This summary was compiled from the tweets posted by allergists/immunologists who attended the 2013 annual meeting of the American Academy of Allergy Asthma and Immunology (AAAAI) (see the list at the end). The tweets were labeled #AAAAI. The text was edited and modified by me.
Dr Busse discussed some new medications/treatments that may get into the new US asthma guidelines: Anticholinergics? Bronchial thermoplasty? Step down with LABA? Intermittent steroid use? Antibiotic use? SMART Symbicort?
LAMA, eg tiotropium, is used in COPD. A NEJM 2010 study looked at asthma. Add on therapy with LAMA was better than LABA. A NEJM 2012 study of tiotropium in poorly controlled asthma showed improvement in FEV1 and reduction in exacerbations.
The likelihood that we will see the addition of LAMA's to the guidelines for more severe asthma is STRONG.
Intermittent use of ICS in mild asthma will be discussed.
Asthma and allergy medications in pregnancy
Dr. Namazy: intranasal budesonide is Category B in pregnancy and the INS of choice but there are no major concerns with the others.
Loratidine and cetrizine are viewed as antihistamines of choice in US, and pseudoephedrine for decongestants.
Meta-analysis of 6 studies of SABA in asthma showed no obvious increase in birth complications. In the past, SABA use was associated with GI defects, but it could be confounded by severity. Large scale QC data did not confirm this.
A study of ICS found no increase in perinatal mortality (Breton JACI article). A "step down" during pregnancy for fear of side effects can cause significant complications.
42% of pregnant women think there are teratogenic effects from OCS. It's 12% for ICS and 5% for SABA.
Allergists are on Twitter - follow them
Allergists increased Twitter use 470% in one year - 25 allergists reached 250,000 individuals from the 2012 #AAAAI meeting (see the references here). This summary was compiled from some of the tweets posted by the following allergists:
This is a list of the allergists who used Twitter to post updates from the 2013 #AAAAI meeting. The list is open for edit, please feel free to add your own info.
Comments from Twitter:
David Fischer, MD @IgECPD: RT @DrAnneEllis: RT @Aller_MD: Allergy Notes: Asthma - Twitter summary from 2013 #AAAAI meeting bit.ly/16W9hdc Tweets by me