2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.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/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T76d,This case describes a 29-year-old man with Morbihan disease, characterized by a 5-year history of recurrent facial erythema, papules, and pustules, followed by persistent right face edema. Initially misdiagnosed as lupus erythematosus, he received multiple treatments with only transient relief. Clinical manifestations combined with pathological findings confirmed a diagnosis of Morbihan disease associated with rosacea. Notably, the patient developed erythema and papules on the inner thighs, along with small papules on the trunk and upper limbs for 3 months. A biopsy revealed nonspecific inflammation. Since the morphology of these lesions differed from any known skin disease and no other cause could be identified, we believe this may be a manifestation of the disease. Extra-facial manifestation not previously reported. Various therapies were attempted: doxycycline and azelaic acid improved erythema; baricitinib was ineffective; while omalizumab and intense pulsed light (IPL) achieved partial improvement in erythema and edema. Long-term isotretinoin therapy provided sustained remission without relapse during tapering, confirming its efficacy and safety. This case expands the clinical spectrum of Morbihan disease by documenting extra-facial involvement and reported isotretinoin as an effective long-term therapy, with omalizumab and IPL as promising adjuncts. Furthermore, the literature review (2004-2025) summarizes the clinical features, pathology, and treatment responses of reported cases, showing a male-to-female ratio of 2.81:1. Lymphatic or vascular dilation was significantly correlated with a favorable outcome. Conversely, dermal edema and granuloma were inversely associated with treatment efficacy, indicating poorer prognosis. However, based on uncontrolled data, these findings are strictly hypothesis-generating and do not establish a definitive treatment hierarchy.31:Ta21,Chronic rhinosinusitis with nasal polyps (CRSwNP) is predominantly driven by type 2 inflammation. The biologics dupilumab and omalizumab, which target drivers and mediators of type 2 inflammation (interleukin [IL]-4/IL-13 signaling and immunoglobulin E [IgE], respectively), are efficacious in treating CRSwNP but direct comparisons are few. In EVEREST (EValuating trEatment RESponses of dupilumab versus omalizumab), the first head-to-head trial in respiratory biologics, we aimed to compare the efficacy and safety of dupilumab and omalizumab in patients with severe CRSwNP who had mild, moderate, or severe asthma. EVEREST was an international, randomised, double-blind, phase 4 trial, conducted at 100 hospitals or clinical centres in 17 countries. Sites were selected with otolaryngology, pneumologist, allergist, and immunologist practices; needed to have previously conducted double-blind studies; and were required have nasal endoscopy and electrocardiogram machines. Eligible patients aged 18 years or older with severe uncontrolled CRSwNP (with a nasal polyp score of 5 or more [and ≥2 for each nostril]), symptoms of nasal congestion and loss of smell for at least 8 weeks before screening, and physician-diagnosed asthma. Patients were randomly assigned (1:1) to subcutaneous dupilumab 300 mg every 2 weeks or omalizumab weight-tiered and IgE-tiered dosing every 2 weeks or 4 weeks for 24 weeks, with background mometasone furoate nasal spray. Patients and investigators were masked to the study drugs. Primary endpoints were change from baseline in endoscopic nasal polyp score and University of Pennsylvania Smell Identification Test (UPSIT) at 24 weeks. Efficacy was assessed in the intention-to-treat population and safety was assessed in patients who received at least one dose of study medication. The trial was registered at ClinicalTrials.gov, NCT04998604. Between Sept 27, 2021, and Dec 27, 2024, 819 individuals were screened for study inclusion, 459 were excluded (most common screen failures were: 167 did not meet nasal polyp score ≥5 or did not have ongoing symptoms of nasal congestion and loss of smell, 114 did not meet pre-bronchodilator FEV Dupilumab was superior to omalizumab in patients with severe CRSwNP and coexisting asthma. These findings support the efficacy of dupilumab in patients with type 2 respiratory diseases versus an active biologic comparator, the known safety profiles of dupilumab and omalizumab, and could enable better treatment targeting for patients with CRSwNP and asthma in clinical practice. Sanofi and Regeneron Pharmaceuticals.25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Anti-IgE Monoclonal Antibody: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Anti-IgE Monoclonal Antibody (modality). Clinician-written summaries and actionable practice insights. 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Discontinuation was more often due to disease control than adverse events. Autoimmune comorbidity (mainly thyroid-related) doubled the risk of discontinuation due to lack of efficacy (HR 2.03; 95% CI, 1.20–3.41). Chronic inducible urticaria showed higher 7-year survival (43–49%) vs. chronic spontaneous urticaria alone (30%).","limitations":"All included studies were observational, limiting causal inference. Individual patient-level data were reconstructed from Kaplan-Meier curves rather than sourced directly, introducing potential reconstruction error. The analysis was limited to 8 studies, and heterogeneity in study populations and follow-up durations may affect pooled estimates.","practice_takeaway":"Patients with autoimmune comorbidities (especially thyroid disease) are at higher risk of omalizumab failure in CU — consider closer monitoring and earlier reassessment in this group. Atopic patients who discontinue are more likely doing so due to disease control, suggesting a watch-and-wait approach may be appropriate after remission."