TY - JOUR
T1 - Considerations on biologicals for patients with allergic disease in times of the COVID-19 pandemic
T2 - An EAACI statement
AU - Vultaggio, Alessandra
AU - Agache, Ioana
AU - Akdis, Cezmi A
AU - Akdis, Mubeccel
AU - Bavbek, Sevim
AU - Bossios, Apostolos
AU - Bousquet, Jean
AU - Boyman, Onur
AU - Chaker, Adam M
AU - Chan, Susan
AU - Chatzipetrou, Alexia
AU - Feleszko, Wojciech
AU - Firinu, Davide
AU - Jutel, Marek
AU - Kauppi, Paula
AU - Klimek, Ludger
AU - Kolios, Antonios
AU - Kothari, Akash
AU - Kowalski, Marek L
AU - Matucci, Andrea
AU - Palomares, Oscar
AU - Pfaar, Oliver
AU - Rogala, Barbara
AU - Untersmayr, Eva
AU - Eiwegger, Thomas
N1 - Funding Information:
Dr Chaker reports grants for clinical studies and research and other from Allergopharma, ALK‐Abello, AstraZeneca, Bencard/Allergen Therapeutics, ASIT Biotech, Lofarma, GSK, Novartis, LETI, Roche, Sanofi Genzyme, Zeller, and the European Institute of Technology (EIT); has received travel support from the European Academy of Allergy and Clinical Immunology (EAACI) and DGAKI, all outside the submitted work. Dr Firinu reports personal fees from Valeas S.p.A., Italy, and GSK, Italy, outside the submitted work. Dr Bossios reports personal fees from Novartis (advisory and/or lecture honorarium), AstraZeneca (advisory and/or lecture honorarium), GSK (advisory and/or lecture honorarium), and Teva (advisory and/or lecture honorarium), outside the submitted work. Dr Akdis reports grants from Allergopharma, Idorsia, Swiss National Science Foundation, Christine Kühne‐Center for Allergy Research and Education, European Commission's Horison's 2020 Framework Programme, Cure, Novartis Research Institutes, Astra Zeneca, Scibase, and advisory board membership in Sanofi/Regeneron. Dr Jutel reports personal fees from ALK‐Abello, Allergopharma, Stallergenes, Anergis, Allergy Therapeutics, Circassia, Leti, Biomay, and HAL, during the conduct of the study; personal fees from AstraZeneca, GSK, Novartis, Teva, Vectura, UCB, Takeda, from Roche, Janssen, Medimmune, and Chiesi, outside the submitted work. Dr Agache is an Associate Editor Allergy. Dr Bousquet reports personal fees from Chiesi, Cipla, Hikma, Menarini, Mundipharma, Mylan, Novartis, Purina, Sanofi‐Aventis, Takeda, Teva, and Uriach, and other from KYomed INNOV, outside the submitted work. Dr Pfaar reports grants and personal fees from ALK‐Abelló, Allergopharma, Stallergenes Greer, HAL Allergy Holding BV/HAL Allergie GmbH, Bencard Allergie GmbH/Allergy Therapeutics, Lofarma, ASIT Biotech Tools SA, Laboratorios LETI/LETI Pharma, and Anergis SA; grants from Biomay, Circassia, and GlaxoSmithKline; and personal fees from MEDA Pharma/MYLAN, Mobile Chamber Experts (a GA2LEN Partner), Indoor Biotechnologies, Astellas Pharma Global, EUFOREA, ROXALL, Novartis, and Sanofi‐Aventis, outside the submitted work. Dr Palomares received research grants from Inmunotek SL and Novartis. Oscar Palomares has received fees for giving scientific lectures from Allergy Therapeutics, Amgen, AstraZeneca, Diater, GlaxoSmithKline, S.A, Inmunotek SL, Novartis, Sanofi Genzyme, and Stallergenes. Oscar Palomares has participated in advisory boards from Novartis and Sanofi Genzyme. Dr Akdis received research grants from Swiss National Science Foundation. Dr Eiwegger reports other from DBV and Regeneron, and grants from Innovation fund Denmark and CIHR. He is the Co‐I or scientific lead in three investigator‐initiated oral immunotherapy trials including the usage of biologicals supported by the Allergy and Anaphylaxis Program SickKids and CIHR. He serves as an associate editor for Allergy. He is on advisory boards for ALK. Dr Chan reports nonfinancial support from Novartis, outside the submitted work.
