EAACI Biologicals Guidelines-Omalizumab for the treatment of chronic spontaneous urticaria in adults and in the paediatric population 12-17 years old.

Chronic spontaneous urticaria (CSU) imposes a significant burden on patients, families and healthcare systems. Management is difficult, due to disease heterogeneity and insufficient efficacy of classical drugs such as H1 R-antihistamines. Better understanding of the mechanisms has enabled a stratified approach to the management of CSU, supporting the use of targeted treatment with omalizumab. However, many practical issues including selection of responders, the definition of response, strategies to enhance the responder rate, the duration of treatment and its regimen (in the clinic or home-based) and its cost-effectiveness still require further clarification. The EAACI Guidelines on the use of omalizumab in CSU follow the GRADE approach in formulating recommendations for each outcome. In addition, future therapeutic approaches and perspectives as well as research priorities are discussed.

Urban vs rural - Prevalence of self-reported allergies in various occupational and regional settings.

BACKGROUND: Allergies have an enormous individual and economic impact worldwide and affect more than one quarter of the population in Germany. Various factors influence the development of allergies: besides genetic predisposition the environment in which a person is raised and living also plays a role. The aim of the study was to evaluate differences in allergy prevalence in relation to age, sex, occupation, and living area (settlement structures). METHODS: A cross-sectional study using a paper-based questionnaire about allergies was performed at the Munich Oktoberfest 2016. Participants were divided into 4 occupational groups and compared using descriptive statistics and multiple regression. RESULTS: Overall, 2701 individuals (mean age 51.9 ± 15.3 years; 53.5% women) participated in the study. The overall rate of any self-reported allergy was 27.3% in the study population, in which women were more likely to be affected than men (OR = 1.82; 95% CI [1.50; 2.22]). Compared to farmers, all other occupational groups had a higher risk of reporting pollen allergies. Participants from rural areas (OR = 0.38; 95% CI [0.26; 0.58]) and suburban areas (OR = 0.44; 95% CI [0.30; 0.64]) were significantly less affected by allergies than participants from urban areas. Around 45.2% of the participants affected by allergies reported not receiving any treatment at all. CONCLUSION: Differences in the self-reported prevalence of allergies were shown for age groups, sex, living area, and occupation. Especially the reported pollen allergy prevalence ranged widely between different occupations, indicating that those individuals with an occupational exposure to pollen may have a lower risk than indoor workers. Overall, there remains a high need for sufficient treatment of allergies.