2f:I[703058,["/_next/static/immutable/chunks/2esyeua7r8hxb.js","/_next/static/immutable/chunks/43wzqu_q6b8co.js","/_next/static/immutable/chunks/02igegklyi312.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/3d54cr_x61503.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/41sb2pnxui1_7.js","/_next/static/immutable/chunks/0z5fu495o1bws.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T782,Allergic rhinitis displays a relevant impact on quality of life. Medications used in the treatment of rhinitis have been assessed on their impact on rhinoconjunctivitis-related quality of life, but not on generic health-related quality of life metrics, such as utilities or EQ-5D visual analogue scale (VAS) levels. This study aimed to compare different medication classes and individual medications on utilities and EQ-5D VAS levels using data from a mobile app. We conducted an observational study using direct patient data from the MASK-air mobile application, collected between May 2015 and December 2024. We compared rhinitis medication classes and individual medications on health utilities (computed from the EQ-5D-5L questionnaire) and the EQ-5D VAS. To account for confounding, we employed inverse probability treatment weighting based on propensity scores, adjusting for demographics, baseline symptom control, and asthma status. The study analysed 69,973 observations with EQ-5D VAS data and 842 observations with utility data. At the medication class level, fixed combinations of intranasal antihistamines and corticosteroids were associated with improvements in EQ-5D VAS (mean difference = 1.900; 95% CI = 1.316-2.484) and utilities (mean difference = 0.022; 95% CI = -0.015 to 0.059) compared with oral antihistamines (OAH). Intranasal antihistamines were associated with lower EQ-5D VAS and utility scores than other intranasal treatments. For individual medications, mometasone was associated with a lower EQ-5D VAS than budesonide and fluticasone furoate, while fexofenadine and levocetirizine tended to be associated with lower VAS values than other OAH. Fixed combinations of intranasal antihistamines and corticosteroids were associated with better quality-of-life than oral antihistamines and intranasal antihistamines. These findings could support future cost-effectiveness analyses.31:Ta20,ABSTRACT Background Allergic rhinitis displays a relevant impact on quality of life. Medications used in the treatment of rhinitis have been assessed on their impact on rhinoconjunctivitis‐related quality of life, but not on generic health‐related quality of life metrics, such as utilities or EQ‐5D visual analogue scale (VAS) levels. This study aimed to compare different medication classes and individual medications on utilities and EQ‐5D VAS levels using data from a mobile app. Methods We conducted an observational study using direct patient data from the MASK‐air mobile application, collected between May 2015 and December 2024. We compared rhinitis medication classes and individual medications on health utilities (computed from the EQ‐5D‐5L questionnaire) and the EQ‐5D VAS. To account for confounding, we employed inverse probability treatment weighting based on propensity scores, adjusting for demographics, baseline symptom control, and asthma status. Results The study analysed 69,973 observations with EQ‐5D VAS data and 842 observations with utility data. At the medication class level, fixed combinations of intranasal antihistamines and corticosteroids were associated with improvements in EQ‐5D VAS (mean difference = 1.900; 95% CI = 1.316–2.484) and utilities (mean difference = 0.022; 95% CI = −0.015 to 0.059) compared with oral antihistamines (OAH). Intranasal antihistamines were associated with lower EQ‐5D VAS and utility scores than other intranasal treatments. For individual medications, mometasone was associated with a lower EQ‐5D VAS than budesonide and fluticasone furoate, while fexofenadine and levocetirizine tended to be associated with lower VAS values than other OAH. Conclusion Fixed combinations of intranasal antihistamines and corticosteroids were associated with better quality‐of‐life than oral antihistamines and intranasal antihistamines. These findings could support future cost‐effectiveness analyses. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"budesonide in Allergy: Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed Allergy papers on budesonide (generic). Clinician-written summaries and practical action steps. 