Dermot Ryan

University of Edinburgh | UoE · Usher Institute

The European Forum for Research and Education in Allergy and Airways diseases (EUFOREA) organized its bi‐annual forum EUFOREUM in Berlin in November 2023. The aim of EUFOREUM 2023 was to highlight pediatric action plans for prevention and optimizing care for type 2 inflammatory conditions starting in childhood, with a focus on early‐stage diagnosis...

Difficult-to-manage asthma occurs either when the person or their clinician finds control and treatment challenging, despite the (apparent) best possible treatment. This leads to the person facing difficulties dealing with some of the following: • Daytime asthma symptoms, more than twice/week • Any night awakening due to asthma-related symptoms • M...

Background Pediatricians are often the first point of contact for children in Primary Care (PC), but still perceive gaps in their allergy knowledge. We investigated self‐perceived knowledge gaps and educational needs in pediatricians across healthcare systems in Europe so that future educational initiatives may better support the delivery of allerg...

Allergic rhinitis (AR) is a chronic respiratory condition that internationally continues to be burdensome and impacts quality of life. Despite availability of medicines and guidelines for healthcare providers for the optimal management of AR, optimisation of its management in the community continues to be elusive. The reasons for this are multi-fac...

Following the European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA) treatment algorithm for chronic rhinosinusitis (CRS) with nasal polyps (CRSwNP), patients suffering from severe uncontrolled CRSwNP are recommended to receive oral corticosteroids, (revision) sinus surgery, systemic biologicals and/or aspirin treatment...

There is no single objective diagnostic test for asthma. Instead, we suggest an approach of collecting and assembling pieces ofclinical information to create a diagnostic picture, like making a jigsaw puzzle. These pieces should include demonstration ofsymptom and airway variability and/or bronchodilator responsiveness over time, to support a clini...

Background: Chronic rhinosinusitis (CRS) disease control is a global metric of disease status for CRS. While there is broad acceptance that it is an important treatment goal, there has been inconsistency in the criteria used to define CRS control. The objective of this study was to identify and develop consensus around essential criteria for asses...

In March 2023, the European Forum for Research and Education in Allergy and Airways diseases (EUFOREA) organized its bi-annual Summit in Brussels with expert panel members of EUFOREA, representatives of the EUFOREA patient advisory board, and the EUFOREA board and management teams. Its aim was to define the research, educational and advocacy initia...

Purpose of review: The aim of this study was to review the practice of general practitioners (GPs) in regard to the diagnosis and management of drug hypersensitivity reactions (DHRs) to identify major challenges and to facilitate the development of decision support tools to GPs confronted with DHRs patients. Recent findings: DHRs are still a cha...

Respiratory diseases remain a significant cause of global morbidity and mortality and primary care plays a central role in their prevention, diagnosis and management. An e-Delphi process was employed to identify and prioritise the current respiratory research needs of primary care health professionals worldwide. One hundred and twelve community-bas...

Systemic corticosteroids (SCS) are a highly effective treatment for acute exacerbations and long-term symptom control in asthma. Long-term SCS use is highly prevalent across all asthma severities, occurring in over 20% of patients with severe or uncontrolled disease globally. It is now well known that exposure to both long-term and repeated acute c...

Chronic rhinosinusitis (CRS) is known to affect around 5 % of the total population, with major impact on the quality of life of those severely affected (1). Despite a substantial burden on individuals, society and health economies, CRS often remains underdiagnosed, under-estimated and under-treated (2). International guidelines like the European Po...

Background: Urticaria is a common condition presenting both as acute and chronic disease within primary care. To those without specialist training it is poorly understood from the points of view of diagnosis and management. It causes a considerable disease burden to sufferers with marked impact on quality of life. Purpose of this review: The rec...

Introduction Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality in Europe; however, it is important to understand how clinical practice patterns differ between countries and how this might relate to disease outcomes, to identify ways of improving local disease management. We aimed to describe and compare the management of...

Most patients presenting with allergies are first seen by primary care health professionals. The perceived knowledge gaps and educational needs were recently assessed in response to which the LOGOGRAM Task Force was established with the remit of constructing pragmatic flow diagrams for common allergic conditions in line with an earlier EAACI propos...

Background Guidelines for management of patients with allergic conditions are available, but the added value of nurses, allied healthcare professionals (AHPs), and general practitioners (GPs), in the management of allergic disease, has not been fully clarified. The European Academy of Allergy and Clinical Immunology (EAACI) appointed a task force t...

Most patients presenting with allergies are first seen by primary care health professionals. The perceived knowledge gaps and educational needs were recently assessed in response to which the LOGOGRAM Task Force was established with the remit of constructing pragmatic flow-diagrams for common allergic conditions in line with an earlier EAACI propos...

