Thomas B. Casale's research while affiliated with University of South Florida and other places

Publications (606)

Chapter
Digital health includes eHealth and areas such as the use of advanced computer sciences. eHealth comprises several components, including electronic health records, telehealth, and mHealth. mHealth is segmented into mHealth apps, mHealth services, and medical devices. The present paper is not intended to provide a systematic review of the current di...
Article
Introduction: Peanut allergy can result in severe, sometimes fatal hypersensitivity reactions that place a considerable burden on the lives of patients. This article reviews the first approved immunotherapy for the mitigation of allergic reactions following accidental peanut exposure, peanut (Arachis hypogaea) allergen powder-dnfp (PTAH; Palforzia...
Article
Background: Fractional exhaled nitric oxide (FeNO) may have a role both as a prognostic and predictive biomarker, in combination with eosinophils, for assessing responsiveness to some biological therapies. Objective: We evaluated the value of baseline FeNO, adjusted for baseline blood eosinophil levels and other clinical characteristics, as an i...
Article
Introduction: Data from mHealth apps can provide valuable information on rhinitis control and treatment patterns. However, in MASK-air®, these data have only been analyzed cross-sectionally, without considering changes of symptoms over time. We analyzed data from MASK-air® longitudinally, clustering weeks according to reported rhinitis symptoms....
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Introduction Chronic spontaneous urticaria (CSU) causes recurrent itchy hives and/or angioedema, significantly impacting quality of life. Many patients experience a substantial disease burden despite treatment with licensed and escalated doses of H1 antihistamines. Methods In LIBERTY-CSU CUPID Study A (NCT04180488), a randomized, placebo-controlle...
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Digital health is an umbrella term which encompasses eHealth and benefits from areas such as advanced computer sciences. eHealth includes mHealth apps, which offer the potential to redesign aspects of healthcare delivery. The capacity of apps to collect large amounts of longitudinal, real‐time, real‐world data enables the progression of biomedical...
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Allergy/immunology specialists in the US prescribing allergy immunotherapy (AIT) have placed a heavy value on practical experience and anecdotal evidence rather than research-based evidence. With the extensive research on AIT conducted in the last few decades, the time has come to better implement evidence-based medicine (EBM) for AIT. The goal of...
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Management of asthma in adults has advanced in the past 10 years. Central to these advances has been further clarification of Type (T) 2 mechanisms of airway inflammation and utilization of T2 biomarkers, i.e. eosinophils and FeNO. In addition, epithelial cells are emerging as significant contributors to inflammation through generation of alarmins...
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We compared education regarding BE/BM introduction and preferences regarding future education between countries and found significant differences in the rate and form information was received. This underscores the need for increased post-oral food challenge education and highlights country-specific education differences.
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Chronic idiopathic/spontaneous urticaria (CIU/CSU) causes significant impairments in quality of life and is often unresponsive to antihistamines. Although the anti-IgE mAb omalizumab has been an important addition to the therapeutic armamentarium for the management of patients with CSU, there are still a significant percentage of patients who do no...
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Oral corticosteroids (OCS) have long been a mainstay of treatment for asthma exacerbations and chronic severe asthma. However, it is increasingly recognized that both long-term and short-term OCS use are directly associated with a wide range of serious adverse effects, and as such OCS-sparing treatment alternatives are now widely recommended for pa...
Article
Patients with asthma who are suboptimally responsive to inhaled corticosteroids (ICS) and long-acting β2-agonists (LABAs) are frequently exposed to oral corticosteroids and high-dose ICS, which can lead to significant side effects. Long-acting muscarinic antagonists (LAMAs) have demonstrated efficacy and safety in a subset of these patients. This r...
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Background Clinical trials (PALISADE [ARC003], ARTEMIS [ARC010]) proving efficacy and safety of peanut (Arachis hypogaea) allergen powder-dnfp (PTAH) used double-blind, placebo-controlled food challenges (DBPCFCs) to screen for eligibility and to evaluate efficacy. In routine clinical practice, individuals with peanut allergy do not always undergo...