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An additional 18 had abnormal Ig levels not meeting PID criteria. Only topical swallowed budesonide unresponsiveness was significantly higher in PID patients (p=.004); endoscopic and histologic features did not differ between groups. Only 2 of 14 PID patients had ≥1 JMF warning sign.","limitations":"Single-center design with small non-EoE EGID subgroup limits generalizability and subgroup analyses. No healthy or disease control group, and no national PID prevalence data, so it is unclear whether PID frequency exceeds background rates. Pediatric-only cohort limits applicability to adults.","practice_takeaway":"JMF warning signs alone are likely insufficient to screen for PID in children with EGIDs — consider adding basic immunologic tests (serum Ig levels, vaccine responses) as a first step for all pediatric EGID patients. Budesonide unresponsiveness in a well-adherent patient may warrant further immunologic evaluation, though this finding needs confirmation in larger studies."}},{"doi":"10.1111/pai.70374","pmid":"42129970","title":"MicroRNA clustering in pediatric asthma reveals differential corticosteroid responsiveness","journal_title":"Pediatric Allergy and Immunology","journal_issn":"0905-6157","published_at":"2026-05-13T00:00:00.000Z","url":"https://doi.org/10.1111/pai.70374","source_score":1,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-16T13:22:33.317Z","updated_at":"2026-05-16T13:22:33.317Z","tags":[{"paper_doi":"10.1111/pai.70374","tag_type":"age_group","value":"child","value_numeric":null},{"paper_doi":"10.1111/pai.70374","tag_type":"brand","value":"Pulmicort","value_numeric":null},{"paper_doi":"10.1111/pai.70374","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1111/pai.70374","tag_type":"condition","value":"Asthma","value_numeric":null},{"paper_doi":"10.1111/pai.70374","tag_type":"generic","value":"budesonide","value_numeric":null},{"paper_doi":"10.1111/pai.70374","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1111/pai.70374","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1111/pai.70374","tag_type":"modality","value":"Inhaled Corticosteroid","value_numeric":null},{"paper_doi":"10.1111/pai.70374","tag_type":"sample_size","value":"n=462","value_numeric":462},{"paper_doi":"10.1111/pai.70374","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1111/pai.70374","tag_type":"study_design","value":"Secondary Analysis of Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1111/pai.70374","tag_type":"warning","value":"Brand name 'Pulmicort' added as the common budesonide brand; paper does not specify formulation or brand name explicitly.","value_numeric":null},{"paper_doi":"10.1111/pai.70374","tag_type":"warning","value":"Cluster 2 had only 20 budesonide-arm participants, limiting statistical power for subgroup comparisons.","value_numeric":null},{"paper_doi":"10.1111/pai.70374","tag_type":"warning","value":"Study design tagged as 'Secondary Analysis of RCT' because participants were drawn from the CAMP RCT but the clustering analysis itself is observational/exploratory; no prospective cluster assignment occurred.","value_numeric":null}],"summaries":{"what_studied":"miRNA expression profiling and k-means clustering were performed on 462 children (ages 5–12) from the CAMP cohort to identify molecular asthma clusters and compare budesonide-related lung function changes across clusters over 12 months, stratified by peripheral blood eosinophil count (≥300 cells/mm³).","key_result":"Three molecular clusters emerged from 246 differentially expressed miRNAs. At 12 months, FEV1 (99.2% vs. 91.5% vs. 100.6% predicted, p=.02) and FEV1/FVC (81.9% vs. 77.4% vs. 81.8%, p=.04) were significantly higher in Clusters 1 and 3 than Cluster 2 on budesonide. In Cluster 3, eosinophilic participants had greater airway hyperresponsiveness at baseline (PC20 0.7 vs. 2.0 mg/mL, p<.001) but showed more FEV1/FVC improvement after budesonide (+3.4 vs. +0.6 percentage points, p=.002). Cluster 2 was unresponsive to budesonide regardless of eosinophil status.","limitations":"- Clusters were not validated in an independent cohort; comparable pediatric cohorts with serum miRNA and longitudinal treatment data are scarce.\n- The same miRNA features used for clustering were also used for differential expression, so results are descriptive of cluster composition, not independent validation.\n- Serum miRNA reflects mixed circulating cell signals; cell-type deconvolution was not done, leaving the cellular origin of findings uncertain.","practice_takeaway":"Blood miRNA profiling may identify pediatric asthma subgroups with differential ICS responsiveness not apparent from standard clinical features alone—particularly a Cluster 2-like group that may not benefit from budesonide. Peripheral blood eosinophilia carries different implications depending on the underlying molecular cluster, so its predictive value for ICS response may need molecular context to interpret."