Purpose There remains a need for a standardized dataset for respiratory studies to accelerate data collection, improve research efficiency and aid the sharing, merging and comparison of datasets. This TORPEDO (Towards Optimum Reporting of Pulmonary Effectiveness Databases and Outcomes) project aimed to develop a checklist of optimum and minimum var...

Background Data to better understand and manage the COVID-19 pandemic is urgently needed. However, there are gaps in information stored within even the best routinely-collected electronic health records (EHR) including test results, remote consultations for suspected COVID-19, shielding, physical activity, mental health, and undiagnosed or untested...

Background: Guidelines for management of patients with allergic conditions are available, but the added value of nurses, allied health care professionals (AHPs) and general practitioners (GPs), in the management of allergic disease has not been fully clarified. The European Academy of Allergy and Clinical Immunology (EAACI) appointed a task force t...

EAACI-Leitlinien zur allergen-spezi-fischen Immuntherapie: Insektengiftall-ergie Die Insektengiftallergie ist eine poten-ziell lebensbedrohliche allergische Reakti-on auf Gifte von Hautflüglern (Hymenopte-ren) wie Honigbienen, Wespen und Ameisen. Systemische allergische Reaktionen auf die Stiche können bei bis zu 7,5% der Erwachse-nen und 3,4% der...

The aim of this survey was to explore the specific educational needs of a cohort of European GPs with regards to allergy training so that future educational initiatives may better support the delivery of allergy services in primary care. Method: This study took the form of a cross‐sectional observational study in which a structured electronic quest...

Guidelines aim to standardize and optimize asthma diagnosis and management. Nevertheless, adherence to guidelines is suboptimal and may vary across different healthcare professional (HCP) groups. Further to these concerns, this ERS/EAACI Statement aims (1) via an international online survey, to evaluate the understanding of and adherence to intern...

Introduction: Symptoms may persist after the initial phases of COVID-19 infection, a phenomenon termed long COVID. Current knowledge on long COVID has been mostly derived from test-confirmed and hospitalized COVID-19 patients. Data are required on the burden and predictors of long COVID in a broader patient group, which includes both tested and un...

BACKGROUND: Clinicians are increasingly recognizing severe asthma patients in whom biologics and other add-on therapies lead to dramatic improvement. Currently, there is no agreedupon super-responder (SR) definition. OBJECTIVE: To survey severe asthma experts using a modified Delphi process, to develop an international consensus-based definition of...

Allergen immunotherapy (AIT), the gradually increasing repeated administration of high doses of allergens to allergic patients, offers the potential for immune tolerance against reactions to the natural exposures to specific allergens. AIT may lead to the long-lasting remission of allergic symptoms and is the only disease-modifying intervention in...

Contexte Le Royaume-Uni (UK) présente des taux de mortalité et d’hospitalisation pour Broncho Pneumopathie Chronique Obstructive (BPCO) plus élevés que ceux de la France. Ces différences pourraient être dues à des différences de prise en charge : le but de cette étude était de décrire la consommation de soins des patients BPCO et les coûts associés...

Background Although there are many asymptomatic patients, one of the problems of COVID‐19 is early recognition of the disease. COVID‐19 symptoms are polymorphic and may include upper respiratory symptoms. However, COVID‐19 symptoms may be mistaken with the common cold or allergic rhinitis. An ARIA‐EAACI study group attempted to differentiate upper...

Physicians still have great difficulty in diagnosing asthma. Over‐ and under diagnosis both occur for this lung disease from which around 300 million people suffer worldwide.¹ For diagnosing asthma, after careful history taking, lung function testing is considered the most relevant investigation. However, other parameters could also assist in compl...

Background: The impact of hormone replacement therapy (HRT) on clinical outcomes in menopausal women is uncertain. Objective: To investigate the association between use of HRT and severe asthma exacerbation in peri-menopausal and post-menopausal women with asthma. Methods: We used the Optimum Patient Care Research Database, a population-based lon...

ABSTRACT Background: MP-AzeFlu (Dymista�; spray of azelastine/fluticasone propionate) is the most effective allergic rhinitis (AR) treatment available. Its effect on asthma outcomes in patients with AR and asthma is unknown. Methods: This pre-post historical cohort study, using the Optimum Patient Care Research Database, included patients aged �12...

Background Severe asthma may be under-recognized in primary care. Objective Identify and quantify patients with potential severe asthma (PSA) in UK primary care, the proportion not referred, and compare primary care PSA patients with confirmed severe asthma patients from UK tertiary care. Methods Historical cohort study including patients from the...

Background The analysis of mobile health (mHealth) data has generated innovative insights into improving allergic rhinitis control, but additive information is needed. A cross-sectional real-world observational study was undertaken in 17 European countries during and outside the estimated pollen season. The aim was to collect novel information incl...

