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Allergy Working Group ERS 2017

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Allergy Working Group ERS 2017

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Allergy Working Group ERS 2017

  1. 1. ERS 2017 Milan, 9th September 2017 Allergy Working Group Meeting
  2. 2. Agenda • Working group progress update • Priorities for future research o Review potential studies o Other research ideas o Setting priorities • Additional items
  3. 3. Attendees • Peter Hellings (chair) • A Azuma • S Turner • A Niimi • Others
  4. 4. Progress update • Published studies o Manise M, Bakayoko B, Schleich F, Corhay JL, Louis R. 2016. IgE mediated sensitization to aeroallergens in an asthmatic cohort: relationship with inflammatory phenotypes and disease severity. The International Journal of Clinical Practice. 70 (7): 596-605
  5. 5. Active study update: Quantify the burden of acute versus chronic rhinosinusitis in routine clinical practice (REG_P001) Objective • Quantify the burden of rhinitis and rhinosinusitus and characterize related management approaches in UK primary care • assess the incidence of acute and chronic rhinosinusitis and rhinitis in current clinical practice • Assess the number of consultations for rhinitis and rhinosinusitis and that result in a prescription of an antibiotic, steroid or antihistamine Methodology Design: Retrospective cohort using OPCRD Population: Consultations coded for rhinitis and rhinosinusitis symptoms resulting in prescriptions for antibiotics, oral steroids and/or antihistamines in the last 5 years.
  6. 6. Results Acute Rhinosinusitis (n=176,353) Antibiotics Oral steroids Nasal Corticosteroid Spray Oral Anti-histamines No medication 71% 19% 0 50,000 100,000 150,000 200,000 250,000 300,000 350,000 Acute Rhinosinusitis Acute Rhinitis Chronic Rhinosinusitis Chronic Allergic Rhinitis Chronic non- allergic Rhinitis Chronic Rhintis (unclear) NumberofPatients No Yes Antibiotics prescribed
  7. 7. Conclusions • In the OPCRD, acute rhinosinusitis consultations make up 35% of all primary care consultations for rhinitis and rhinosinusitis • Interestingly, almost three-quarters of patients (71%) consulting for acute rhinosinusitis and 58% of patients with chronic rhinosinusitis receive an antibiotic prescription Paper in draft format (Prof. Fokkens)
  8. 8. Australian Survey of Allergic Rhinitis Sufferers (REG-RES1615) Aim To build and disseminate a comprehensive picture of the burden and unmet need of allergic rhinitis patients in Australia. Methodology Design: Online survey with discrete choice experiment with patients recruited through specialist recruitment agency Inclusion criteria: • Self-reported diagnosis of allergic rhinitis by a medical professional. • 18 years of age or older • Currently resident in Australia • Able to give informed consent • Able to complete the protocol requirements
  9. 9. Australian Survey of Allergic Rhinitis Sufferers (REG-RES1615) • In total 1151 participants completed the survey, of those 621 (54%) were symptomatic on the day of completing the survey. • Most of the sample (N=1016, 88%) used medication to treat their AR • Most participants (80%) use more than one medication • Two thirds of participants see a doctor or specialist for their AR • Only 13% of participants had received immunotherapy for their AR, this was most commonly for grass pollen (66%) or dust mite (62%) allergies
  10. 10. Australian Survey of Allergic Rhinitis Sufferers (REG-RES1615) • In discrete choice analysis, participants showed a strong preference for: o a treatment that provides complete symptom relief compared to mild symptom relief (OR:12.069; 95% CIs: 10.674 - 13.646; WTP: $73.63) o a treatment that provides moderate symptom relief compared to mild symptom relief (OR:2.584; 95% CIs: 2.431 - 2.747; WTP: $28.07) o a treatment that is taken once a day compared to three times a day (OR: 0.643; CIs: 0.607 – 0.681: WTP: -$13.06) o administration attribute (tablets and nasal spray compared to nasal spray alone) was not a significant predictor of choice
  11. 11. Future interests • Two projects with short proposals • Four other potential project ideas
  12. 12. Working title Burden of allergic diseases Objective 1. Improve understanding of the true burden of allergic disease 2. Gain evidence to inform improved consumer guidance in the future Rationale • A substantial proportion of patients with allergic disease do not present in primary care; instead purchase OTC therapies from the pharmacy. • To understand the true burden of allergic disease there is a need to evaluate the burden of allergic disease presenting in the pharmacy setting as well as in clinical practice. Evaluate the burden of allergic disease study from the multi-stakeholder (primary case, secondary care, pharmacy) perspectives (REG_P016) Proposed by Dermot Ryan; 2016 Proposed methodology Design: Questionnaire based study within the pharmacy setting with digital data collection
  13. 13. Objective 1. To characterise people with asthma in primary care prescribed at least one course of oral steroids in the preceding 12 months based on their medication profile and asthma management practices. 2. To identify the patient-related factors associated with oral steroid use. Proposed methodology Design: This will be a retrospective, real-world, cross-sectional observational study using data extracted from the OPCRD Population: Adult (18-70 years) asthma patients Exclusion criteria: People with a diagnosis of COPD Evaluate the prevalence and clinical implications of comorbid nasal and bronchial hyper responsiveness in patients managed in a range of settings (primary care, specialist/secondary care, pharmacy) (REG_P017) Working title Characterising the factors associated with oral steroid use by patients with asthma in primary care. Proposed by Sinthia Bosnic-Anticevich; 2016 Rationale • Suboptimal asthma medication use is fundamental in poor asthma control. • To date we do not know whether people with asthma make decisions not only about whether they will take their medications, but which medications they chose to take when they experience poor asthma control. • By identifying the factors associated with oral steroid use, we may be able to distinguish patients with severe asthma from those with less severe asthma who have inappropriate asthma management practices.
  14. 14. Potential projects with no proposals • REG_P018: Real-world effectiveness of allergen immunotherapy • Link between severe asthma and allergic/nasal symptoms o REG to look at questions on ISAR dataset, and in OPCRD. • EUFOREA App: o Potential validation study through REG allergy working group. Overlap with Technologies and Asthma working groups. • REG project to validate EUFOREA clinical project on reasons for uncontrolled disease. o Study nearly completed
  15. 15. Other research ideas? • Real-life impact of sinus surgery on the following relevant parameters o Asthma o Oral AB/CS use o Absenteism • Exploratory study on the patients’ ideas / feedback on mHealth tools and what these tools could mean for them o Rhinosinusitis o Astma
  16. 16. Setting priorities • Are these projects still: o Relevant? o Feasible? o Valid? o A priority? • How do we set priorities in allergy research? o Close collaboration with patients / organizations o Brainstorming during ERRF, Nov. 2017 • How to we ensure these priorities are pursued? o Project leader + post-doctoral researcher + REG responsible per project • What are the two most important projects to push forwards? o MySinusitisCoach
  17. 17. Any other business?