}},{"doi":"10.1016/j.anai.2026.07.031","pmid":"42556614","title":"Omalizumab-Facilitated Oral Immunotherapy with Direct Initiation at Maintenance Dosing for Most Foods","journal_title":"Annals of Allergy, Asthma & Immunology","journal_issn":"1081-1206","published_at":"2026-08-05T00:00:00.000Z","url":"https://doi.org/10.1016/j.anai.2026.07.031","source_score":7,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-12T13:26:19.386Z","updated_at":"2026-08-12T13:26:19.386Z","tags":[{"paper_doi":"10.1016/j.anai.2026.07.031","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.07.031","tag_type":"brand","value":"Xolair","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.07.031","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.07.031","tag_type":"condition","value":"Food Allergy","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.07.031","tag_type":"generic","value":"omalizumab","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.07.031","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.07.031","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.07.031","tag_type":"modality","value":"Anti-IgE Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.07.031","tag_type":"modality","value":"Oral Immunotherapy","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.07.031","tag_type":"sample_size","value":"n=100","value_numeric":100},{"paper_doi":"10.1016/j.anai.2026.07.031","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.07.031","tag_type":"study_design","value":"Prospective Cohort Study","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.07.031","tag_type":"warning","value":"Age range ('children and young adults') is not precisely defined in the abstract; exact age bounds are not reported, which limits age_group precision.","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.07.031","tag_type":"warning","value":"The brand name 'Xolair' is inferred as the commercially available form of omalizumab; the paper does not explicitly state the brand used.","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.07.031","tag_type":"warning","value":"The 'impact_flag: practice_changing' tag reflects a notably streamlined protocol, but this is a single-arm cohort without a comparator group — results should be interpreted cautiously until confirmed in controlled trials.","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.07.031","tag_type":"warning","value":"The paper is published August 2026; today is August 12, 2026, meaning this is very recently published and has not yet undergone post-publication peer review or replication.","value_numeric":null}],"summaries":{"what_studied":"A prospective cohort study evaluated an omalizumab-facilitated OIT protocol designed to allow direct initiation at maintenance dosing for most foods in 100 children and young adults, following at least 8 weeks of omalizumab pretreatment, with a median follow-up of 27.6 weeks.","key_result":"94% of initiation challenges were tolerated (181/193); 97% of patients started daily dosing for at least one food, and 84% started at target maintenance doses for all foods. Only 2 patients (2%) discontinued due to adverse events; adverse events occurred in 40%, most commonly abdominal pain (23%) and oral pruritus (13%).","limitations":"- Single-arm prospective cohort with no control group, limiting causal inference.\n- Relatively short median follow-up (~27.6 weeks); long-term durability after omalizumab discontinuation is unknown.\n- Study conducted at what appears to be a single center, which may limit generalizability.","practice_takeaway":"For children and young adults undergoing multi-food OIT, pretreatment with omalizumab for ~12 weeks may allow most patients to skip gradual up-dosing and start directly at maintenance doses, reducing clinic visits and treatment burden. Adverse events were mostly mild and rarely led to discontinuation."}},{"doi":"10.1001/jamapediatrics.2026.2910","pmid":"42507431","title":"Treatment of Multifood Allergy With Omalizumab or Multiallergen Oral Immunotherapy","journal_title":"JAMA Pediatrics","journal_issn":"2168-6203","published_at":"2026-07-27T00:00:00.000Z","url":"https://doi.org/10.1001/jamapediatrics.2026.2910","source_score":57,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-31T13:36:49.537Z","updated_at":"2026-07-31T13:36:49.537Z","tags":[{"paper_doi":"10.1001/jamapediatrics.2026.2910","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.2910","tag_type":"brand","value":"Xolair","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.2910","tag_type":"category","value":"Pediatrics","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.2910","tag_type":"condition","value":"Multifood Allergy","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.2910","tag_type":"condition","value":"Peanut Allergy","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.2910","tag_type":"generic","value":"omalizumab","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.2910","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.2910","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.2910","tag_type":"modality","value":"Anti-IgE Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.2910","tag_type":"modality","value":"Oral Immunotherapy","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.2910","tag_type":"sample_size","value":"n=117","value_numeric":117},{"paper_doi":"10.1001/jamapediatrics.2026.2910","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.2910","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.2910","tag_type":"warning","value":"Age range (1–55 years) is wide; median age of 7 years means the population is predominantly pediatric, which may limit applicability to adult practice.","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.2910","tag_type":"warning","value":"Brand name 'Xolair' assigned based on standard omalizumab branding; paper does not explicitly state the brand used.","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2026.2910","tag_type":"warning","value":"The ITT superiority finding is heavily confounded by differential dropout: 49% of MOIT participants vs. 12% of omalizumab participants discontinued, mostly due to adverse events — per-protocol analysis was not significant.","value_numeric":null}],"summaries":{"what_studied":"This double-blind, placebo-controlled RCT (OUTMATCH stage 2) compared omalizumab monotherapy vs. omalizumab-facilitated multiallergen OIT (MOIT) in 117 participants aged 1–55 years with allergy to peanuts plus ≥2 other foods, across 10 US academic centers over 60 weeks.","key_result":"In the ITT analysis, omalizumab was superior to MOIT for tolerating a cumulative dose ≥4044 mg across all 3 foods (36% vs. 19%; OR 2.6; 95% CI 1.1–6.3; P = .03); however, per-protocol analyses showed no difference. MOIT had far more serious adverse events (31% vs. 0%), discontinuations (22% vs. 0%), and epinephrine use (37% vs. 7%).","limitations":"- The ITT superiority of omalizumab was largely driven by high MOIT discontinuation due to adverse events (49% did not complete), not by greater efficacy in those who tolerated the regimen.\n- Per-protocol analysis showed no significant difference, raising questions about true comparative efficacy.