Background: There is uncertainty about the role of hormonal replacement therapy (HRT) in development of asthma. Objective: We investigated whether use of HRT and duration of use was associated with risk of developing asthma in peri- and post-menopausal women. Methods: We constructed a 17-year (1/1/2000 – 12/31/2016) open cohort of 353,173 women (...

In 2019, it was reported that changes to asthma management reported in the Global Initiative for Asthma (GINA) "…might be considered the most fundamental changes in asthma management in 30 years." These changes refer to the recommendation that the treatment of asthma in adolescents and adults would no longer include short-acting ß2-agonist (SABA) o...

p>Allergic rhinitis (AR) is the most common chronic inflammatory disease, affecting an estimated 100 million Europeans (1). Despite a substantial burden on individuals, society and health economies (2), AR remains under-diagnosed, under-estimated (in terms of severity), and under-treated (3). Although effective and safe treatments exist, patients w...

Introduction The Fostair® 100/6 (BDP/FF) pressurized metered-dose inhaler, delivering an extrafine formulation, is licensed for asthma and COPD in the UK. However, its real-life effectiveness for COPD has not been evaluated. This study compared the clinical effectiveness of BDP/FF against other licensed ICS/LABA combination inhalers: the Seretide®...

Background: Longitudinal studies investigating impact of exogenous sex steroids on clinical outcomes of asthma in women are lacking. We investigated the association between use of hormonal contraceptives and risk of severe asthma exacerbation in reproductive-age women with asthma. Methods: We used the Optimum Patient Care Research Database, a popu...

An amendment to this paper has been published and can be accessed via the original article.

Digital anamorphosis is used to define a distorted image of health and care that may be viewed correctly using digital tools and strategies. MASK digital anamorphosis represents the process used by MASK to develop the digital transformation of health and care in rhinitis. It strengthens the ARIA change management strategy in the prevention and mana...

Purpose There is a dearth of research regarding the prevalence and nature of patient-reported rhinitis and its relationship with risk of asthma exacerbations. The aim of this study was to (i) determine the prevalence, severity and treatment of self-reported rhinitis symptoms among adults aged ≥18 years with asthma treated at Global Initiative for A...

Since the first description of anaphylaxis in 1902, its clinical importance as an emergency condition has been recognized worldwide. Anaphylaxis is a severe, potentially life-threatening systemic hypersensitivity reaction characterized by rapid onset and the potential to endanger life through respiratory or circulatory compromise. It is usually, al...

Background: Severe asthma is a serious condition with a significant burden on patients' morbidity, mortality, and quality of life. Some biological therapies targeting the IgE and interleukin-5 (IL5) mediated pathways are now available. Due to the lack of direct comparison studies, the choice of which medication to use varies. We aimed to explore t...

Background Chronic rhinosinusitis (CRS) is a chronic inflammatory disease associated with a substantial personal and socioeconomic burden. Monitoring of patient‐reported outcomes by mobile technology offers the possibility to better understand real‐life burden of CRS. Methods This study reports on the cross‐sectional evaluation of data of 626 user...

Introduction L’urticaire est une dermatose fréquente, la majorité des cas sont d’abord vus par les médecins généralistes (MG) ou les urgences, et éventuellement par des allergologues sur orientation du MG. Cette revue systématique vise à créer un algorithme simple pour les soins primaires optimisant la prise en charge et l’orientation des patients....

Introduction L’HSM représente une cause de décès évitable importante. Les médecins de soins primaires (SP) constituent souvent le premier contact pour les patients présentant une HSM. Cette revue systématique vise à fournir des preuves afin de faciliter le développement d’outils d’aide à la décision aux médecins généralistes (MG). Méthodes Une rev...

Background Despite well-described sex differences in asthma incidence, there remains uncertainty about the role of female sex hormones in the development of asthma. Objective We sought to investigate whether hormonal contraceptive use, its subtypes, and duration of use were associated with new-onset asthma in reproductive-age women. Methods Using...

The European Position Paper on Rhinosinusitis and Nasal Polyps 2020 is the update of similar evidence based position papers published in 2005 and 2007 and 2012. The core objective of the EPOS2020 guideline is to provide revised, up-to-date and clear evidence-based recommendations and integrated care pathways in ARS and CRS. EPOS2020 provides an upd...

Factors related to the discrepancy between patient-perceived and actual disease control remain unclear. Identifying patients at risk of overestimation of asthma control remains elusive. This study aimed to (i) investigate the relationship between patient-reported and actual level of asthma control (ii), compare the characteristics between patients...

Aims Mobile Airways Sentinel NetworK (MASK) belongs to the Fondation Partenariale MACVIA-LR of Montpellier, France and aims to provide an active and healthy life to rhinitis sufferers and to those with asthma multimorbidity across the life cycle, whatever their gender or socio-economic status, in order to reduce health and social inequities incurre...