}},{"doi":"10.1111/cea.70335","pmid":"42087806","title":"Comparison of Allergic Rhinitis Treatments on Utilities and Quality of Life: A\n MASK\n ‐air Study","journal_title":"Clinical & Experimental Allergy","journal_issn":"0954-7894","published_at":"2026-05-06T00:00:00.000Z","url":"https://doi.org/10.1111/cea.70335","source_score":4,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-05-08","doi":"10.1111/cea.70335","days":"14","issn":"0954-7894","rank":"7","field":"Clinical Medicine","score":"4","category":"Allergy","categories":["Allergy"],"_categories":["Allergy"]},"pubmed":{"doi":"10.1111/cea.70335","title":"Comparison of Allergic Rhinitis Treatments on Utilities and Quality of Life: A MASK-air Study.","journal":"Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology","methods":"","results":"The study analysed 69,973 observations with EQ-5D VAS data and 842 observations with utility data. At the medication class level, fixed combinations of intranasal antihistamines and corticosteroids were associated with improvements in EQ-5D VAS (mean difference = 1.900; 95% CI = 1.316-2.484) and utilities (mean difference = 0.022; 95% CI = -0.015 to 0.059) compared with oral antihistamines (OAH). Intranasal antihistamines were associated with lower EQ-5D VAS and utility scores than other intranasal treatments. For individual medications, mometasone was associated with a lower EQ-5D VAS than budesonide and fluticasone furoate, while fexofenadine and levocetirizine tended to be associated with lower VAS values than other OAH.","abstract":"$30","keywords":[],"pubmed_id":"42087806","conclusions":"Fixed combinations of intranasal antihistamines and corticosteroids were associated with better quality-of-life than oral antihistamines and intranasal antihistamines. These findings could support future cost-effectiveness analyses.","publication_date":"2026-05-06T00:00:00"},"crossref":{"DOI":"10.1111/cea.70335","URL":"https://doi.org/10.1111/cea.70335","ISSN":["0954-7894","1365-2222"],"link":[{"URL":"https://onlinelibrary.wiley.com/doi/pdf/10.1111/cea.70335","content-type":"application/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https://onlinelibrary.wiley.com/doi/full-xml/10.1111/cea.70335","content-type":"application/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https://onlinelibrary.wiley.com/doi/pdf/10.1111/cea.70335","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["Comparison of Allergic Rhinitis Treatments on Utilities and Quality of Life: A\n MASK\n ‐air Study"],"author":[{"given":"Nuno","family":"Lourenço‐Silva","sequence":"first","affiliation":[{"name":"MEDCIDS – Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine University of Porto Porto Portugal"},{"name":"CINTESIS@RISE – Health Research Network, Faculty of Medicine University of Porto Porto Portugal"}]},{"given":"Bernardo","family":"Sousa‐Pinto","sequence":"additional","affiliation":[{"name":"MEDCIDS – Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine University of Porto Porto Portugal"},{"name":"CINTESIS@RISE – Health Research Network, Faculty of Medicine University of Porto Porto Portugal"}]},{"given":"Antonio","family":"Bognanni","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology and Research Center (CERC) Humanitas University and Humanitas Research Hospital Milan Italy"}]},{"given":"Ana Margarida","family":"Pereira","sequence":"additional","affiliation":[{"name":"MEDCIDS – Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine University of Porto Porto Portugal"},{"name":"CINTESIS@RISE – Health Research Network, Faculty of Medicine University of Porto Porto Portugal"},{"name":"Allergy Unit Instituto and Hospital CUF Porto Portugal"}]},{"given":"João","family":"Coutinho‐Almeida","sequence":"additional","affiliation":[{"name":"MEDCIDS – Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine University of Porto Porto Portugal"},{"name":"CINTESIS@RISE – Health Research Network, Faculty of Medicine University of Porto Porto Portugal"}]},{"given":"Rita","family":"Amaral","sequence":"additional","affiliation":[{"name":"MEDCIDS – Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine University of Porto Porto Portugal"},{"name":"CINTESIS@RISE – Health Research Network, Faculty of Medicine University of Porto Porto Portugal"},{"name":"Department of Cardiovascular and Respiratory Sciences, Porto Health School Polytechnic Institute of Porto Porto Portugal"},{"name":"Department of Women's and Children's Health, Paediatric Research Uppsala University Uppsala Sweden"}]},{"given":"Luisa","family":"Brussino","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences University of Torino Torino Italy"},{"name":"Allergy and Clinical Immunology Unit Mauriziano Hospital Torino