe reaction during treatment,” senior author Edmond Chan, MD, clinical professor of allergy at the University of British Columbia and pediatric allergist at BC Children’s Hospital, both in Vancouver, British Columbia, Canada, told this news organization. “With that knowledge, we decided to explore SLIT as another first-phase therapy for the older kids.”

The investigators recruited 188 high-risk older children aged 4-18 years for multifood SLIT. Most (61.7%) participants had multiple food allergies. Approximately 68% were male, and the population’s median age was 11.3 years.

Nearly half (48.4%) of participants had atopic dermatitis, 45.2% had asthma, 58.0% had allergic rhinitis, and 2.66% had preexisting eosinophilic esophagitis.

Most (75.0%) of the children were classified as higher risk, and 23 had a history of a grade 3 or 4 reaction before beginning SLIT.

Of the 188 children who were initially enrolled in the study, 173 (92.0%) finished their SLIT buildup phase.

Because the study started when COVID-19 pandemic restrictions were in place, the SLIT protocol mandated that patients be seen virtually. The patients’ caregivers learned how to mix and administer the required doses at home using recipes specially developed by the research team that used products bought at the grocery store.

A wide variety of food allergens were treated, including peanut, other legumes, tree nuts, sesame, other seeds, egg, cow’s milk, fish, wheat, shrimp, and other allergens.

The children built up to 2-mg protein SLIT maintenance over the course of three to five visits under nurse supervision.

After 1-2 years of daily SLIT maintenance, patients were offered a low-dose oral food challenge (OFC; cumulative dose: 300 mg of protein) with the goal of bypassing OIT buildup.

Nearly all patients (93.1%) had symptoms during SLIT buildup, but most were mild grade 1 (52.1%) or 2 (40.4%) reactions. Only one patient had a grade 3 reaction. None of the patients experienced a severe grade 4 reaction.

The most common grade 1 reaction was oral itch, an expected symptom of SLIT, which occurred in 82.7% of the patients.

Four patients (2.10%) received epinephrine during buildup and went to the emergency department. All these patients returned to continue SLIT without further need for epinephrine.

To test the effectiveness of SLIT, the researchers performed 50 low-dose OFCs in 20 patients. Of these food challenges, 35 (70%) were successful, and patients were asked to start daily 300-mg OIT maintenance, thus bypassing OIT buildup.

An additional nine OFCs that were unsuccessful were counseled to self-escalate from 80 mg or higher to 300 mg at home with medical guidance as needed.

“Our preliminary data of 20 patients and 50 low-dose oral food challenges suggest that an initial phase of 1-2 years of 2-mg daily SLIT therapy may be a safe and effective way to bypass the OIT buildup phase without the need for dozens of in-person visits with an allergist,” said Dr. Chan.

“So now we have the best of both worlds. We harness the safety of SLIT for the first 1-2 years, with the effectiveness of OIT for the remainder of the treatment period,” he said.
 

Adds to Evidence

Commenting on the study for this news organization, Julia Upton, MD, associate professor of pediatrics at the University of Toronto, Toronto, Ontario, Canada, said, “This study adds to the evidence that consistent, low exposure to food drives meaningful desensitization far above the daily dose.” Upton did not participate in the research.

“Prior prospective studies in SLIT demonstrated that small single-digit-milligram doses and time greatly increased the threshold of reaction. This real-world report suggests that a way to utilize that threshold increase is by switching to a commonly used maintenance dose of OIT,” said Dr. Upton.

“Although few patients have been assessed for the 300-mg challenge, this study is notable for the age group of 4-18 years, and that many of the patients had reacted to low doses in the past. It also shows that many families are capable of diluting and mixing their own immunotherapy solutions with store-bought foods under the guidance of an experienced allergy clinic,” she added.

“Overall, evidence is building that by various routes, initial small amounts with minimal updoses, plus the tincture of time, may be preferred to multiple frequent updosing from multiple perspectives, including safety, feasibility, cost, and medical resources. It will also be important to understand the preferences and goals of the patient and family as various regimens become more available,” Dr. Upton concluded.