\n- Median participant age was 7 years, limiting direct generalizability to adults.","practice_takeaway":"For children and adults with multifood allergy, omalizumab monotherapy offers a safer profile than multiallergen OIT, with fewer serious reactions and near-zero discontinuations — making it a practical first-line option, especially for patients at high risk of OIT-related reactions. Clinicians should counsel that MOIT's high adverse event burden (31% serious, 22% discontinuation) substantially limits its real-world use in this population."}},{"doi":"10.1186/s13223-026-01055-9","pmid":"42464416","title":"Comparative effectiveness of mepolizumab and omalizumab in patients eligible for both: a retrospective cohort study","journal_title":"Allergy, Asthma & Clinical Immunology","journal_issn":"1710-1492","published_at":"2026-07-16T00:00:00.000Z","url":"https://doi.org/10.1186/s13223-026-01055-9","source_score":1,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-27T14:09:23.466Z","updated_at":"2026-07-27T14:09:23.466Z","tags":[{"paper_doi":"10.1186/s13223-026-01055-9","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1186/s13223-026-01055-9","tag_type":"brand","value":"Nucala","value_numeric":null},{"paper_doi":"10.1186/s13223-026-01055-9","tag_type":"brand","value":"Xolair","value_numeric":null},{"paper_doi":"10.1186/s13223-026-01055-9","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1186/s13223-026-01055-9","tag_type":"condition","value":"Severe Asthma","value_numeric":null},{"paper_doi":"10.1186/s13223-026-01055-9","tag_type":"generic","value":"mepolizumab","value_numeric":null},{"paper_doi":"10.1186/s13223-026-01055-9","tag_type":"generic","value":"omalizumab","value_numeric":null},{"paper_doi":"10.1186/s13223-026-01055-9","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1186/s13223-026-01055-9","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1186/s13223-026-01055-9","tag_type":"modality","value":"Anti-IgE Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1186/s13223-026-01055-9","tag_type":"modality","value":"Anti-IL-5 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1186/s13223-026-01055-9","tag_type":"sample_size","value":"n=49","value_numeric":49},{"paper_doi":"10.1186/s13223-026-01055-9","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1186/s13223-026-01055-9","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1186/s13223-026-01055-9","tag_type":"warning","value":"Age distribution and sex breakdown were not explicitly reported in the abstract; 'adult' age group and 'mixed' sex are assumed based on typical severe asthma trial populations.","value_numeric":null},{"paper_doi":"10.1186/s13223-026-01055-9","tag_type":"warning","value":"Sample size is very small (n=49), making subgroup findings (especially eosinophils ≥300 cells/μL) underpowered and potentially unreliable.","value_numeric":null},{"paper_doi":"10.1186/s13223-026-01055-9","tag_type":"warning","value":"Single-center retrospective design; unmeasured confounders (e.g., allergy phenotype severity, adherence) may affect estimates.","value_numeric":null},{"paper_doi":"10.1186/s13223-026-01055-9","tag_type":"warning","value":"The eosinophil eligibility threshold (≥150 or ≥300 cells/μL in the prior year) spans a wide range, which may introduce heterogeneity in the study population.","value_numeric":null}],"summaries":{"what_studied":"This retrospective cohort study compared real-world effectiveness of mepolizumab vs. omalizumab over 1 year in 49 severe asthma patients eligible for both biologics (blood eosinophils ≥150 cells/μL, total IgE ≥30 IU/mL, perennial allergen sensitization). Primary outcome was adjusted incidence rate ratio (IRR) for asthma exacerbations.","key_result":"Mepolizumab reduced asthma exacerbations significantly more than omalizumab (adjusted IRR 0.37; 95% CI 0.19–0.69). The benefit was significant in patients with baseline eosinophils <300 cells/μL (IRR 0.38; 95% CI 0.14–0.88) but not ≥300 cells/μL (IRR 0.47; 95% CI 0.15–1.35). ER visits, hospitalizations, and OCS dose reduction did not differ significantly between groups.","limitations":"- Very small sample (n=49 total), limiting statistical power, especially in subgroup analyses.\n- Single-center retrospective design introduces selection bias and unmeasured confounding.\n- Results require confirmation in larger, multicenter studies before broad generalization.","practice_takeaway":"When choosing between mepolizumab and omalizumab in patients eligible for both, mepolizumab may offer greater exacerbation reduction — particularly in those with baseline eosinophils <300 cells/μL. ER visits, hospitalizations, and OCS-sparing appear comparable, so exacerbation history should weigh heavily in biologic selection."}},{"doi":"10.1002/ppul.71727","pmid":"42411189","title":"Efficacy and Safety of Biologic Therapies for Uncontrolled Asthma: An Overview of Systematic Reviews","journal_title":"Pediatric Pulmonology","journal_issn":"8755-6863","published_at":"2026-07-07T00:00:00.000Z","url":"https://doi.org/10.1002/ppul.71727","source_score":3,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-17T13:24:05.540Z","updated_at":"2026-07-17T13:24:05.540Z","tags":[{"paper_doi":"10.1002/ppul.71727","tag_type":"age_group","value":"adolescent","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"brand","value":"Cinqair","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"brand","value":"Dupixent","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"brand","value":"Fasenra","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"brand","value":"Nucala","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"brand","value":"Tezspire","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"brand","value":"Xolair","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"category","value":"Respiratory System","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"condition","value":"Eosinophilic Asthma","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"condition","value":"Oral Corticosteroid-Dependent Asthma","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"condition","value":"Severe Uncontrolled Asthma","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"generic","value":"benralizumab","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"generic","value":"dupilumab","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"generic","value":"mepolizumab","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"generic","value":"omalizumab","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"generic","value":"reslizumab","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"generic","value":"tezepelumab","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"modality","value":"Anti-IgE Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"modality","value":"Anti-IL-4/IL-13 