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Pascal Demoly,1,2 Andrew H Liu,3 Pablo Rodriguez del Rio,4 Soren Pedersen,5 Thomas B Casale,6,7 David Price8 1Division of Allergy, Department of Pulmonology, Hôpital Arnaud de Villeneuve, Montpellier, France; 2IDESP Inserm, University, Hospital of Montpellier, Montpellier, France; 3Airway Inflammation, Resilience & the Environment (AIRE) Program, B...
Conference Paper
Aims Peanut (Arachis hypogaea) allergen powder-dnfp (PTAH; previously ‘AR101’) is a once-daily oral immunotherapy approved by the FDA (Palforzia®) to mitigate allergic reactions that may occur with accidental peanut exposure in peanut-allergic individuals aged 4-17 years. Previously, safety data from trial participants receiving PTAH over ≤3.5 year...
Article
(word count 231) Vaping by adolescents and young adults is a legitimate concern as there is a risk that some may start smoking and that electronic cigarette (EC) use may have adverse effects in the developing lungs of adolescents. This commentary provides updated information on vaping patterns among adolescents and young adults in the United States...
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Background: Different treatments exist for allergic rhinitis (AR), including pharmacotherapy and allergen immunotherapy (AIT), but they have not been compared using direct patient data (i.e., "real-world data"). Objective: To compare AR pharmacological treatments on (i) daily symptoms, (ii) frequency of use in co-medication, (iii) visual analogu...
Article
The appropriate at home management of anaphylaxis begins with patient education on recognition and treatment, especially when and how to use epinephrine. Delayed administration of epinephrine as well as having severe symptoms and needing multiple doses of epinephrine to treat symptoms are risk factors for biphasic anaphylaxis. The successful implem...
Article
Background Regulator of G-Protein Signaling (RGS)-2 terminates bronchoconstrictive Gαq-signaling; murine RGS2 knockout demonstrate airway hyperresponsiveness. While RGS2 promoter variants rs2746071 and rs2746072 associate with a clinical mild asthma phenotype, their impact on human airway smooth muscle (HASM) contractility and asthma severity outco...
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Asthma is a major driver of health care costs across ages. Despite widely disseminated asthma-treatment guidelines and a growing variety of effective therapeutic options, most patients still experience symptoms and/or refractoriness to standard of care treatments. As a result, most patients undergo a further intensification of therapy to optimize s...
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Background: Evidence regarding the effectiveness of allergen immunotherapy (AIT) on allergic rhinitis has been provided mostly by randomised controlled trials, with little data from real-life studies. Objective: To compare the reported control of allergic rhinitis symptoms in three groups of users of the MASK-air® app: those receiving sublingual...
Article
Background: Black and Latinx patients bear a disproportionate burden of asthma. Efforts to reduce the disproportionate morbidity have been mostly unsuccessful, and guideline recommendations have not been based on studies in these populations. Methods: In this pragmatic, open-label trial, we randomly assigned Black and Latinx adults with moderate...
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Background Effectiveness of asthma treatment, including biologics, may be different in patients with higher body mass index (BMI). Objective We examined response to omalizumab (dosed by serum immunoglobin E level and weight) by BMI category. Methods Pooled data from 2 randomized, double-blind, placebo-controlled studies of adults with moderate-to...
Article
Background Validated combined symptom-medication scores (CSMSs) are needed to investigate the effects of allergic rhinitis treatments. This study aimed to use real-life data from the MASK-air® app to generate and validate hypothesis- and data-driven CSMSs. Methods We used MASK-air® data to assess the concurrent validity, test-retest reliability an...
Article
Background: Peanut (Arachis hypogaea) allergen powder-dnfp (PTAH; previously known as AR101) is a daily oral immunotherapy approved to mitigate allergic reactions after accidental peanut exposure in peanut-allergic individuals aged 4-17 years. Objective: We sought to comprehensively summarize the PTAH safety profile for up to ∼2 years of treatme...