The study was funded by BC Children’s Hospital Foundation. Dr. Chan reported receiving research support from DVB Technologies; has been a member of advisory boards for Pfizer, Miravo, Medexus, Leo Pharma, Kaleo, DBV, AllerGenis, Sanofi, Genzyme, Bausch Health, Avir Pharma, AstraZeneca, ALK, and Alladapt; and was a colead of the CSACI OIT guidelines. Dr. Upton reported research support/grants from Novartis, Regeneron, Sanofi, ALK Abello, DBV Technologies, CIHR, and SickKids Food Allergy and Anaphylaxis Program and fees from Pfizer, ALK Abello, Bausch Health, Astra Zeneca, and Pharming. She serves as an associate editor for Allergy, Asthma & Clinical Immunology and is on the Board of Directors of Canadian Society of Allergy and Clinical Immunology and the Healthcare Advisory Board of Food Allergy Canada.

A version of this article appeared on Medscape.com .

Sublingual immunotherapy (SLIT) is as safe and effective for high-risk older children and adolescents as oral immunotherapy (OIT) is for infants and preschoolers, according to new research.

Preliminary data from a study of more than 180 pediatric patients with multiple food allergies showed that while most patients had mild symptoms, none experienced a severe grade 4 reaction during the buildup and maintenance phase of SLIT.

In addition, 70% of those tested at the end of the treatment protocol were able to tolerate 300 mg of their allergen, a success rate nearly as high as that for OIT.

The study was published in The Journal of Allergy and Clinical Immunology: In Practice.

SLIT has been used successfully in the treatment of environmental allergens such as grass and tree pollen and dust mites. In this study, researchers decided to test SLIT’s effectiveness and safety in the treatment of food allergies in older children.

“We knew that OIT is very effective and safe in infants and toddlers, but there was literature illustrating that for older, school-age kids and adolescents, OIT is not safe enough, as those older age groups tend to have higher risk of severe reaction during treatment,” senior author Edmond Chan, MD, clinical professor of allergy at the University of British Columbia and pediatric allergist at BC Children’s Hospital, both in Vancouver, British Columbia, Canada, told this news organization. “With that knowledge, we decided to explore SLIT as another first-phase therapy for the older kids.”

The investigators recruited 188 high-risk older children aged 4-18 years for multifood SLIT. Most (61.7%) participants had multiple food allergies. Approximately 68% were male, and the population’s median age was 11.3 years.

Nearly half (48.4%) of participants had atopic dermatitis, 45.2% had asthma, 58.0% had allergic rhinitis, and 2.66% had preexisting eosinophilic esophagitis.

Most (75.0%) of the children were classified as higher risk, and 23 had a history of a grade 3 or 4 reaction before beginning SLIT.

Of the 188 children who were initially enrolled in the study, 173 (92.0%) finished their SLIT buildup phase.

Because the study started when COVID-19 pandemic restrictions were in place, the SLIT protocol mandated that patients be seen virtually. The patients’ caregivers learned how to mix and administer the required doses at home using recipes specially developed by the research team that used products bought at the grocery store.

A wide variety of food allergens were treated, including peanut, other legumes, tree nuts, sesame, other seeds, egg, cow’s milk, fish, wheat, shrimp, and other allergens.

The children built up to 2-mg protein SLIT maintenance over the course of three to five visits under nurse supervision.

After 1-2 years of daily SLIT maintenance, patients were offered a low-dose oral food challenge (OFC; cumulative dose: 300 mg of protein) with the goal of bypassing OIT buildup.

Nearly all patients (93.1%) had symptoms during SLIT buildup, but most were mild grade 1 (52.1%) or 2 (40.4%) reactions. Only one patient had a grade 3 reaction. None of the patients experienced a severe grade 4 reaction.

The most common grade 1 reaction was oral itch, an expected symptom of SLIT, which occurred in 82.7% of the patients.

Four patients (2.10%) received epinephrine during buildup and went to the emergency department. All these patients returned to continue SLIT without further need for epinephrine.

To test the effectiveness of SLIT, the researchers performed 50 low-dose OFCs in 20 patients. Of these food challenges, 35 (70%) were successful, and patients were asked to start daily 300-mg OIT maintenance, thus bypassing OIT buildup.

An additional nine OFCs that were unsuccessful were counseled to self-escalate from 80 mg or higher to 300 mg at home with medical guidance as needed.

