Werner Aberer

Medical University of Graz, Gratz, Styria, Austria

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Publications (256)1060.54 Total impact

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    ABSTRACT: Icatibant, a selective bradykinin B2 receptor antagonist for the treatment of acute hereditary angio-oedema (HAE) attacks in adults, can be administered by health care professionals (HCPs) or self-administered. This analysis compared characteristics and outcomes of acute HAE attacks treated with self-administered and HCP-administered icatibant in a real-world setting. The Icatibant Outcome Survey (Shire, Zug, Switzerland; NCT01034969) is an international observational study monitoring the safety and effectiveness of icatibant treatment. Descriptive retrospective analyses were performed (February 2008 to December 2012). Icatibant was used in 652 attacks in 170 patients with HAE type I/II. Most icatibant injections were self-administered (431/652, 68.5%). The proportion of self-treated attacks increased over time (40.3% in 2009 vs. 89.7% in 2012). The median time to administration was significantly shorter in self- versus HCP-treated attacks (1.5 vs. 2.4 h; p = 0.016). Earlier treatment (<2 h after onset) was significantly associated with a shorter median time to resolution (2.5 vs. 5.0 h; p = 0.032) and attack duration (3.0 vs. 14.0 h; p < 0.0001), regardless of administration method. Patients self-administered icatibant for attacks of all severities; overall, 34.7% of severe and 30.2% of very severe attacks were HCP treated. Logistic regression analysis did not find use of long-term prophylaxis, attack location or gender to be predictive for self-administration. The proportion of HAE attacks treated with self-administered icatibant increased over time. Patients successfully self-administered icatibant for a wide variety of HAE attacks, demonstrating that icatibant is generally well tolerated and effective for self-administration. Self-administration of icatibant provides a complementary option to HCP administration, enabling optimization of patient care. © 2015 S. Karger AG, Basel.
    International Archives of Allergy and Immunology 06/2015; 167(1):21-28. DOI:10.1159/000430864 · 2.43 Impact Factor
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    ABSTRACT: Drug hypersensitivity reactions are unpredictable adverse drug reactions. They manifest either within 1–6 h following drug intake (immediate reactions) with mild to life-threatening symptoms of anaphylaxis, or several hours to days later (delayed reactions), primarily as exanthematous eruptions. It is not always possible to detect involvement of the immune system (allergy). Waiving diagnostic tests can result in severe reactions on renewed exposure on the one hand, and to unjustified treatment restrictions on the other. With this guideline, experts from various specialist societies and institutions have formulated recommendations and an algorithm for the diagnosis of drug allergies. The key principles of diagnosing allergic/hypersensitivity drug reactions are presented. Where possible, the objective is to perform allergy diagnostics within 4 weeks–6 months following the reaction. A clinical classification of symptoms based on the morphology and time course of the reaction is required in order to plan a diagnostic work-up. In the case of typical symptoms of a drug hypersensitivity reaction and unequivocal findings from validated skin and/or laboratory tests, a reaction can be attributed to a trigger with sufficient confidence. However, skin and laboratory tests are often negative or insufficiently reliable. In such cases, controlled provocation testing is required to clarify drug reactions. This method is reliable and safe when attention is paid to indications and contraindications and performed under appropriate medical supervision. The results of the overall assessment are discussed with the patient and documented in an „allergy passport“ in order to ensure targeted avoidance in the future and allow the use of alternative drugs where possible.