Italy"}]},{"given":"Mattia","family":"Giovannini","sequence":"additional","affiliation":[{"name":"Allergy Unit Meyer Children's Hospital IRCCS Florence Italy"},{"name":"Department of Health Sciences University of Florence Florence Italy"}]},{"given":"Bilun","family":"Gemicioglu","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Diseases, Cerrahpaşa Faculty of Medicine Istanbul University‐Cerrahpaşa Istanbul Turkey"},{"name":"Department of Pulmonary Diseases, Institute of Pulmonology and Tuberculosis Istanbul University‐Cerrahpaşa Istanbul Turkey"}]},{"given":"Violeta","family":"Kvedariene","sequence":"additional","affiliation":[{"name":"Clinic of Chest Diseases and Allergology, Faculty of Medicine, Institute of Clinical Medicine Vilnius University Vilnius Lithuania"},{"name":"Department of Pathology, Faculty of Medicine, Institute of Biomedical Sciences Vilnius University Vilnius Lithuania"}]},{"given":"Desiree E.","family":"Larenas‐Linnemann","sequence":"additional","affiliation":[{"name":"Center of Excellence in Asthma and Allergy Médica Sur Clinical Foundation and Hospital México City Mexico"}]},{"given":"Manuel","family":"Marques‐Cruz","sequence":"additional","affiliation":[{"name":"MEDCIDS – Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine University of Porto Porto Portugal"},{"name":"CINTESIS@RISE – Health Research Network, Faculty of Medicine University of Porto Porto Portugal"}]},{"given":"Nikolaos G.","family":"Papadopoulos","sequence":"additional","affiliation":[{"name":"Allergy Department, 2nd Pediatric Clinic University of Athens Athens Greece"}]},{"given":"Nhân","family":"Pham‐Thi","sequence":"additional","affiliation":[{"name":"Ecole Polytechnique de Palaiseau Palaiseau France"},{"name":"IRBA (Institut de Recherche Bio‐Médicale des Armées) Bretigny sur Orge France"},{"name":"Université Paris Cité Paris France"},{"name":"Center for Allergy and Clinical Immunology, Alésia Paris France"}]},{"given":"Frederico S.","family":"Regateiro","sequence":"additional","affiliation":[{"name":"Allergy and Clinical Immunology Department, Hospitais da Universidade de Coimbra Unidade Local de Saúde de Coimbra Coimbra Portugal"},{"name":"Center for Innovative Biomedicine and Biotechnology (CIBB), Faculty of Medicine University of Coimbra Coimbra Portugal"},{"name":"Faculty of Medicine, Institute of Immunology University of Coimbra Coimbra Portugal"},{"name":"UBIAir – Clinical & Experimental Lung Centre and CICS‐UBI Health Sciences Research Centre University of Beira Interior Covilhã Portugal"}]},{"given":"Sanna K.","family":"Toppila‐Salmi","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology University of Eastern Finland and the North Savo Wellbeing Services County Kuopio Finland"},{"name":"Department of Allergy, Skin and Allergy Hospital, Inflammation Center Helsinki University Hospital and University of Helsinki Helsinki Finland"}]},{"given":"Boleslaw","family":"Samolinski","sequence":"additional","affiliation":[{"name":"Department of Prevention of Environmental Hazards, Allergology and Immunology Medical University of Warsaw Warsaw Poland"}]},{"given":"Joaquin","family":"Sastre","sequence":"additional","affiliation":[{"name":"Allergy Service, Fundacion Jimenez Diaz Universidad Autonoma de Madrid, CIBERES‐ISCIII Madrid Spain"}]},{"given":"Luís","family":"Taborda‐Barata","sequence":"additional","affiliation":[{"name":"RISE‐Health, Faculty of Health Sciences, and UBIAir‐Clinical & Experimental Lung Centre University of Beira Interior Covilhã Portugal"},{"name":"Department of Immunoallergology Unidade Local de Saúde, Cova da Beira Covilhã Portugal"}]},{"given":"Arunas","family":"Valiulis","sequence":"additional","affiliation":[{"name":"Clinic of Asthma, Allergy and Chronic Lung Diseases Vilnius Lithuania"},{"name":"Institute of Clinical Medicine and Institute of Health Sciences Medical Faculty of Vilnius University Vilnius Lithuania"}]},{"given":"Leticia de las","family":"Vecillas","sequence":"additional","affiliation":[{"name":"Department of Allergy Hospital La Paz Institute for Health Research (IdiPAZ) Madrid Spain"}]},{"given":"Maria Teresa","family":"Ventura","sequence":"additional","affiliation":[{"name":"University of Bari Medical School Bari Italy"},{"name":"Institute of Sciences of Food Production National Research Council (ISPA‐CNR) Bari Italy"}]},{"given":"Oliver","family":"Pfaar","sequence":"additional","affiliation":[{"name":"Section of Rhinology and Allergy, Department of Otorhinolaryngology, Head and Neck Surgery University Hospital Marburg, Philipps‐Universität Marburg Marburg Germany"}]},{"given":"João A.","family":"Fonseca","sequence":"additional","affiliation":[{"name":"MEDCIDS – Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine University of Porto Porto Portugal"},{"name":"CINTESIS@RISE – Health Research Network, Faculty of Medicine University of Porto Porto Portugal"},{"name":"Allergy Unit Instituto and Hospital CUF Porto Portugal"}]},{"given":"Torsten","family":"Zuberbier","sequence":"additional","affiliation":[{"name":"Institute of Allergology, Charité – Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin Germany"},{"name":"Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology Berlin Germany"}]},{"given":"Ludger","family":"Klimek","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery Universitätsmedizin Mainz Mainz Germany"},{"name":"Center for Rhinology and Allergology Wiesbaden Germany"}]},{"given":"Jean","family":"Bousquet","sequence":"additional","affiliation":[{"name":"Institute of Allergology, Charité – Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin Germany"},{"name":"Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology Berlin Germany"},{"name":"ARIA (Allergic Rhinitis and its Impact on Asthma) Montpellier France"},{"name":"MASK‐air Montpellier France"}]},{"given":"Rafael José","family":"Vieira","sequence":"additional","affiliation":[{"name":"MEDCIDS – Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine University of Porto Porto Portugal"},{"name":"CINTESIS@RISE – Health Research Network, Faculty of Medicine University of Porto Porto 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Antihistamine/Corticosteroid","value_numeric":null},{"paper_doi":"10.1111/cea.70335","tag_type":"modality","value":"Intranasal Antihistamine","value_numeric":null},{"paper_doi":"10.1111/cea.70335","tag_type":"modality","value":"Intranasal Corticosteroid","value_numeric":null},{"paper_doi":"10.1111/cea.70335","tag_type":"modality","value":"Oral Antihistamine","value_numeric":null},{"paper_doi":"10.1111/cea.70335","tag_type":"sample_size","value":"n=69973","value_numeric":69973},{"paper_doi":"10.1111/cea.70335","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1111/cea.70335","tag_type":"study_design","value":"Observational Study","value_numeric":null},{"paper_doi":"10.1111/cea.70335","tag_type":"warning","value":"Individual drug comparisons (e.g., mometasone vs. fluticasone furoate) should be interpreted with caution given uncontrolled confounding in an app-based real-world dataset.","value_numeric":null},{"paper_doi":"10.1111/cea.70335","tag_type":"warning","value":"Study design is observational with propensity-score weighting; causal inference is limited. The sample_size tag reflects the larger VAS dataset; utility sample is much smaller.","value_numeric":null},{"paper_doi":"10.1111/cea.70335","tag_type":"warning","value":"The finding that fexofenadine and levocetirizine were associated with *lower* (worse) EQ-5D VAS values than other oral antihistamines is counterintuitive and may reflect confounding by indication rather than true inferiority.","value_numeric":null},{"paper_doi":"10.1111/cea.70335","tag_type":"warning","value":"The utility comparison (n=842) is substantially underpowered relative to the VAS comparison (n=69,973); the key utility result's 95% CI crosses zero, indicating uncertain clinical significance.","value_numeric":null}],"summaries":{"what_studied":"This observational study used real-world data from the MASK-air mobile app (May 2015–Dec 2024) to compare allergic rhinitis medication classes and individual drugs on generic health-related quality of life — specifically EQ-5D VAS scores and health utilities — using inverse probability treatment weighting to adjust for confounding.","key_result":"Fixed combinations of intranasal antihistamines + corticosteroids outperformed oral antihistamines on EQ-5D VAS (mean difference +1.900; 95% CI 1.316–2.484) and utilities (mean difference +0.022; 95% CI −0.015 to 0.059). Intranasal antihistamines alone scored lower than other intranasal treatments. Among oral antihistamines, fexofenadine and levocetirizine tended toward lower (worse) VAS values; among intranasal corticosteroids, mometasone was associated with lower EQ-5D VAS than budesonide or fluticasone furoate.","limitations":"- The utility dataset was very small (n=842), making utility comparisons underpowered and the confidence interval for the key utility result crossing zero.\n- Observational design with propensity-score weighting cannot fully eliminate confounding by indication (e.g., sicker patients may preferentially receive certain drugs).\n- App-based self-report data may not be representative of the broader allergic rhinitis population.","practice_takeaway":"Fixed intranasal antihistamine–corticosteroid combinations appear to offer the best generic quality-of-life benefit among rhinitis drug classes and may be preferred when patient-centered outcomes matter. Clinicians should interpret individual-drug comparisons (e.g., mometasone vs. fluticasone furoate) cautiously given the observational design and small utility sample."