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Asthma is classically described as either a T2 eosinophilic phenotype or a non-T2 neutrophilic phenotype. T2 asthma usually responds to classical bronchodilation therapy and corticosteroid treatment. Non-T2 neutrophilic asthma is often more severe. Patients with non-T2 asthma or late-onset T2 asthma show poor response to the currently available ant...
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Background Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of morbidity and mortality, despite evidence there is a high proportion of underdiagnosis. Online screening assessments are low-cost solutions to identify high-risk adults who may benefit from confirmatory screening (ie, spirometry test). Little evidence exists to support wh...
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Objective To summarize the therapeutic effects and safety of biologics either approved or in clinical development for asthma, COPD, urticaria, nasal polyps, atopic dermatitis, and eosinophilic esophagitis. This review attempts to provide some guidance when choosing between agents. Data Sources Recent published papers obtained through PubMed databa...
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Background Peanut allergy (PA), a common food allergy, is increasing in prevalence and is associated with high rates of anaphylaxis. Prevalence of food-related anaphylaxis is higher in children and adolescents than in adults, and the pediatric incidence is increasing. We conducted a systematic literature review and meta-analysis to determine the in...
Article
Background: Advances in oral immunotherapy (OIT) have led to recently expanded treatment options for food allergy (FA) patients. However, to inform future outreach efforts and ensure equitable access to emerging treatments, a greater understanding of current OIT-related awareness, attitudes and experiences is needed. Objective: To characterize c...
Article
Background Fractional exhaled nitric oxide (FeNO) has potential as a prognostic biomarker in asthma, but its prognostic value among other recognised indicators is unclear. We assessed the added prognostic value of baseline FeNO to blood eosinophil count and prior severe asthma exacerbations for subsequent exacerbations. Methods In this post-hoc an...
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Introduction La poudre de graine d’Arachis hypogaea allégée en graisses (précédemment appelé AR101) est une immunothérapie orale récemment approuvée pour atténuer les réactions allergiques après exposition accidentelle aux arachides chez les allergiques à l’arachide âgées de 4 à 17 ans. Des données long terme permettront de mieux caractériser le pr...
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Background Patients with severe asthma frequently have associated comorbidities, which can compound existing symptoms, complicating asthma management. Objective To describe mepolizumab's real-world effectiveness in patients with severe asthma stratified by common overlapping comorbidities. Methods This was a retrospective analysis of patients wit...
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Background Understanding about patient-reported biphasic food-related allergic reactions currently remains sparse. Objective To characterize patient-reported biphasic food-related allergic reactions among a national food allergy registry. Methods We utilized two Patient Registry surveys established by Food Allergy Research & Education (FARE). Var...
Article
Older adults, especially men and/or those with diabetes, hypertension and/or obesity, are prone to severe COVID‐19. In some countries, older adults, particularly those residing in nursing homes, have been prioritised to receive COVID‐19 vaccines due to high risk of death. In very rare instances,the COVID‐19 vaccines can induce anaphylaxis, and the...
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Background The anti-IgE therapy omalizumab improves asthma control and reduces exacerbations in patients with moderate-to-severe allergic asthma. However, it has been suggested that omalizumab should be reserved for highly allergic patients with multiple allergen sensitivities or perennial-only sensitivities. Objective To examine impact of allergy...
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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 withthe common cold or allergic rhinitis. An ARIA‐EAACI study group attempted to differentiate upper r...
Article
Purpose of review: Despite the COVID-19 pandemic, progress continued in the field of peanut oral immunotherapy over the past 12 to 18 months. Of importance, the first oral immunotherapy product for the treatment of peanut allergy was approved by the US Food and Drug Administration in January 2020. Recent findings: Suggested modifications to the...