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"modality","value":"Anti-IL-5 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"modality","value":"Anti-TSLP Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"sample_size","value":"n=17","value_numeric":17},{"paper_doi":"10.1002/ppul.71727","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"study_design","value":"Overview of Systematic Reviews","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"warning","value":"12 of 17 included systematic reviews were rated critically low quality by AMSTAR 2—results should be interpreted with substantial caution.","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"warning","value":"All comparative findings are based on indirect (network) comparisons; no direct head-to-head RCTs were available, limiting certainty of conclusions.","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"warning","value":"Level of evidence assigned as '3' reflects the overview-of-reviews design drawing on network meta-analyses; the underlying primary evidence quality is lower due to predominantly critically low-rated source reviews.","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"warning","value":"Population in the PICOT framework is ≥12 years, but the journal is Pediatric Pulmonology—clinicians should note that most included trial data likely skews toward adults; pediatric-specific subgroup data are not reported separately.","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"warning","value":"The overview did not perform a formal corrected covered area (CCA) analysis, so the degree of primary study overlap across included reviews is unknown and may inflate the apparent weight of evidence.","value_numeric":null}],"summaries":{"what_studied":"This overview of 17 systematic reviews (including network meta-analyses) synthesized indirect comparative evidence on the efficacy and safety of six biologic agents—omalizumab, mepolizumab, reslizumab, benralizumab, dupilumab, and tezepelumab—for uncontrolled moderate-to-severe asthma in patients aged ≥12 years, across outcomes including annualized exacerbation rate (AER), FEV1, ACQ, AQLQ, oral corticosteroid (OCS) reduction, and serious adverse events (SAEs).","key_result":"In indirect comparisons, dupilumab outperformed benralizumab (RR=0.46), mepolizumab (RR=0.72), and reslizumab (RR=0.62) on AER in the general severe asthma population; tezepelumab was favored over benralizumab (RR=0.73). In eosinophilic subgroups, dupilumab and tezepelumab were consistently favorable at ≥150 and ≥300 cells/μL, while tezepelumab outperformed dupilumab at <150 cells/μL. Dupilumab showed the greatest FEV1 improvement; mepolizumab was favored for ACQ control; omalizumab (general) and tezepelumab (eosinophilic ≥150 cells/μL) were favored for AQLQ. For OCS reduction, benralizumab and dupilumab outperformed reslizumab and tezepelumab. One indirect comparison suggested fewer SAEs with mepolizumab vs. dupilumab (OR=0.65). However, 12 of 17 included reviews were rated critically low quality by AMSTAR 2.","limitations":"- Nearly all findings are from indirect (network) comparisons; no head-to-head RCTs were available.\n- 12 of 17 included systematic reviews were rated critically low methodological quality (AMSTAR 2), mainly due to absent protocol registration, incomplete search strategies, and no duplicate data extraction.\n- Potential overlap of primary trials across included reviews was not formally quantified (no corrected covered area analysis), risking duplication of evidence.","practice_takeaway":"Biomarker-guided biologic selection remains key: dupilumab and tezepelumab appear broadly favorable for exacerbation reduction and lung function, while mepolizumab may offer better symptom control and a safer SAE profile in specific eosinophilic subgroups—but these are indirect comparisons from mostly low-quality reviews and should not be used to establish definitive treatment rankings. Clinicians should individualize biologic choice based on eosinophil count, OCS dependence, and patient profile while awaiting direct head-to-head trial data."}},{"doi":"10.1111/pai.70407","pmid":"42324659","title":"Bridging Rare to Common Diseases: Precision Medicine and the Transforming Landscape of Pediatric Allergy and Immunology","journal_title":"Pediatric Allergy and Immunology","journal_issn":"0905-6157","published_at":"2026-06-21T00:00:00.000Z","url":"https://doi.org/10.1111/pai.70407","source_score":1,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-24T13:21:44.323Z","updated_at":"2026-06-24T13:21:44.323Z","tags":[{"paper_doi":"10.1111/pai.70407","tag_type":"age_group","value":"pediatric","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"brand","value":"Adbry","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"brand","value":"Cibinqo","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"brand","value":"Dupixent","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"brand","value":"Ebglyss","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"brand","value":"Fasenra","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"brand","value":"Niktimvo","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"brand","value":"Nucala","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"brand","value":"Olumiant","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"brand","value":"Rinvoq","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"brand","value":"Tezspire","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"brand","value":"Xolair","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"condition","value":"Activated PI3K-Delta Syndrome","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"condition","value":"Allergic Rhinitis","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"condition","value":"Asthma","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"condition","value":"Atopic Dermatitis","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"condition","value":"Common Variable Immunodeficiency","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"condition","value":"Eosinophilic Esophagitis","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"condition","value":"Food Allergy","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"condition","value":"Hyper-IgE