Progress on Allergies Highlighted at ACAAI

NEW ORLEANS — As the American College of Allergy, Asthma, & Immunology (ACAAI) annual meeting gets underway on Friday, attendees — online and in person here — can catch up on the latest news on allergy prevention and management, as well as the gamut of topics summed up in the organization’s name.

Some of the highlight presentations include the following:

• Eggs introduced in infancy may reduce the risk of later egg allergy. Survey data on some 1,200 children indicated that those with egg allergy at age 6 had eaten no eggs in their first 9 months, whereas the mean egg intake in infancy for those with no later egg allergy was nearly one full egg per week

• Four years ago, guidelines calling for infants to be exposed to peanut protein were introduced, meant to head off development of peanut allergy. But in a different survey, fewer than half of parents said their primary care physicians (PCPs) never recommended it to them. “Our survey showed that while PCPs are discussing the idea of early peanut introduction with parents of infants, they aren’t recommending that most parents begin peanut by 11 months of age,” said the study’s lead author in an ACAAI press release

• In pregnancy, it’s a good idea to test those reporting penicillin allergy to confirm that it’s real. In a small study, every woman said to be allergic had negative results on skin-prick testing. This is important because penicillin is highly effective against group B Streptococcus infections, which occur commonly and can be damaging to newborns. “If [a woman] is labeled as allergic, she will be offered a less effective, and possibly more harmful antibiotic. It is important to have penicillin de-labeling ahead of the need for penicillin,” said Mariana Castells, MD, PhD, chair of the ACAAI Task Force on Drug Allergy

In other news expected from the meeting, researchers are slated to report that Hispanic Americans with asthma were vastly more likely to develop exacerbations during the COVID-19 pandemic relative to whites and African Americans, and that teenagers with asthma are generally unprepared for the transition to adult care.

Also on the agenda are new clinical trial reports, including:

• A phase II trial involving an antisense oligonucleotide targeting prekallikrein, seen as a potential prophylactic therapy in hereditary angioedema (HAE)

• Also in phase II, a randomized study of another anti-kallikrein treatment for HAE, an oral drug called KVD900

• Secondary analyses from the phase IIIa CAPTAIN study of a so-called triple therapy in asthma, combining umeclidinium, vilanterol, and fluticasone, and from the NAVIGATOR study of an investigational asthma biologic, tezepelumab

• Early data on a potential COVID-19 treatment targeting caspase enzymes, thought to be involved in the multi-organ inflammatory conditions sometimes seen with the infection

Of course, the meeting will also feature a range of symposia, “product theater” presentations, lectures, and practice management sessions. There will also be a pro/con debate on treatments for mild asthma — specifically, whether patients should be started on dual-drug daily inhalers right away or stay with on-demand, short-acting beta agonists.

And the meeting, which ends Monday, will see the installation of ACAAI’s new president: Mark Corbett, MD, who is in private practice in Louisville, Kentucky.