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Five biologic medications are approved in the United States for the treatment of asthma that is not well controlled with other therapies. All target asthma with elevated type 2 inflammatory markers, such as elevated eosinophils, fractional exhaled nitric oxide, or total and specific IgE. Asthma severity, phenotype, age, biomarkers, treatment goals/...
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Background Asthma prevalence, morbidity, and mortality disproportionately impact African American/Black (AA/B) and Hispanic/Latinx (H/L) communities. Adherence to daily inhaled corticosteroid (ICS), recommended by asthma guidelines in all but the mildest cases of asthma, is generally poor. As-needed ICS has shown promise as a patient-empowering ast...
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BACKGROUND Food allergic reactions of varying severity occur in restaurants. Studies to date have shown there are gaps in knowledge of and communication between restaurant staff and food allergic individuals. OBJECTIVE We sought to characterize allergic reactions in restaurants to better inform the restaurant industry, food allergic individual, an...
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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...
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Overuse of β2-adrenoceptor agonist bronchodilators evokes receptor desensitization, decreased efficacy, and an increased risk of death in asthma patients. Bronchodilators that do not target β2-adrenoceptors represent a critical unmet need for asthma management. Here, we characterize the utility of osthole, a coumarin derived from a traditional Chin...
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Biologic agents, monoclonal antibodies that target highly-specific molecular pathways of inflammation, are becoming integrated into care pathways for multiple disorders that are relevant in otolaryngology and allergy. These conditions share common inflammatory mechanisms of so-called Type 2 inflammation with dysregulation of immunoglobulin E produc...
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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...
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Background: Allergic rhinitis induced by house dust mites (HDMs) is a highly prevalent but often underdiagnosed and undertreated/untreated chronic disease. It often has a negative impact on sleep, work, leisure activities, and health-related quality of life. Allergen immunotherapy is a proven, safe treatment for respiratory allergies. Objective:...
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The introduction of personalized medicine (PM) has been a milestone in the history of medical therapy, because it has revolutionized the previous approach of treating the disease with that of treating the patient. It is known today that diseases can occur in different genetic variants, making specific treatments of proven efficacy necessary for a g...
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Large differences in COVID‐19 death rates exist between countries and between regions of the same country. Some very low death rate countries such as Eastern Asia, Central Europe or the Balkans have a common feature of eating large quantities of fermented foods. Although biases exist when examining ecological studies, fermented vegetables or cabbag...
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Asthma is a global disease affecting almost 400 million people. Simultaneously, the overall burden of allergies is increasing. Although allergies are frequent and commonly recognized triggers of asthma severity and exacerbations, the majority of patients with asthma are not investigated for their underlying aeroallergen sensitizations, despite the...
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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 manag...
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Severe asthma imposes a significant burden on patients, families and healthcare systems. Management is difficult, due to disease heterogeneity, comorbidities, complexity in care pathways and differences between national or regional healthcare systems. Better understanding of the mechanisms has enabled a stratified approach to the management of seve...
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Food allergy is a major health problem affecting 5 to 10% of the population in developed nations, including an estimated 32 million Americans. Despite the large number of patients suffering from food allergies, up until the end of January 2020, no treatment for food allergies had been approved by the U.S. Food and Drug Administration (FDA). The onl...
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The International Classification of Diseases (ICD) provides a common language for use worldwide as a diagnostic and classification tool for epidemiology, clinical purposes and health management. Since its first edition, the ICD has maintained a framework distributing conditions according to topography, with the result that some complex conditions,...
Preprint
The ARIA initiative was started during a World Health Organization workshop in 1999. The initial goals were to propose a new classification for allergic rhinitis, to promote the concept of multi-morbidity in asthma and rhinitis and to develop guidelines with stakeholders for worldwide use. ARIA is now focused on the implementation of emerging techn...
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Background Asthma prevalence decreases post-puberty in males. Testosterone inhibits airway smooth muscle contraction and attenuates type 2 inflammation. Objective To investigate the relationship between serum testosterone and current asthma prevalence and lung function in a nationally-representative dataset. Methods Serum testosterone and self-re...