}},{"doi":"10.1080/02770903.2026.2644873","pmid":"41841274","title":"Impact of aging on high-dose inhaled corticosteroid use and specialist care management in patients with asthma: a Danish nationwide cohort study","journal_title":"Journal of Asthma","journal_issn":"0277-0903","published_at":"2026-03-26T00:00:00.000Z","url":"https://doi.org/10.1080/02770903.2026.2644873","source_score":10,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-07T22:50:31.843Z","updated_at":"2026-05-07T22:50:31.843Z","tags":[{"paper_doi":"10.1080/02770903.2026.2644873","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1080/02770903.2026.2644873","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1080/02770903.2026.2644873","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1080/02770903.2026.2644873","tag_type":"condition","value":"Asthma","value_numeric":null},{"paper_doi":"10.1080/02770903.2026.2644873","tag_type":"generic","value":"budesonide","value_numeric":null},{"paper_doi":"10.1080/02770903.2026.2644873","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1080/02770903.2026.2644873","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1080/02770903.2026.2644873","tag_type":"modality","value":"Inhaled Corticosteroid","value_numeric":null},{"paper_doi":"10.1080/02770903.2026.2644873","tag_type":"sample_size","value":"n=184,565","value_numeric":184565},{"paper_doi":"10.1080/02770903.2026.2644873","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1080/02770903.2026.2644873","tag_type":"study_design","value":"Nationwide Cohort Study","value_numeric":null},{"paper_doi":"10.1080/02770903.2026.2644873","tag_type":"warning","value":"Exclusion of COPD patients may be incomplete in older cohorts given frequent diagnostic overlap, which could affect the generalizability of high-dose ICS findings in the ≥76 age group.","value_numeric":null},{"paper_doi":"10.1080/02770903.2026.2644873","tag_type":"warning","value":"ICS dose is derived from pharmacy dispensing records, not actual patient adherence — true exposure may differ.","value_numeric":null},{"paper_doi":"10.1080/02770903.2026.2644873","tag_type":"warning","value":"Results are from Denmark's healthcare system; specialist referral patterns and formulary practices may not generalize to other countries.","value_numeric":null},{"paper_doi":"10.1080/02770903.2026.2644873","tag_type":"warning","value":"The study is cross-sectional (2021 snapshot), so trends over time or treatment changes cannot be assessed. The cohort study design label is used, but the analysis is largely prevalence-based.","value_numeric":null}],"summaries":{"what_studied":"This Danish nationwide cohort study examined age-related differences in high-dose inhaled corticosteroid (ICS) use and specialist vs. primary care management among all Danish adults with an asthma diagnosis or active ICS treatment in 2021 (n=184,565).","key_result":"15.7% of patients overall were on high or supratherapeutic ICS doses; prevalence was lowest in ages 18–45 (9.7%) and peaked at ages 66–75 (18.9%). Specialist care access declined in the oldest patients (56–65 years: 18.9% seen in specialist care; >86 years: 11.4%). Notably, 77.3% of patients on high/supratherapeutic ICS doses were managed in primary care only.","limitations":"Cross-sectional 2021 registry data cannot establish causality or capture prescribing intent. ICS dose was calculated from dispensing records (redemptions), not confirmed adherence or actual use. COPD was excluded but diagnostic overlap (asthma-COPD overlap) may persist in older age groups, potentially inflating high-dose ICS rates.","practice_takeaway":"Older adults with asthma (≥56 years) are more likely to be on high or supratherapeutic ICS doses yet less likely to see a specialist — clinicians should proactively review ICS dose appropriateness in this group and consider earlier referral or add-on therapies to reduce steroid burden."}},{"doi":"10.1016/j.anai.2026.02.009","pmid":"41771482","title":"Asthma in pregnancy: Optimizing treatment strategies and the emerging role of biologic therapies","journal_title":"Annals of Allergy, Asthma & Immunology","journal_issn":"1081-1206","published_at":"2026-02-28T00:00:00.000Z","url":"https://doi.org/10.1016/j.anai.2026.02.009","source_score":2,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-23T13:24:42.109Z","updated_at":"2026-05-23T13:24:42.109Z","tags":[{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"brand","value":"Xolair","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"condition","value":"Asthma","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"condition","value":"Asthma