Some PCPs may be doing patients a ‘disservice’ when diagnosing allergy

May is Asthma and Allergy Awareness Month, “a perfect time” for primary care physicians to brush up on the best approaches to diagnosis and treatment, according the president-elect of the American College of Allergy, Asthma and Immunology.

For example, “a positive allergy test or a positive blood test to a product does not mean a patient is allergic. It means they are sensitized and could be allergic,” Mark Corbett, MD, who is also a board-certified allergist with Family Allergy & Asthma in Kentucky, told Healio Primary Care.

“We see a lot of patients who come in with a whole list of foods that they have been told not to eat anymore” based solely on those test results, he said. “This does a disservice to the patient and can cause them to inappropriately avoid foods,” he said.

To “get the true picture” of what is causing the patient’s reaction, Corbett encouraged PCPs to use test results in combination with the patient’s history.

Regarding asthma, Corbett pointed to updated guidance from the Global Initiative for Asthma, which recommends using albuterol in combination with an inhaled steroid for flareups.

“You shouldn’t just be using your rescue bronchodilator — you should also add an inhaled steroid to that,” he said.

Corbet also emphasized that “a lot of patients with asthma do not need to be on daily oral steroids anymore.”

“If a patient is having to take oral steroids on a routine basis, they need to see an asthma specialist or an allergist to see if they can get off of those and move on to other therapies, such as biologics,” he said. “We have had very good success with biologics, and there are likely to be more biologics approved in the next year or so to add to the armamentarium.”

To mark Asthma and Allergy Awareness Month, here are 10 recent updates on research and clinical practice:

Prevalence of penicillin allergy label similar among kids, adults

The number of inpatients with a penicillin allergy label at a children’s hospital approached 9% — “on trend with what’s out there in the adult world” —according to results from a retrospective chart review. Read more.

Most health care professionals still misunderstand peanut allergy guidelines

Nearly 90% of health care professionals incorrectly answered questions based on peanut allergy guidelines from the National Institute of Allergy and Infectious Diseases, survey results showed. Read more.

VIDEO: Allergy diagnosis requires close look at symptoms, environment, proteins

Pet allergy affects at least 1 in 10 people worldwide, according to Lakiea Wright, MD, a board-certified allergist and associate physician at Brigham Women’s Hospital. She said properly diagnosing pet allergy requires taking a detailed look at a patient’s history, environment and the proteins that are causing the allergy. Watch video.

Algorithm reduces need for oral food challenges to diagnose walnut, pecan allergy

Researchers validated an algorithm in a new cohort of patients with suspected walnut and pecan allergy, and they said it reduced the number of oral food challenges required for diagnosis by almost 80%. Read more.

Patients with documented penicillin allergy more likely to receive ‘inferior’ antibiotics

Hospitalized patients who had a documented penicillin allergy had higher odds of receiving “inferior” antibiotics — some that could potentially cause adverse drug events, data published in JAMA Internal Medicine show. Read more.

Antibiotic use in pregnancy linked to childhood asthma risk

Maternal antibiotic use in the second and third trimester of pregnancy was associated with an increased risk for developing childhood asthma, according to research published in Archives of Diseases in Children. Read more.

Odds of asthma significantly higher among children with disability or delay

Asthma prevalence estimates were 10 percentage points higher among children with a developmental disability or delay than among children without one, according to a study in JAMA Network Open. Read more.

Survey: Many cannabis users with uncontrolled asthma choose to smoke it

A survey revealed that many patients with allergy and asthma who use cannabis — including those with uncontrolled asthma — smoke or vape cannabis rather than use edibles or tinctures. Read more.

UV irradiation unit installed in homes decreases asthma severity in children

Study data presented at the American Academy of Allergy, Asthma & Immunology meeting demonstrated a significant decrease in asthma severity in children following the installation of ultraviolet irradiation units compared with sham units. Read more.

FDA approves self-injectable formulation of Xolair

The FDA has approved a self-injectable formulation of Xolair for appropriate patients with moderate to severe persistent allergic asthma, nasal polyps or chronic idiopathic urticaria, according to the manufacturers. Read more.

References:

Asthma and Allergy Foundation. May is Asthma and Allergy Awareness Month. https://www.aafa.org/asthma-and-allergy-awareness-month/. Accessed May 24, 2021.

Global Initiative for Asthma. 2021 GINA Report, Global Strategy for Asthma Management and Prevention. https://ginasthma.org/gina-reports/. Accessed May 24, 2021.