“Our preliminary data of 20 patients and 50 low-dose oral food challenges suggest that an initial phase of 1-2 years of 2-mg daily SLIT therapy may be a safe and effective way to bypass the OIT buildup phase without the need for dozens of in-person visits with an allergist,” said Dr. Chan.

“So now we have the best of both worlds. We harness the safety of SLIT for the first 1-2 years, with the effectiveness of OIT for the remainder of the treatment period,” he said.
 

Adds to Evidence

Commenting on the study for this news organization, Julia Upton, MD, associate professor of pediatrics at the University of Toronto, Toronto, Ontario, Canada, said, “This study adds to the evidence that consistent, low exposure to food drives meaningful desensitization far above the daily dose.” Upton did not participate in the research.

“Prior prospective studies in SLIT demonstrated that small single-digit-milligram doses and time greatly increased the threshold of reaction. This real-world report suggests that a way to utilize that threshold increase is by switching to a commonly used maintenance dose of OIT,” said Dr. Upton.

“Although few patients have been assessed for the 300-mg challenge, this study is notable for the age group of 4-18 years, and that many of the patients had reacted to low doses in the past. It also shows that many families are capable of diluting and mixing their own immunotherapy solutions with store-bought foods under the guidance of an experienced allergy clinic,” she added.

“Overall, evidence is building that by various routes, initial small amounts with minimal updoses, plus the tincture of time, may be preferred to multiple frequent updosing from multiple perspectives, including safety, feasibility, cost, and medical resources. It will also be important to understand the preferences and goals of the patient and family as various regimens become more available,” Dr. Upton concluded.

The study was funded by BC Children’s Hospital Foundation. Dr. Chan reported receiving research support from DVB Technologies; has been a member of advisory boards for Pfizer, Miravo, Medexus, Leo Pharma, Kaleo, DBV, AllerGenis, Sanofi, Genzyme, Bausch Health, Avir Pharma, AstraZeneca, ALK, and Alladapt; and was a colead of the CSACI OIT guidelines. Dr. Upton reported research support/grants from Novartis, Regeneron, Sanofi, ALK Abello, DBV Technologies, CIHR, and SickKids Food Allergy and Anaphylaxis Program and fees from Pfizer, ALK Abello, Bausch Health, Astra Zeneca, and Pharming. She serves as an associate editor for Allergy, Asthma & Clinical Immunology and is on the Board of Directors of Canadian Society of Allergy and Clinical Immunology and the Healthcare Advisory Board of Food Allergy Canada.

A version of this article appeared on Medscape.com .

Sublingual immunotherapy (SLIT) is as safe and effective for high-risk older children and adolescents as oral immunotherapy (OIT) is for infants and preschoolers, according to new research.

Preliminary data from a study of more than 180 pediatric patients with multiple food allergies showed that while most patients had mild symptoms, none experienced a severe grade 4 reaction during the buildup and maintenance phase of SLIT.

In addition, 70% of those tested at the end of the treatment protocol were able to tolerate 300 mg of their allergen, a success rate nearly as high as that for OIT.

The study was published in The Journal of Allergy and Clinical Immunology: In Practice.

SLIT has been used successfully in the treatment of environmental allergens such as grass and tree pollen and dust mites. In this study, researchers decided to test SLIT’s effectiveness and safety in the treatment of food allergies in older children.

“We knew that OIT is very effective and safe in infants and toddlers, but there was literature illustrating that for older, school-age kids and adolescents, OIT is not safe enough, as those older age groups tend to have higher risk of severe reaction during treatment,” senior author Edmond Chan, MD, clinical professor of allergy at the University of British Columbia and pediatric allergist at BC Children’s Hospital, both in Vancouver, British Columbia, Canada, told this news organization. “With that knowledge, we decided to explore SLIT as another first-phase therapy for the older kids.”

The investigators recruited 188 high-risk older children aged 4-18 years for multifood SLIT. Most (61.7%) participants had multiple food allergies. Approximately 68% were male, and the population’s median age was 11.3 years.

Nearly half (48.4%) of participants had atopic dermatitis, 45.2% had asthma, 58.0% had allergic rhinitis, and 2.66% had preexisting eosinophilic esophagitis.

Most (75.0%) of the children were classified as higher risk, and 23 had a history of a grade 3 or 4 reaction before beginning SLIT.