    Allergo Journal International 05/2015; 24(3):94-105. DOI:10.1007/s40629-015-0052-6
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    ABSTRACT: Patients with elevated basal tryptase (sBT) >15μg/L and anaphylaxis may have an underlying mastocytosis. A monoclonal mast cell activation syndrome (MMAS) with aberrant mast cells (MC) at extracutaneous sites has been described in patients with severe hypotension or anaphylaxis. Since MC in patients with elevated sBT might be altered in the skin as well, we studied MCs in normal neck skin in anaphylaxis and urticaria patients with elevated sBT. A mean of 93.1 (SD 19.1) MC/mm² was counted in normal neck skin in 14 patients with anaphylaxis, 84.0 (SD 13.6) in 7 patients with urticaria, 142.0 (SD 24.0) in 2 patients with eczema, 124.4 (SD 43.2) in 5 patients with systemic mastocytosis (SM) in comparison to autopsy skin (39.1 MC/mm², SD 12.4). In 5/14 (35.7%) of the anaphylaxis and 3/5 (60%) SM patients more than 25% of MCs were spindle shaped and expressed CD 25 antigen. We could show for the first time that the normal skin can harbour clonal MC in anaphylaxis patients. Analogous to the criteria for mastocytosis, we suggest a skin score criteria including an elevated number of MC, spindle shape, CD 25 expression, c-Kit mutation and sBT values >20μg/L. In patients with anaphylaxis and elevated sBT skin should be biopsied and, as with the approach for mastocytosis diagnosis in the bone marrow, MC should be analysed for their number, clonality and c-Kit mutation. This approach should be confirmed in further studies. Patients with aberrant skin MC should be handled as mastocytosis patients. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Allergy 04/2015; 70(7). DOI:10.1111/all.12634 · 6.00 Impact Factor
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    ABSTRACT: Mastocytosis is a clonal disorder characterized by the proliferation and accumulation of mast cells (MC) in different tissues, with a preferential localization in skin and bone marrow (BM). The excess of MC in mastocytosis as well as the increased releasability of MC may lead to a higher frequency and severity of immediate hypersensitivity reactions. Mastocytosis in adults is associated with a history of anaphylaxis in 22-49%. Fatal anaphylaxis has been described particularly following hymenoptera stings, but also occasionally after intake of drugs such as non-steroidal antiinflammatory drugs, opioids and in the perioperative setting. However, data on the frequency of drug hypersensitivity in Mastocytosis and vice-versa are scarce and evidence for an association appears to be limited. Nevertheless, clonal MC disorders should be ruled out in cases of severe anaphylaxis: basal serum tryptase determination, physical examination for Cutaneous Mastocytosis lesions and clinical characteristics of anaphylactic reaction might be useful for differential diagnosis. In this position paper, the ENDA group performed a literature search on immediate drug hypersensitivity reactions in clonal MC disorders using MEDLINE EMBASE, and Cochrane Library, reviewed and evaluated the literature in five languages using the GRADE system for quality of evidence and strength of recommendation. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Allergy 03/2015; 70(7). DOI:10.1111/all.12617 · 6.00 Impact Factor
  • Journal of Allergy and Clinical Immunology 02/2015; 135(2):AB279. DOI:10.1016/j.jaci.2014.12.1850 · 11.25 Impact Factor
  • Journal of Allergy and Clinical Immunology 02/2015; 135(2):AB194. DOI:10.1016/j.jaci.2014.12.1569 · 11.25 Impact Factor
  • Journal of Allergy and Clinical Immunology 02/2015; 135(2):AB194. DOI:10.1016/j.jaci.2014.12.1568 · 11.25 Impact Factor
  • Journal of Allergy and Clinical Immunology 02/2015; 135(2):AB278. DOI:10.1016/j.jaci.2014.12.1847 · 11.25 Impact Factor
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    ABSTRACT: In Germany over 2.5 million employees have an increased risk of skin cancer due to their occupational exposure to natural UV-irradiation. The medical consultation board “Occupational diseases” of the Ministry of Labor and Social affairs has investigated the association between occupational UV-irradiation and skin cancer risk and recommends to add the following new occupational disease into the appendix1 of the German ordinance on occupational diseases: “Squamous cell carcinoma and multiple actinic keratosis due to natural UV-irradiation”.In this article we report in the view of the German Society of Occupational and Environmental Dermatology (ABD) and the German Statutory accident insurance (DGUV), whose criteria have to be fulfilled for the notification and recognition of an occupational skin cancer due to natural UV-irradiation.