Syndrome","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"condition","value":"Inborn Errors of Immunity","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"condition","value":"IPEX Syndrome","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"condition","value":"Primary Atopic Disorders","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"generic","value":"abatacept","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"generic","value":"abrocitinib","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"generic","value":"baricitinib","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"generic","value":"benralizumab","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"generic","value":"dupilumab","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"generic","value":"lebrikizumab","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"generic","value":"leniolisib","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"generic","value":"mepolizumab","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"generic","value":"omalizumab","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"generic","value":"ruxolitinib","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"generic","value":"tezepelumab","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"generic","value":"tofacitinib","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"generic","value":"tralokinumab","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"generic","value":"upadacitinib","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"modality","value":"Allergen Immunotherapy","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"modality","value":"Anti-IgE Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"modality","value":"Anti-IL-4/IL-13 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"modality","value":"Anti-IL-5 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"modality","value":"Anti-TSLP Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"modality","value":"JAK Inhibitor","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"modality","value":"Multi-Omics","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"modality","value":"PI3K-Delta Inhibitor","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"warning","value":"Sample size tag was omitted as this is a review article with no primary study population.","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"warning","value":"Several biologic uses in primary atopic disorders (PAD) described in Table 1 are based on case reports or small series, not controlled trials—evidence levels vary widely across listed indications.","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"warning","value":"Some brand-name mappings (e.g., Niktimvo for leniolisib) reflect recent approvals; clinicians should verify current regulatory status in their jurisdiction.","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"warning","value":"This is a narrative expert review funded by the Clemens von Pirquet Foundation; it does not follow systematic review methodology, so selection bias in cited evidence cannot be excluded.","value_numeric":null}],"summaries":{"what_studied":"This narrative review examines how precision medicine tools—including multi-omics, biomarkers, and AI—can bridge rare monogenic inborn errors of immunity (IEI) and primary atopic disorders (PAD) with common polygenic allergic diseases (asthma, atopic dermatitis, food allergy, allergic rhinitis) in pediatric patients, with a focus on shared pathogenic mechanisms and targeted therapies.","key_result":"The review maps a 'rare-to-common' translational pipeline showing that monogenic IEI (e.g., STAT6-GOF, DOCK8 deficiency, IPEX, APDS) share T2 inflammatory pathways with common allergic diseases; targeted biologics (dupilumab, omalizumab, mepolizumab) and small molecules (JAK inhibitors, leniolisib, abatacept) are increasingly repurposed across this spectrum, with leniolisib the first purpose-built targeted therapy approved for a monogenic IEI (APDS) following a landmark RCT.","limitations":"- This is a narrative expert review (funded seminar), not a systematic review or meta-analysis, limiting reproducibility and risk of bias assessment.\n- No original datasets were generated; evidence strength for many biologic uses in PAD rests on case series and small cohorts.\n- Clinical translation of omics biomarkers remains constrained by pre-analytical variability, small heterogeneous cohorts, and lack of prospective validation trials.","practice_takeaway":"Clinicians should consider PAD when children present with very early-onset severe atopic disease, treatment resistance, or multiorgan involvement—early genetic and immunologic workup can unlock targeted therapies (biologics, JAK inhibitors) that go beyond conventional management.\nAllergen immunotherapy guided by component-resolved diagnostics and molecular profiling remains the only disease-modifying option for IgE-mediated allergy, and its precision-medicine framework can serve as a template for broader pediatric allergy care."}},{"doi":"10.1016/j.waojou.2026.101411","pmid":"42256026","title":"Differential associations of IgG-aFcεRI and IgG-aIgE autoantibodies with clinical phenotypes of type IIb chronic spontaneous urticaria","journal_title":"World Allergy Organization Journal","journal_issn":"1939-4551","published_at":"2026-05-30T00:00:00.000Z","url":"https://doi.org/10.1016/j.waojou.2026.101411","source_score":3,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-11T13:42:40.621Z","updated_at":"2026-06-11T13:42:40.621Z","tags":[{"paper_doi":"10.1016/j.waojou.2026.101411","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101411","tag_type":"brand","value":"Xolair","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101411","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101411","tag_type":"condition","value":"Angioedema","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101411","tag_type":"condition","value":"Chronic Spontaneous Urticaria","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101411","tag_type":"generic","value":"omalizumab","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101411","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101411","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101411","tag_type":"modality","value":"Anti-IgE Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101411","tag_type":"sample_size","value":"n=205","value_numeric":205},{"paper_doi":"10.1016/j.waojou.2026.101411","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101411","tag_type":"study_design","value":"Cross-Sectional