What's New
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Family Medicine - Immunizations
Booster dose of BNT162b2 (Pfizer COVID-19 vaccine) for select high-risk individuals (September 2021)
Because of the possibility of waning vaccine efficacy against symptomatic COVID-19 and decreased efficacy against certain SARS-CoV-2 variants, several countries have introduced booster COVID-19 vaccines for individuals who have completed a primary series. In the United States, the US Food and Drug Administration has authorized and the Centers for Disease Control (CDC) recommends a booster dose of BNT162b2 (Pfizer COVID-19 vaccine), to be given six months after the last dose of the primary BNT162b2 series, for certain high-risk adults, including adults >=65 years and adults >=50 years who have comorbidities that increase the risk of severe COVID-19.2,3 Adults <50 years with such comorbidities and adults who are at risk for exposure because of occupation or congregate living situations are also eligible for a booster dose. Booster doses for individuals who received other COVID-19 vaccines have not yet been authorized.
Dermatology - Psoriasis and other Papulosquamous Disorders
Bimekizumab versus adalimumab and secukinumab for plaque psoriasis (August 2021)
In phase 3 trials, bimekizumab, an investigational monoclonal IgG1 antibody that inhibits interleukin (IL) 17A and IL-17F, has demonstrated clinical efficacy for moderate to severe plaque psoriasis in adults and superiority over ustekinumab. Two new phase 3 trials also support greater efficacy of bimekizumab compared with adalimumab and secukinumab for this indication. In the BE SURE trial (n = 478), 86 percent of adults treated with bimekizumab had at least 90 percent improvement in the Psoriasis Area and Severity Index score (PASI 90) at week 16, compared with 47 percent of adults treated with adalimumab.4 In the BE RADIANT trial (n = 743), 62 percent of adults in the bimekizumab group achieved complete skin clearance (PASI 100) compared with 49 percent in the secukinumab group.5 These findings offer further support for combined inhibition of IL-17A and IL-17F as a therapeutic strategy for moderate to severe plaque psoriasis.
Allergy and Immunology - Food Allergy and Intolerance
Inhaled albuterol for acute abdominal pain due to IgE-mediated food allergy (September 2021)
Acute abdominal pain is common with immunoglobulin E (IgE)-mediated food reactions and can be prolonged and difficult to manage. Beta agonists relax visceral smooth muscle and have been used to treat other causes of visceral pain. In a retrospective study of 57 patients with peanut allergy who had a positive oral food challenge, treatment with albuterol (8 to 10 inhalations of 100 mcg MDI) was associated with faster onset of improvement (12.5 versus 65 minutes) and time to complete resolution of abdominal pain (32.5 versus 90 minutes).1 While these results suggest that high-dose albuterol may hasten resolution of abdominal pain due to IgE-mediated allergy, the study approach had several significant potential biases. Thus, randomized trial confirmation is needed before routine use in clinical practice.
1. Frugier C, Graham F, Samaan K, et al Potential Efficacy of High-Dose Inhaled Salbutamol for the Treatment of Abdominal Pain During Oral Food Challenge. J Allergy Clin Immunol Pract 2021; 9:3130. [Context Link]
2. U.S. Food & Drug Administration. FDA Authorizes Booster Dose of Pfizer-BioNTech COVID-19 Vaccine for Certain Populations https://www.fda.gov/news-events/press-announcements/fda-authorizes-booster-dose-. [Context Link]
3. Centers for Disease Control and Prevention. CDC Statement on ACIP Booster Recommendations. https://www.cdc.gov/media/releases/2021/p0924-booster-recommendations-.html. [Context Link]
4. Warren RB, Blauvelt A, Bagel J, et al Bimekizumab versus Adalimumab in Plaque Psoriasis. N Engl J Med 2021; 385:130. [Context Link]
5. Reich K, Warren RB, Lebwohl M, et al Bimekizumab versus Secukinumab in Plaque Psoriasis. N Engl J Med 2021; 385:142. [Context Link]
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