G. Passalacqua

Rhinitis and asthma in athletes: an ARIA document in collaboration with GA2LEN

This consensus document is aimed at reviewing evidence that the rhinits‐asthma links have peculiar features in athletes. Beside a review of epidemological data on the high prevalence of rhinitis and asthma in athletes, the effects on intense physical exercise on the immune system and repiratory functions are discussed, with special reference to the role of allergens and pollutants. In extending the Allergic Rhinitis and its Impact on Asthma (ARIA) recommendations to athletes, the issue is addressed of adapting diagnosis and management to criteria set by the International Olympic Committee (IOC) and regulations adopted by the World Anti‐Doping Agency (WADA).

A prospective Italian survey on the safety of subcutaneous immunotherapy for respiratory allergy

Background Subcutaneous immunotherapy is effective for the treatment of respiratory allergy, and it is largely used in Italy, but no systematic safety assessment has been carried out so far.

The type of sensitizing allergen can affect the evolution of respiratory allergy.

Background:u2002 Numerous factors affect the evolution of respiratory allergy, in children, but little is known in adults. We assessed in a prospective study the influence of the type of allergen on the progression of disease.

Pilot study of mobile phone technology in allergic rhinitis in European countries. The MASK-rhinitis study.

The use of Apps running on smartphones and tablets profoundly affects medicine. The MASK‐rhinitis (MACVIA‐ARIA Sentinel NetworK for allergic rhinitis) App (Allergy Diary) assesses allergic rhinitis symptoms, disease control and impact on patients’ lives. It is freely available in 20 countries (iOS and Android platforms).

Work productivity in rhinitis using cell phones: The MASK pilot study.

Allergic rhinitis often impairs social life and performance. The aim of this cross‐sectional study was to use cell phone data to assess the impact on work productivity of uncontrolled rhinitis assessed by visual analogue scale (VAS). A mobile phone app (Allergy Diary, Google Play Store and Apple App Store) collects data from daily visual analogue scales (VAS) for overall allergic symptoms (VAS‐global measured), nasal (VAS‐nasal), ocular (VAS‐ocular) and asthma symptoms (VAS‐asthma) as well as work (VAS‐work). A combined nasal‐ocular score is calculated. The Allergy Diary is available in 21 countries. The app includes the Work Productivity and Activity Impairment Allergic Specific Questionnaire (WPAI:AS) in six EU countries. All consecutive users who completed the VAS‐work from 1 June to 31 October 2016 were included in the study. A total of 1136 users filled in 5818 days of VAS‐work. Symptoms of allergic rhinitis were controlled (VAS‐global <20) in approximately 60% of the days. In users with uncontrolled rhinitis, approximately 90% had some work impairment and over 50% had severe work impairment (VAS‐work >50). There was a significant correlation between VAS‐global calculated and VAS‐work (Rho=0.83, P<0.00001, Spearmans rank test). In 144 users, there was a significant correlation between VAS‐work and WPAI:AS (Rho=0.53, P<0.0001). This pilot study provides not only proof‐of‐concept data on the work impairment collected with the app but also data on the app itself, especially the distribution of responses for the VAS. This supports the interpretation that persons with rhinitis report both the presence and the absence of symptoms.

The Allergic Rhinitis and its Impact on Asthma (ARIA) score of allergic rhinitis using mobile technology correlates with quality of life: The MASK study

Mobile technology has been used to appraise allergic rhinitis control, but more data are needed. To better assess the importance of mobile technologies in rhinitis control, the ARIA (Allergic Rhinitis and its Impact on Asthma) score ranging from 0 to 4 of the Allergy Diary was compared with EQ‐5D (EuroQuol) and WPAI‐AS (Work Productivity and Activity Impairment in allergy) in 1288 users in 18 countries. This study showed that quality‐of‐life data (EQ‐5D visual analogue scale and WPA‐IS Question 9) are similar in users without rhinitis and in those with mild rhinitis (scores 0‐2). Users with a score of 3 or 4 had a significant impairment in quality‐of‐life questionnaires.

Anaphylaxis due to carrot as hidden food allergen

Carrot is frequently involved in food allergies and oral allergy syndromes, usually in association with other foods. Nevertheless, carrot alone is rarely responsible for severe systemic reactions. We report a case of anaphylactic shock due to the inadvertent ingestion of carrot as a hidden allergen contained in an ice-cream. The etiological role of carrot in provoking the symptoms was thoroughly ascertained through appropriate in vivo and in vitro assays and by excluding, through double-blind placebo-controlled challenge, the involvement of other ingredients of the food. We highlight once again the harm and risks due to hidden food allergens contained in commercial preparations and the importance of thorough patient education and information.

CHRODIS criteria applied to the MASK (MACVIA-ARIA Sentinel NetworK) Good Practice in allergic rhinitis: A SUNFRAIL report

A Good Practice is a practice that works well, produces good results, and is recommended as a model. MACVIA-ARIA Sentinel Network (MASK), the new Allergic Rhinitis and its Impact on Asthma (ARIA) initiative, is an example of axa0Good Practice focusing on the implementation of multi-sectoral care pathways using emerging technologies with real life data in rhinitis and asthma multi-morbidity. The European Union Joint Action on Chronic Diseases and Promoting Healthy Ageing across the Life Cycle (JA-CHRODIS) has developed a checklist of 28 items for the evaluation of Good Practices. SUNFRAIL (Reference Sites Network for Prevention and Care of Frailty and Chronic Conditions in community dwelling persons of EU Countries), a European Union project, assessed whether MASK is in line with the 28 items of JA-CHRODIS. A short summary was proposed for each item and 18 experts, allxa0members of ARIA and SUNFRAIL from 12 countries, assessed the 28 items using a Survey Monkey-based questionnaire. A visual analogue scale (VAS) from 0 (strongly disagree) to 100 (strongly agree) was used. Agreement equal or over 75% was observed for 14 items (50%). MASK is following the JA-CHRODIS recommendations for the evaluation of Good Practices.

Treatment of allergic rhinitis using mobile technology with real world data: The MASK observational pilot study

Large observational implementation studies are needed to triangulate the findings from randomized control trials as they reflect “real‐world” everyday practice. In a pilot study, we attempted to provide additional and complementary insights on the real‐life treatment of allergic rhinitis (AR) using mobile technology.

Work Productivity and Activity Impairment Allergic Specific (WPAI-AS) Questionnaire using Mobile Technology: The MASK study.

J Bousquet, MD , O VandenPlas, MD , M Bewick, MD , S Arnavielhe, PhD , A Bedbrook, BSc , R Murray, PhD , M van Eerd, MSc , J Fonseca, MD , M Morais-Almeida, MD , A Todo Bom, MD , AA Cruz, MD , F Sarquis Serpa, MD, 12 J da Silva, MD, 13 E Menditto, PhD, , G Passalacqua, MD , C Stellato , MD, 16 , MT Ventura, MD , D Caimmi, MD , P Demoly, MD , KC Bergmann, MD , T Keil, MD , L Klimek, MD , R Mösges, MD , S Shamai, MD, 22 T Zuberbier, MD , D Larenas-Linnemann, MD , M Rodriguez Gonzalez, MD, 24 MT Burguete Cabañas, MD, 25 D Ryan, MD , A Sheikh, MD , JM Anto, MD , J Mullol, MD , A Valero, MD 29 ML Kowalski, MD , P Kuna, MD , B Samolinski, MD , PV Tomazic, MD , S Bosnic-Anticevich, PhD , RE OHehir MD, , G De Vries, MSc , D Laune, PhD 5