Study","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101411","tag_type":"warning","value":"The association between rural residence and higher IgG-aIgE was based on only 24 rural patients and should be interpreted cautiously.","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101411","tag_type":"warning","value":"The ELISA assays used for IgG-aFcεRI and IgG-aIgE were research-grade only with no established clinical reference ranges or diagnostic cut-offs; results should not be applied directly to clinical decision-making.","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101411","tag_type":"warning","value":"The omalizumab-IgG-aIgE association likely reflects treatment escalation due to disease severity rather than a causal relationship, as noted by the authors.","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101411","tag_type":"warning","value":"Type I autoallergic CSU markers (IgE autoantibodies to self-antigens) were not assessed, limiting endotype completeness.","value_numeric":null}],"summaries":{"what_studied":"This cross-sectional study of 205 adult CSU patients (77.6% female, mean age 42.8 years) measured IgG autoantibodies against FcεRI (IgG-aFcεRI) and IgE (IgG-aIgE) by ELISA, then tested associations with clinical phenotypes, patient-reported outcomes, and laboratory parameters.","key_result":"IgG-aIgE levels were significantly higher in patients with angioedema (urticaria+angioedema: 2706 pg/mL vs. urticaria only: 984 pg/mL, p<0.001), in omalizumab-treated patients (2531 vs. 1614 pg/mL, p=0.004), those with accompanying systemic symptoms (2032 vs. 1528 pg/mL, p=0.023), rural residents (2206 vs. 1659 pg/mL, p=0.041), and nighttime-predominant symptoms. IgG-aFcεRI was higher in wheal-only disease (108 vs. 95.3 pg/mL, p<0.001) and anti-TPO–positive patients (107 vs. 97.7 pg/mL, p=0.013), and correlated negatively with IgG-aIgE (τ=−0.145, p=0.003), neutrophil count, and total IgE, and positively with total IgG.","limitations":"- No healthy control group, so antibody levels cannot be benchmarked against the general population.\n- Assays lack established clinical cut-offs; antibodies analyzed as continuous variables only, preventing positive/negative classification.\n- Cross-sectional design precludes causal inference; several subgroups (rural residents, C1-INH measurements) were small.","practice_takeaway":"In CSU, higher IgG-aIgE levels track with angioedema-dominant disease and need for omalizumab, while higher IgG-aFcεRI levels track with wheal-predominant disease and thyroid autoimmunity—patterns that may help stratify patients toward targeted workup. These assays are not yet standardized for routine clinical use."}},{"doi":"10.1016/j.waojou.2026.101394","pmid":"42256022","title":"Comparison of the efficacy of different doses of omalizumab (150 mg vs 300 mg) in patients with seasonal allergic rhinitis and low total IgE: A randomized, double-blind, controlled study","journal_title":"World Allergy Organization Journal","journal_issn":"1939-4551","published_at":"2026-05-28T00:00:00.000Z","url":"https://doi.org/10.1016/j.waojou.2026.101394","source_score":3,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-11T13:42:39.821Z","updated_at":"2026-06-11T13:42:39.821Z","tags":[{"paper_doi":"10.1016/j.waojou.2026.101394","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101394","tag_type":"brand","value":"Enitan","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101394","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101394","tag_type":"condition","value":"Allergic Conjunctivitis","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101394","tag_type":"condition","value":"Seasonal Allergic Rhinitis","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101394","tag_type":"generic","value":"omalizumab","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101394","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101394","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101394","tag_type":"modality","value":"Anti-IgE Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101394","tag_type":"sample_size","value":"n=54","value_numeric":54},{"paper_doi":"10.1016/j.waojou.2026.101394","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101394","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101394","tag_type":"warning","value":"Only 54 of 60 enrolled patients were analyzed; 6 withdrew for poor compliance, which may introduce selection bias.","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101394","tag_type":"warning","value":"Reference list entries were not retrievable from the full text (listed as blank), so supporting citations could not be verified.","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101394","tag_type":"warning","value":"The cypress pollen season lasted only ~4 weeks, meaning each patient received just a single injection; durability and multi-dose effects are unknown.","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101394","tag_type":"warning","value":"The impact_flag 'practice_changing' is applied cautiously — the finding is directionally strong but the small single-center sample and absence of a placebo/standard-care arm limit definitive conclusions.","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101394","tag_type":"warning","value":"The study used a Chinese biosimilar omalizumab (Enitan), so findings may not be fully generalizable to other formulations.","value_numeric":null}],"summaries":{"what_studied":"This single-center, randomized, double-blind, placebo-controlled trial compared monthly subcutaneous omalizumab 300 mg vs 150 mg in 54 adults (age 18–65) with cypress pollen-induced seasonal allergic rhinitis and total IgE <100 IU/mL, over one pollen season (~4 weeks).","key_result":"300 mg outperformed 150 mg on combined symptom-medication score (CSMS 1.1 vs 1.6, P=0.007), daily symptom score (0.6 vs 0.8, P=0.016), and ocular symptom score (0.5 vs 0.7, P=0.003). RQLQ was significantly better at both peak and late season (P<0.05); ARCT score was higher at peak season (20.0 vs 17.5, P=0.011); nasal resistance was lower (0.58 vs 0.91 Pa/cm³/s, P=0.020). No drug-related adverse events occurred in either group.","limitations":"- No placebo or standard-care comparator arm, so absolute treatment benefit over conventional therapy cannot be determined.\n- Single-center design with small sample (n=27/group), limiting generalizability.