Of the 188 children who were initially enrolled in the study, 173 (92.0%) finished their SLIT buildup phase.

Because the study started when COVID-19 pandemic restrictions were in place, the SLIT protocol mandated that patients be seen virtually. The patients’ caregivers learned how to mix and administer the required doses at home using recipes specially developed by the research team that used products bought at the grocery store.

A wide variety of food allergens were treated, including peanut, other legumes, tree nuts, sesame, other seeds, egg, cow’s milk, fish, wheat, shrimp, and other allergens.

The children built up to 2-mg protein SLIT maintenance over the course of three to five visits under nurse supervision.

After 1-2 years of daily SLIT maintenance, patients were offered a low-dose oral food challenge (OFC; cumulative dose: 300 mg of protein) with the goal of bypassing OIT buildup.

Nearly all patients (93.1%) had symptoms during SLIT buildup, but most were mild grade 1 (52.1%) or 2 (40.4%) reactions. Only one patient had a grade 3 reaction. None of the patients experienced a severe grade 4 reaction.

The most common grade 1 reaction was oral itch, an expected symptom of SLIT, which occurred in 82.7% of the patients.

Four patients (2.10%) received epinephrine during buildup and went to the emergency department. All these patients returned to continue SLIT without further need for epinephrine.

To test the effectiveness of SLIT, the researchers performed 50 low-dose OFCs in 20 patients. Of these food challenges, 35 (70%) were successful, and patients were asked to start daily 300-mg OIT maintenance, thus bypassing OIT buildup.

An additional nine OFCs that were unsuccessful were counseled to self-escalate from 80 mg or higher to 300 mg at home with medical guidance as needed.

“Our preliminary data of 20 patients and 50 low-dose oral food challenges suggest that an initial phase of 1-2 years of 2-mg daily SLIT therapy may be a safe and effective way to bypass the OIT buildup phase without the need for dozens of in-person visits with an allergist,” said Dr. Chan.

“So now we have the best of both worlds. We harness the safety of SLIT for the first 1-2 years, with the effectiveness of OIT for the remainder of the treatment period,” he said.
 

Adds to Evidence

Commenting on the study for this news organization, Julia Upton, MD, associate professor of pediatrics at the University of Toronto, Toronto, Ontario, Canada, said, “This study adds to the evidence that consistent, low exposure to food drives meaningful desensitization far above the daily dose.” Upton did not participate in the research.

“Prior prospective studies in SLIT demonstrated that small single-digit-milligram doses and time greatly increased the threshold of reaction. This real-world report suggests that a way to utilize that threshold increase is by switching to a commonly used maintenance dose of OIT,” said Dr. Upton.

“Although few patients have been assessed for the 300-mg challenge, this study is notable for the age group of 4-18 years, and that many of the patients had reacted to low doses in the past. It also shows that many families are capable of diluting and mixing their own immunotherapy solutions with store-bought foods under the guidance of an experienced allergy clinic,” she added.

“Overall, evidence is building that by various routes, initial small amounts with minimal updoses, plus the tincture of time, may be preferred to multiple frequent updosing from multiple perspectives, including safety, feasibility, cost, and medical resources. It will also be important to understand the preferences and goals of the patient and family as various regimens become more available,” Dr. Upton concluded.

The study was funded by BC Children’s Hospital Foundation. Dr. Chan reported receiving research support from DVB Technologies; has been a member of advisory boards for Pfizer, Miravo, Medexus, Leo Pharma, Kaleo, DBV, AllerGenis, Sanofi, Genzyme, Bausch Health, Avir Pharma, AstraZeneca, ALK, and Alladapt; and was a colead of the CSACI OIT guidelines. Dr. Upton reported research support/grants from Novartis, Regeneron, Sanofi, ALK Abello, DBV Technologies, CIHR, and SickKids Food Allergy and Anaphylaxis Program and fees from Pfizer, ALK Abello, Bausch Health, Astra Zeneca, and Pharming. She serves as an associate editor for Allergy, Asthma & Clinical Immunology and is on the Board of Directors of Canadian Society of Allergy and Clinical Immunology and the Healthcare Advisory Board of Food Allergy Canada.

A version of this article appeared on Medscape.com .