    Journal der Deutschen Dermatologischen Gesellschaft 12/2014; 12(12). DOI:10.1111/ddg.12537 · 1.40 Impact Factor
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    ABSTRACT: ZusammenfassungIn Deutschland sind über 2,5 Millionen Arbeitnehmer aufgrund ihrer beruflichen Tätigkeit als Outdoor-Worker im besonderen Maße gegenüber natürlicher UV-Strahlung exponiert. Der Ärztliche Sachverständigenbeirat „Berufskrankheiten“ beim Bundesministerium für Arbeit und Soziales hat den Zusammenhang zwischen beruflicher UV-Strahlung und Hautkrebs geprüft und empfohlen, in die Anlage1 zur Berufskrankheiten-Verordnung folgende neue Berufskrankheit aufzunehmen: „Plattenepithelkarzinome oder multiple aktinische Keratosen der Haut durch natürliche UV-Strahlung“.Es wird aus Sicht der Arbeitsgemeinschaft für Berufs- und Umweltdermatologie (ABD) in der Deutschen Dermatologischen Gesellschaft (DDG) und der Deutschen Gesetzlichen Unfallversicherung (DGUV) dargestellt, welche Voraussetzungen für eine Meldung und Anerkennung einer beruflichen Hautkrebserkrankung durch natürliche UV-Strahlung erfüllt sein müssen.
    Journal der Deutschen Dermatologischen Gesellschaft 12/2014; 12(12). DOI:10.1111/ddg.12537_suppl · 1.40 Impact Factor
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  • Lukas Koch, Werner Aberer
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    ABSTRACT: A large variety of methods and a wide range of products from several manufacturers are available for IgE-based in vitro allergy testing. In the large majority of cases, the attending physician lacks information about the devices and products used in the laboratory performing the tests. To determine the comparability and reliability of different laboratories, we analyzed the findings of an international ring trial established in Austria 25 years ago.The results were satisfactory: 97.4 % of total IgE tests and 93.9 % of antigen-specific IgE tests were correct. Further analysis revealed more false-positive than false-negative antigen-specific IgE levels (17.1 vs. 5.2 %). The investigation of different allergen groups yielded excellent results for some allergens (97.8 % correct values for mites, or 99.6 % correct values for recombinant antigens), but quite unfavorable for others (21.4 % incorrect values for drugs). In view of this paucity of comparability and reliability, it would be appropriate to establish mandatory quality control in laboratories and manufacturing units.
    Wiener klinische Wochenschrift 09/2014; 126(19-20). DOI:10.1007/s00508-014-0594-5 · 0.79 Impact Factor
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    ABSTRACT: PräliminarienZweck der LeitlinieDiese Leitlinie „Kontaktekzem“ ist als Orientierung für Ärzte aller Fachrichtungen gedacht, die Patienten mit Kontaktekzem betreuen. Sie soll auf der Basis des aktuellen Wissens über Kontaktekzeme die anerkannten diagnostischen, therapeutischen und interventionellen Maßnahmen darstellen.Für den Themenbereich Handekzem gibt es eine gesonderte Leitlinie [1].Verfahren zur Entwicklung und KonsensbildungDie Leitlinie wurde in formaler Konsensfindung einer Expertengruppe (s. Autoren) entwickelt, deren Zusammensetzung von den wissenschaftlichen Fachgesellschaften bestimmt wurde, die auf dem Gebiet Kontaktekzem in Deutschland aktiv sind. Es handelt sich dabei um die Deutsche Kontaktallergie-Gruppe (DKG) der Deutschen Dermatologischen Gesellschaft (Aberer, Kränke, Becker, Bircher, Brasch), den Informationsverbund Dermatologischer Kliniken (IVDK; Schnuch, Aberer, Brasch), die Deutsche Gesellschaft für Allergologie und klinische Immunologie (DGAKI; Przybilla, Biede ...