Publisher Copyright:
© 2020 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.
PY - 2020/11/1
Y1 - 2020/11/1
N2 - The outbreak of the SARS-CoV-2-induced coronavirus disease 2019 (COVID-19) pandemic re-shaped doctor-patient interaction and challenged capacities of healthcare systems. It created many issues around the optimal and safest way to treat complex patients with severe allergic disease. A significant number of the patients are on treatment with biologicals, and clinicians face the challenge to provide optimal care during the pandemic. Uncertainty of the potential risks for these patients is related to the fact that the exact sequence of immunological events during SARS-CoV-2 is not known. Severe COVID-19 patients may experience a "cytokine storm" and associated organ damage characterized by an exaggerated release of pro-inflammatory type 1 and type 3 cytokines. These inflammatory responses are potentially counteracted by anti-inflammatory cytokines and type 2 responses. This expert-based EAACI statement aims to provide guidance on the application of biologicals targeting type 2 inflammation in patients with allergic disease. Currently, there is very little evidence for an enhanced risk of patients with allergic diseases to develop severe COVID-19. Studies focusing on severe allergic phenotypes are lacking. At present, noninfected patients on biologicals for the treatment of asthma, atopic dermatitis, chronic rhinosinusitis with nasal polyps, or chronic spontaneous urticaria should continue their biologicals targeting type 2 inflammation via self-application. In case of an active SARS-CoV-2 infection, biological treatment needs to be stopped until clinical recovery and SARS-CoV-2 negativity is established and treatment with biologicals should be re-initiated. Maintenance of add-on therapy and a constant assessment of disease control, apart from acute management, are demanded.
AB - The outbreak of the SARS-CoV-2-induced coronavirus disease 2019 (COVID-19) pandemic re-shaped doctor-patient interaction and challenged capacities of healthcare systems. It created many issues around the optimal and safest way to treat complex patients with severe allergic disease. A significant number of the patients are on treatment with biologicals, and clinicians face the challenge to provide optimal care during the pandemic. Uncertainty of the potential risks for these patients is related to the fact that the exact sequence of immunological events during SARS-CoV-2 is not known. Severe COVID-19 patients may experience a "cytokine storm" and associated organ damage characterized by an exaggerated release of pro-inflammatory type 1 and type 3 cytokines. These inflammatory responses are potentially counteracted by anti-inflammatory cytokines and type 2 responses. This expert-based EAACI statement aims to provide guidance on the application of biologicals targeting type 2 inflammation in patients with allergic disease. Currently, there is very little evidence for an enhanced risk of patients with allergic diseases to develop severe COVID-19. Studies focusing on severe allergic phenotypes are lacking. At present, noninfected patients on biologicals for the treatment of asthma, atopic dermatitis, chronic rhinosinusitis with nasal polyps, or chronic spontaneous urticaria should continue their biologicals targeting type 2 inflammation via self-application. In case of an active SARS-CoV-2 infection, biological treatment needs to be stopped until clinical recovery and SARS-CoV-2 negativity is established and treatment with biologicals should be re-initiated. Maintenance of add-on therapy and a constant assessment of disease control, apart from acute management, are demanded.
KW - Academies and Institutes
KW - Biological Products/immunology
KW - COVID-19/complications
KW - Europe
KW - Humans
KW - Hypersensitivity/complications
KW - Pandemics
UR - http://www.scopus.com/inward/record.url?scp=85095419977&partnerID=8YFLogxK
U2 - 10.1111/all.14407
DO - 10.1111/all.14407
M3 - Journal article
C2 - 32500526
SN - 0105-4538
VL - 75
SP - 2764
EP - 2774
JO - Allergy: European Journal of Allergy and Clinical Immunology
JF - Allergy: European Journal of Allergy and Clinical Immunology
IS - 11
ER -