By Beth Gilbert HealthDay Reporter
The annual meeting of the American College of Allergy, Asthma & Immunology was held from Nov. 9 to 13 in Anaheim, California, and attracted participants from around the world, including allergy and immunology specialists as well as other health care professionals. The conference featured presentations focusing on the latest advances in the prevention and treatment of asthma, food and medication allergies, immune dysfunction, and sleep apnea.
As part of the phase 1 OMEGA (Oral Mucosal Escalation Goal Assessment) clinical trial investigating INT301 toothpaste in adults with peanut allergy using oral mucosal immunotherapy (OMIT), William Berger, M.D., of the University of California Irvine School of Medicine/Children’s Hospital of Orange County, and colleagues found that treating patients through OMIT in the form of a fully functioning toothpaste (INT301) is an innovative approach to peanut desensitization that is safe and well tolerated.
The authors performed a subset analysis of trial participants who completed a double-blind, placebo-controlled, oral food challenge at both study entry and exit. The researchers found that INT301 met all primary and secondary objectives, with the majority of the adverse events being mild and no severe adverse events or anaphylaxis observed. In addition, exploratory objectives provided documented indications of efficacy, with indications of immune response in the INT301 active treatment arm based on an increase in specific immunoglobulin G4 (sIgG4) and a decrease in the IgE/IgG4 ratio.
“With the oral mucosal immunotherapy, food allergy desensitization has been transformed into an easy-to-use platform by an innovative technology in which immunotherapy is conveniently administered with daily teeth brushing,” Berger said. “This approach should have a significant impact on clinical practice due to a 97 percent adherence rate and no moderate nor severe systemic reactions. Local reactions of mild itching in the oral cavity were transient and did not result in any patients dropping out of the study. Clearly, efficacy of treatment is directly related to adherence and patient acceptance of therapy and should translate into improved clinical outcomes.”
The study was funded by Intrommune Therapeutics, which is developing the INT301 toothpaste.
In another study, Arabelle Abellard, M.D., of the Rush University Medical Center in Chicago, and colleagues found that children with private insurance are more likely to outgrow food allergies compared with their counterparts with Medicaid.
As part of a cohort study, the authors investigated factors that may be associated with outgrowing food allergies among 188 children. The researchers observed a significant association between insurance type and outgrowing food allergies. In addition, having private insurance was associated with outgrowing food allergies compared with having Medicaid insurance. Milk and egg were the most frequently outgrown food allergies, followed by soy, peanut, and tree nuts. The mean age for the development of tolerance was 5.02 years, which was within the first six years of life and consistent with other studies for milk, egg, and soy.
“Children with Medicaid/public insurance, particularly those from disadvantaged racial/ethnic groups, may face barriers to care because of underinsurance and gaps in coverage that decrease health care access,” Abellard said. “Their caregivers may make decisions with the expectation of losing coverage and may prefer fewer follow-ups. Additionally, insurance plans do not cover all health-related financial expenses such as transportation costs, lost work time for caregivers, and lifestyle modifications. There may be fewer resources within the family, including lower income, limited education, language proficiency, and health literacy.”
Jimmy Espinoza, M.D., of UTHealth Houston, and colleagues found that saltwater gargling and nasal rinsing are cost-effective and widely available interventions that may reduce hospital admission among patients diagnosed with COVID-19 infection.
The authors randomly selected individuals aged 18 to 65 years with a positive polyermase chain reaction test for severe acute respiratory syndrome coronavirus 2 infection between 2020 and 2022 to undergo low- or high-dose saline regimens for 14 days. The investigators observed no differences in the duration of symptoms, hospitalization rates, use of mechanical ventilation, or death between patients who used a low-dose or a high-dose regimen of saltwater gargling and nasal rinsing for 14 days. Meanwhile, the researchers noted that the hospitalization rates among individuals diagnosed with COVID-19 infection at their institution during the study period who did not use these interventions were more than twice as high compared with the rates for individuals allocated either to the low-salt regimen or high-salt regimen.
“It is important to consider that the latter observation needs confirmation from larger studies designed specifically to compare patients using saltwater nasal rinsing and gargling and those who did not use these interventions,” Espinoza said. “If our observations are confirmed by additional studies, it is possible that saltwater gargling and nasal rinsing may be complementary to other conventional treatments for COVID-19 infections.”
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