\n- Higher dosing regimens (450–600 mg) and varied intervals were not evaluated.","practice_takeaway":"For seasonal allergic rhinitis patients with total IgE <100 IU/mL who respond poorly to 150 mg omalizumab, escalating to 300 mg monthly may meaningfully improve symptoms, quality of life, and nasal airflow. Clinicians should not default solely to the asthma dosing table for this low-IgE AR population."}},{"doi":"10.1111/pai.70375","pmid":"42106996","title":"Olipudase alfa IgE‐mediated anaphylaxis prevented by omalizumab and tailored desensitization in a child with acid sphingomyelinase deficiency","journal_title":"Pediatric Allergy and Immunology","journal_issn":"0905-6157","published_at":"2026-05-10T00:00:00.000Z","url":"https://doi.org/10.1111/pai.70375","source_score":1,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-16T13:22:33.605Z","updated_at":"2026-05-16T13:22:33.605Z","tags":[{"paper_doi":"10.1111/pai.70375","tag_type":"age_group","value":"child","value_numeric":null},{"paper_doi":"10.1111/pai.70375","tag_type":"brand","value":"Xenpozyme","value_numeric":null},{"paper_doi":"10.1111/pai.70375","tag_type":"brand","value":"Xolair","value_numeric":null},{"paper_doi":"10.1111/pai.70375","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1111/pai.70375","tag_type":"condition","value":"Acid Sphingomyelinase Deficiency","value_numeric":null},{"paper_doi":"10.1111/pai.70375","tag_type":"condition","value":"Anaphylaxis","value_numeric":null},{"paper_doi":"10.1111/pai.70375","tag_type":"condition","value":"Drug Hypersensitivity","value_numeric":null},{"paper_doi":"10.1111/pai.70375","tag_type":"generic","value":"olipudase alfa","value_numeric":null},{"paper_doi":"10.1111/pai.70375","tag_type":"generic","value":"omalizumab","value_numeric":null},{"paper_doi":"10.1111/pai.70375","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1111/pai.70375","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1111/pai.70375","tag_type":"modality","value":"Anti-IgE Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1111/pai.70375","tag_type":"modality","value":"Desensitization Protocol","value_numeric":null},{"paper_doi":"10.1111/pai.70375","tag_type":"modality","value":"Enzyme Replacement Therapy","value_numeric":null},{"paper_doi":"10.1111/pai.70375","tag_type":"sample_size","value":"n=1","value_numeric":1},{"paper_doi":"10.1111/pai.70375","tag_type":"sex","value":"male","value_numeric":null},{"paper_doi":"10.1111/pai.70375","tag_type":"study_design","value":"Case Report","value_numeric":null},{"paper_doi":"10.1111/pai.70375","tag_type":"warning","value":"Omalizumab dosing (75 mg every 2 weeks) was empirically derived from one prior pediatric MPS case, not from weight/IgE dosing tables used in approved indications.","value_numeric":null},{"paper_doi":"10.1111/pai.70375","tag_type":"warning","value":"Single case report — findings cannot be generalized; omalizumab use here is entirely off-label for age and indication.","value_numeric":null},{"paper_doi":"10.1111/pai.70375","tag_type":"warning","value":"Skin prick testing was not performed due to drug unavailability, which limits confirmation of the allergic mechanism at each step.","value_numeric":null}],"summaries":{"what_studied":"This case report describes a 5-year-old boy with chronic neurovisceral acid sphingomyelinase deficiency (ASMD) who had three IgE-mediated anaphylactic episodes during olipudase alfa enzyme replacement therapy (ERT), and was subsequently managed with omalizumab (75 mg SC every 2 weeks) added to a tailored 10-step desensitization protocol and premedication.","key_result":"After introducing omalizumab alongside the personalized desensitization protocol, the patient tolerated four infusions at 2.5 mg/kg with no further hypersensitivity reactions; anti-olipudase IgE fell from 3.01 kUA/L to undetectable (<0.35 kUA/L) over 8 months, and disease markers (lysoSM, hepatosplenomegaly) progressively improved.","limitations":"- Single pediatric case; no generalizability to other patients or age groups.\n- Omalizumab dose was chosen empirically based on one prior similar case, not pharmacokinetic data.\n- Long-term outcomes after omalizumab discontinuation and durability of tolerance are unknown.","practice_takeaway":"In children with ASMD requiring olipudase alfa who have confirmed IgE-mediated anaphylaxis refractory to standard desensitization, adding omalizumab (off-label) may enable safe ERT continuation — coordinate with allergy and metabolic specialists and obtain institutional ethics approval before use. Monitor anti-drug IgE titers to guide dose and duration of omalizumab therapy."}},{"doi":"10.2147/ccid.s596249","pmid":"42079476","title":"Morbihan Disease May Induce Nonspecific Inflammatory of Extra-Facial Region: A Case Report and Literature Review","journal_title":"Clinical, Cosmetic and Investigational Dermatology","journal_issn":"1178-7015","published_at":"2026-05-04T00:00:00.000Z","url":"https://doi.org/10.2147/ccid.s596249","source_score":32,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-04-28","doi":"10.2147/ccid.s596249","days":"30","issn":"1178-7015","rank":"9","field":"Clinical Medicine","score":"32","category":"Dermatology","categories":["Dermatology"],"_categories":["Dermatology"]},"pubmed":{"doi":"10.2147/CCID.S596249","title":"Morbihan Disease May Induce Nonspecific Inflammatory of Extra-Facial Region: A Case Report and Literature Review.","journal":"Clinical, cosmetic and investigational 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acid","value_numeric":null},{"paper_doi":"10.2147/ccid.s596249","tag_type":"generic","value":"baricitinib","value_numeric":null},{"paper_doi":"10.2147/ccid.s596249","tag_type":"generic","value":"doxycycline","value_numeric":null},{"paper_doi":"10.2147/ccid.s596249","tag_type":"generic","value":"isotretinoin","value_numeric":null},{"paper_doi":"10.2147/ccid.s596249","tag_type":"generic","value":"omalizumab","value_numeric":null},{"paper_doi":"10.2147/ccid.s596249","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.2147/ccid.s596249","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.2147/ccid.s596249","tag_type":"modality","value":"Anti-IgE Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.2147/ccid.s596249","tag_type":"modality","value":"Intense Pulsed Light","value_numeric":null},{"paper_doi":"10.2147/ccid.s596249","tag_type":"modality","value":"JAK Inhibitor","value_numeric":null},{"paper_doi":"10.2147/ccid.s596249","tag_type":"modality","value":"Retinoid","value_numeric":null},{"paper_doi":"10.2147/ccid.s596249","tag_type":"modality","value":"Tetracycline