Asthma care and responses to recombinant C1 esterase inhibitor infusions
The April issue of the Annals of Allergy, asthma and Immunology has many different features that will inform, challenge and (at least sometimes) entertain our readers. Two articles in particular are worth mentioning.
The first is an extremely timely article by Dr. Butz and colleagues from Johns Hopkins and the University of Maryland. It looks for factors associated with proper guideline-based care and controller medication adherence for inner-city children who had high emergency department utilization during a three-year clinical trial. They found being involved with asthma specialty care, having an allergy profile that was positive for ragweed and negative for dust mite sensitivity, and caregivers who reported minimal worry about negative side effects from medication (i.e. steroids), were associated with increased medication adherence. This study reconfirms the notion that asthma specialists really do make important positive impact on asthma patient clinical conditions.
Another paper of note in the April issue is by Dr. Bernstein and colleagues reporting on the clinical durability of the response to recombinant C1 esterase inhibitor infusion. This post hoc analysis of two commercial trials revealed that clinical responses (defined as symptom relief), when they occurred, were generally prompt (within four hours) and durable (at least three days). There were, of course, variations in response and durability among the study active group members. This reinforces the continuing need to develop better strategies to select the right agent for the right patient particularly in this potentially life-threatening condition that requires expensive biological therapy.
As always, we welcome your comments and thoughts about the content of the Annals. We continue to strive to make ours the best journal available for the practicing allergist.
Gailen D. Marshall, Jr., MD, PhD, FACAAI