    Allergologie 06/2014; 37(08):309-324. DOI:10.5414/ALX01690 · 0.30 Impact Factor
  • Journal of Allergy and Clinical Immunology 05/2014; 134(3). DOI:10.1016/j.jaci.2014.03.038 · 11.25 Impact Factor
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    ABSTRACT: Background Quality assurance is a task of the medical profession, but it is also a duty of the occupational health insurance (OHI). Data on the interaction quality between physicians practicing occupational dermatology and the OHI are limited.Material and Methods An online survey was performed in 854 German members of the Working Group on Occupational and Environmental Dermatology in October 2013. Items included demographic data, a judgment on the cooperation between the dermatologists and OHI companies, an economic grading of the current compensation scheme, and prioritization of optimization tasks.Results182 members (21.3 % of the invited population) participated in the survey. The cooperation with the OHI companies was judged as “very good” by 10.8 %, as “good” by 56.7 %, as “satisfactory” by 24.2 %, as “sufficient” by 7.0 % and as “inadequate” by 1.3 %. 93.4 % of the interviewed mentioned problems and improvement potentials in the cooperation of their practice or clinic with OHI companies. Main points of criticisms were reimbursement (44.7 %), followed by impairments of the treatment options (36.5 %) and the delay or scope of the treatment in the dermatologist's procedure (29.4 %).Conclusions While most physicians practicing occupational dermatology give a positive judgment of their cooperation with OHI companies, quality optimization potentials exist regarding the reimbursement of dermatological services, especially regarding time-intensive counselling in the prevention of occupational skin diseases, in the enablement of diagnostic and therapeutic procedures according to current guidelines and in a timely preventive intervention to use the therapeutic window before chronification of skin diseases may occur.
    Journal der Deutschen Dermatologischen Gesellschaft 05/2014; 12(5). DOI:10.1111/ddg.12348 · 1.40 Impact Factor
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    W. Aberer
    Allergy 05/2014; 69(5). DOI:10.1111/all.12362 · 6.00 Impact Factor
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    ABSTRACT: ZusammenfassungHintergrundQualitätssicherung ist Aufgabe der Ärzteschaft, aber auch der gesetzlichen Unfallversicherung (GUV). Daten zur Qualität der Interaktion zwischen berufsdermatologisch tätigen Ärzten und Unfallversicherungsträgern stehen nur begrenzt zur Verfügung.Material und MethodikBei 854 Mitgliedern der Arbeitsgemeinschaft für Berufs- und Umweltdermatologie in Deutschland wurde im Oktober 2013 eine Online-Umfrage durchgeführt. Erfasst wurden demographische Daten, die Beurteilung der Zusammenarbeit mit den Trägern der GUV, eine betriebswirtschaftliche Beurteilung der Vergütung berufsdermatologischer Leistungen sowie prioritär zu optimierende Fragestellung(en) in der Zusammenarbeit.ErgebnisseDie Beteiligung an der Umfrage lag bei 182 Teilnehmern (21,3 % der Befragten). Die Zusammenarbeit mit den Unfallversicherungsträgern beurteilten 10,8 % als „sehr gut“, 56,7 % als „gut“, 24,2 % als „befriedigend“, 7,0 % als „ausreichend“ und nur 1,3 % als „mangelhaft“. 93,4 % äußerten sich zu Problemen bzw. Verbesserungspotenzial in der Zusammenarbeit Ihrer Praxis/Klinik mit der GUV. An vorderer Stelle stehen Abrechnungsfragen (44,7 %), gefolgt von Eingriffen in die Behandlungsfreiheit (36,5 %) und dem Behandlungsauftrag im Hautarztverfahren (29,4 %).SchlussfolgerungenOptimierungspotenziale für die Zusammenarbeit zwischen berufsdermatologisch tätigen Ärzten und GUV bestehen in der Vergütung der dermatologischen Leistungen bezüglich der „sprechenden Medizin“, in der Ermöglichung leitliniengerechter Diagnostik und Therapie und in zeitnaher Erteilung von Behandlungsaufträgen im Hautarztverfahren zur Nutzung des therapeutischen Fensters in der Prävention von Berufsdermatosen.SummaryBackground Quality assurance is a task of the medical profession, but it is also a duty of the occupational health insurance (OHI). Data on the interaction quality between physicians practicing occupational dermatology and the OHI are limited.Material and Methods An online survey was performed in 854 German members of the Working Group on Occupational and Environmental Dermatology in October 2013. Items included demographic data, a judgment on the cooperation between the dermatologists and OHI companies, an economic grading of the current compensation scheme, and priorization of optimization tasks.Results182 members (21.3 % of the invited population) participated in the survey. The cooperation with the OHI companies was judged as ìvery goodî by 10.8 %, as ìgoodî by 56.7 %, as ìsatisfactoryî by 24.2 %, as ìsufficientî by 7.0 % and as ìinsufficientî by 1.3 %. 93.4 % of the interviewed mentioned problems and improvement potentials in the cooperation of their practice or clinic with OHI companies. Main points of criticisms were reimbursement (44.7 %), followed by impairments of the treatment options (36.5 %) and the delay or scope of the treatment in the dermatologist's procedure (29.4 %).Conclusions While most physicians practicing occupational dermatology give a positive judgment of their cooperation with OHI companies, quality optimization potentials exist regarding the reimbursement of dermatological services, especially regarding time-intensive counselling in the prevention of occupational skin diseases, in the enablement of diagnostic and therapeutic procedures according to current guidelines and in a timely preventive intervention to use the therapeutic window before chronification of skin diseases may occur.