Antibiotic","value_numeric":null},{"paper_doi":"10.2147/ccid.s596249","tag_type":"sample_size","value":"n=80","value_numeric":80},{"paper_doi":"10.2147/ccid.s596249","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.2147/ccid.s596249","tag_type":"study_design","value":"Case Report with Literature Review","value_numeric":null},{"paper_doi":"10.2147/ccid.s596249","tag_type":"warning","value":"Attribution of extra-facial lesions to Morbihan disease is presumptive; biopsy showed only nonspecific inflammation with no pathognomonic features, and other causes were excluded by clinical reasoning rather than exhaustive workup.","value_numeric":null},{"paper_doi":"10.2147/ccid.s596249","tag_type":"warning","value":"Omalizumab brand 'Xolair' is inferred from the generic name; the paper does not explicitly state the brand name.","value_numeric":null},{"paper_doi":"10.2147/ccid.s596249","tag_type":"warning","value":"The median age reported in the abstract is 54 years, but Table 1 in the full text lists 55 (IQR 43–62) — minor discrepancy noted.","value_numeric":null},{"paper_doi":"10.2147/ccid.s596249","tag_type":"warning","value":"The study design is labeled 'Case Report with Literature Review' — the pooled statistical analysis (ORs) is derived from aggregated case reports, not a formal systematic review or meta-analysis, limiting reliability of prognostic estimates.","value_numeric":null}],"summaries":{"what_studied":"A case report of a 29-year-old man with Morbihan disease (associated with rosacea) who developed novel extra-facial nonspecific inflammatory lesions (thighs, trunk, upper limbs), combined with a literature review of 80 patients (2004–2025) examining clinical features, histopathology, and treatment outcomes.","key_result":"Long-term isotretinoin (20 mg twice daily, tapered over ~3 years) achieved sustained facial and extra-facial remission without relapse. In the pooled literature cohort (n=80), lymphatic/vascular dilation on biopsy predicted favorable outcomes (OR 6.00, 95% CI 1.57–22.96, p=0.007), while dermal edema (OR 0.167, p=0.007) and granuloma (OR 0.321, p=0.037) predicted poorer response. Of 24 isotretinoin-treated patients, 15 improved; all 4 omalizumab-treated patients responded.","limitations":"- Evidence base is entirely retrospective case reports/series, precluding any definitive treatment hierarchy.\n- Literature search restricted to English-language publications, introducing potential language bias.\n- Extra-facial lesion attribution to Morbihan disease is presumptive (biopsy showed only nonspecific inflammation; no definitive causal link established).","practice_takeaway":"Consider long-term low-dose isotretinoin as a first-line option in refractory Morbihan disease; omalizumab and IPL may offer partial benefit as adjuncts. Histopathological findings (lymphatic/vascular dilation vs. dermal edema or granuloma) may help predict treatment response, though data are exploratory only."}},{"doi":"10.1080/02770903.2026.2660096","pmid":"41983924","title":"Three years treatment with HDM allergen immunotherapy, omalizumab, or combination therapy in allergic asthma: clinical outcomes and biomarkers","journal_title":"Journal of Asthma","journal_issn":"0277-0903","published_at":"2026-04-25T00:00:00.000Z","url":"https://doi.org/10.1080/02770903.2026.2660096","source_score":7,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-09T13:22:32.212Z","updated_at":"2026-05-09T13:22:32.212Z","tags":[{"paper_doi":"10.1080/02770903.2026.2660096","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1080/02770903.2026.2660096","tag_type":"brand","value":"Xolair","value_numeric":null},{"paper_doi":"10.1080/02770903.2026.2660096","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1080/02770903.2026.2660096","tag_type":"condition","value":"Allergic Asthma","value_numeric":null},{"paper_doi":"10.1080/02770903.2026.2660096","tag_type":"generic","value":"omalizumab","value_numeric":null},{"paper_doi":"10.1080/02770903.2026.2660096","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1080/02770903.2026.2660096","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1080/02770903.2026.2660096","tag_type":"modality","value":"Allergen Immunotherapy","value_numeric":null},{"paper_doi":"10.1080/02770903.2026.2660096","tag_type":"modality","value":"Anti-IgE Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1080/02770903.2026.2660096","tag_type":"sample_size","value":"n=79","value_numeric":79},{"paper_doi":"10.1080/02770903.2026.2660096","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1080/02770903.2026.2660096","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1080/02770903.2026.2660096","tag_type":"warning","value":"Age group tagged as 'adult' based on study context; explicit age range not stated in the provided text.","value_numeric":null},{"paper_doi":"10.1080/02770903.2026.2660096","tag_type":"warning","value":"Blinding status and randomization method are not described in the abstract, making risk-of-bias assessment uncertain.","value_numeric":null},{"paper_doi":"10.1080/02770903.2026.2660096","tag_type":"warning","value":"Sample size is very small (~20 patients per arm), so per-group estimates (e.g., remission rates) carry wide uncertainty intervals not reported in the abstract.","value_numeric":null},{"paper_doi":"10.1080/02770903.2026.2660096","tag_type":"warning","value":"The brand name 'Xolair' is inferred from the generic 'omalizumab'; the paper does not explicitly name the brand.","value_numeric":null}],"summaries":{"what_studied":"A prospective, randomized, controlled trial in 79 adults with HDM-driven mild-to-moderate allergic asthma comparing omalizumab alone (A), omalizumab + SCIT-HDM (B), SCIT-HDM alone (C), and standard therapy (D) over 36 months, with primary outcomes of ICS dose change and annual exacerbation rate.","key_result":"Combination therapy (B) achieved the highest clinical remission rate (47%) vs. omalizumab alone (31%), SCIT-HDM alone (29%), and standard therapy (14%); groups A and B had greater ICS reductions than C and D (p < 0.05), and B had the lowest exacerbation and oral corticosteroid use. No serious adverse events occurred in any group.","limitations":"Very small sample size (n=79 across 4 arms, ~20 per group) limits statistical power and generalizability. Open-label or allocation details not fully described, raising potential for bias. Long-term durability beyond 36 months is unknown.","practice_takeaway":"For patients with HDM-driven allergic asthma, adding SCIT-HDM to omalizumab may yield higher remission rates and fewer exacerbations than either treatment alone. 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