in Pregnancy","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"generic","value":"benralizumab","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"generic","value":"budesonide","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"generic","value":"dupilumab","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"generic","value":"formoterol","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"generic","value":"mepolizumab","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"generic","value":"omalizumab","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"generic","value":"reslizumab","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"generic","value":"tezepelumab","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"modality","value":"Anti-IgE Therapy","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"modality","value":"Anti-IL-4/IL-13 Therapy","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"modality","value":"Anti-IL-5 Therapy","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"modality","value":"Anti-TSLP Therapy","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"modality","value":"Inhaled Corticosteroid","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"modality","value":"Long-Acting Beta-2 Agonist","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"sex","value":"female","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"warning","value":"Aspirin-exacerbated respiratory disease discussion and low-dose aspirin use in pre-eclampsia are covered but peripheral to the main asthma management focus.","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"warning","value":"One author (Rupani) discloses advisory board, speaker, and grant relationships with GSK, AstraZeneca, Sanofi, Chiesi, and Boehringer Ingelheim — relevant given the review covers biologics made by these companies.","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"warning","value":"The impact_flag 'practice_changing' is applied cautiously — the biologic recommendations are consensus-based (Delphi) rather than RCT-derived, and registry data are limited mostly to omalizumab.","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"warning","value":"This is a narrative (non-systematic) review; evidence grading and study selection may reflect author judgment rather than a reproducible search strategy.","value_numeric":null}],"summaries":{"what_studied":"This narrative review examines strategies to optimize asthma management during pregnancy, including objective monitoring tools (spirometry, FeNO), a four-pillar management framework, anti-inflammatory reliever strategies (AIR/MART), and the safety and use of biologic therapies in women with severe asthma.","key_result":"Pregnancy does not significantly alter FEV1, FVC, or FeNO, making these tools valid for diagnosis and monitoring. Over 65% of women with severe asthma experience exacerbations requiring treatment during pregnancy. FeNO-guided management reduced exacerbations by ~50% in one RCT (Managing Asthma in Pregnancy trial), though a larger multicenter trial (Breathing for Life) found no significant improvement in perinatal or exacerbation outcomes. An international Delphi consensus supports continuing or initiating biologics during pregnancy when clinically indicated, with omalizumab registry data showing no increased risk of preterm delivery or major congenital anomalies.","limitations":"- Pregnant women are excluded from pivotal biologic and AIR/MART clinical trials, so direct pregnancy-specific efficacy and safety data are lacking.\n- Biologic safety data rely on small case series, registries, and animal studies rather than RCTs.\n- FeNO-guided management showed conflicting results across trials, and the optimal delivery model remains undefined.","practice_takeaway":"Do not withhold standard asthma therapies (ICS, combination inhalers, systemic corticosteroids for exacerbations) during pregnancy — uncontrolled disease poses greater risk than medication exposure. For women with severe asthma on biologics, shared decision-making and multidisciplinary review should guide continuation or initiation during pregnancy, rather than routine discontinuation."}}],"initialOffset":5,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"category","value":"Allergy"},{"tag_type":"generic","value":"budesonide"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Allergy","href":"/hub/Allergy"},{"name":"generic: budesonide","metadata":{"type":"generic","value":"budesonide"}}],"hrefConfig":{"basePath":"/hub/Allergy/papers","webViewQueryParams":{"hub_ctx":"category_tag","hub_category":"Allergy","hub_tag_type":"generic","hub_tag_value":"budesonide"}}}]]

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