    Journal der Deutschen Dermatologischen Gesellschaft 05/2014; 12(5). DOI:10.1111/ddg.12348_suppl · 1.40 Impact Factor
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    ABSTRACT: This guideline is the result of a systematic literature review using the 'Grading of Recommendations Assessment, Development and Evaluation' (GRADE) methodology and a structured consensus conference held on 28 and 29 November 2012, in Berlin. It is a joint initiative of the Dermatology Section of the European Academy of Allergy and Clinical Immunology (EAACI), the EU-funded network of excellence, the Global Allergy and Asthma European Network (GA(2) LEN), the European Dermatology Forum (EDF), and the World Allergy Organization (WAO) with the participation of delegates of 21 national and international societies. Urticaria is a frequent, mast cell-driven disease, presenting with wheals, angioedema, or both. The life-time prevalence for acute urticaria is approximately 20%. Chronic spontaneous urticaria and other chronic forms of urticaria do not only cause a decrease in quality of life, but also affect performance at work and school and, as such, are members of the group of severe allergic diseases. This guideline covers the definition and classification of urticaria, taking into account the recent progress in identifying its causes, eliciting factors and pathomechanisms. In addition, it outlines evidence-based diagnostic and therapeutic approaches for the different subtypes of urticaria. This guideline was acknowledged and accepted by the European Union of Medical Specialists (UEMS).
    Allergy 04/2014; 69(7). DOI:10.1111/all.12313 · 6.00 Impact Factor
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    ABSTRACT: Angioedema is defined as localized and self-limiting edema of the subcutaneous and submucosal tissue, due to a temporary increase in vascular permeability caused by the release of vasoactive mediator(s). When angioedema recurs without significant wheals, the patient should be diagnosed to have angioedema as a distinct disease. In the absence of accepted classification, different types of angioedema are not uniquely identified. For this reason, the European Academy of Allergy and Clinical Immunology gave its patronage to a consensus conference aimed at classifying angioedema. Four types of acquired and three types of hereditary angioedema were identified as separate forms from the analysis of the literature and were presented in detail at the meeting. Here, we summarize the analysis of the data and the resulting classification of angioedema.
    Allergy 03/2014; 69(5). DOI:10.1111/all.12380 · 6.00 Impact Factor

Publication Stats

4k Citations
1,060.54 Total Impact Points

Institutions

  • 1998–2015
    • Medical University of Graz
      • • Institute of Experimental and Clinical Pharmacology
      • • Universitätsklinik für Dermatologie und Venerologie
      Gratz, Styria, Austria
  • 1995–2013
    • Karl-Franzens-Universität Graz
      Gratz, Styria, Austria
  • 2012
    • King's College London
      Londinium, England, United Kingdom
  • 2009–2012
    • Friedrich-Alexander Universität Erlangen-Nürnberg
      • Department of Medical Informatics, Biometry and Epidemiology
      Erlangen, Bavaria, Germany
  • 2005
    • Centre Hospitalier Universitaire de Nancy
      Nancy, Lorraine, France
  • 2004
    • Landeskrankenhaus Graz
      Gratz, Styria, Austria
  • 2003
    • Universität Witten/Herdecke
      • Chair of Dermatology
      Witten, North Rhine-Westphalia, Germany
  • 1993
    • University of Vienna
      Wien, Vienna, Austria