Browsing by Author "Pinto, Paula Leiria"
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- Profiling Persistent Asthma Phenotypes in Adolescents: A Longitudinal Diagnostic Evaluation from the INSPIRERS StudiesPublication . Amaral, Rita; Jácome, Cristina; Almeida, Rute; Pereira, Ana Margarida; Alves-Correia, Magna; Mendes, Sandra; Rodrigues, José Carlos Cidrais; Carvalho, Joana; Araújo, Luís; Costa, Alberto; Silva, Armandina; Teixeira, Fernanda; Ferreira-Magalhães, Manuel; Alves, Rodrigo Rodrigues; Moreira, Ana Sofia; Fernandes, Ricardo M.; Ferreira, Rosário; Pinto, Paula Leiria; Neuparth, Nuno; Bordalo, Diana; Bom, Ana Todo; Cálix, Maria José; Ferreira, Tânia; Gomes, Joana; Vidal, Carmen; Mendes, Ana; Vasconcelos, Maria João; Silva, Pedro Morais; Ferraz, José; Morête, Ana; Pinto, Claúdia Sofia; Santos, Natacha; Loureiro, Claúdia Chaves; Arrobas, Ana; Marques, Maria Luís; Lozoya, Carlos; Lopes, Cristina; Cardia, Francisca; Loureiro, Carla Chaves; Câmara, Raquel; Vieira, Inês; Silva, Sofia da; Silva, Eurico; Rodrigues, Natalina; Fonseca, João A.We aimed to identify persistent asthma phenotypes among adolescents and to evaluate longitudinally asthma-related outcomes across phenotypes. Adolescents (13-17 years) from the prospective, observational, and multicenter INSPIRERS studies, conducted in Portugal and Spain, were included (n = 162). Latent class analysis was applied to demographic, environmental, and clinical variables, collected at a baseline medical visit. Longitudinal differences in clinical variables were assessed at a 4-month follow-up telephone contact (n = 128). Three classes/phenotypes of persistent asthma were identified. Adolescents in class 1 (n = 87) were highly symptomatic at baseline and presented the highest number of unscheduled healthcare visits per month and exacerbations per month, both at baseline and follow-up. Class 2 (n = 32) was characterized by female predominance, more frequent obesity, and uncontrolled upper/lower airways symptoms at baseline. At follow-up, there was a significant increase in the proportion of controlled lower airway symptoms (p < 0.001). Class 3 (n = 43) included mostly males with controlled lower airways symptoms; at follow-up, while keeping symptom control, there was a significant increase in exacerbations/month (p = 0.015). We have identified distinct phenotypes of persistent asthma in adolescents with different patterns in longitudinal asthma-related outcomes, supporting the importance of profiling asthma phenotypes in predicting disease outcomes that might inform targeted interventions and reduce future risk.
- Successful off-label use of omalizumab in a child with chronic spontaneous urticariaGonçalves, Tânia; Coutinho, Iolanda Alen; Pita, Joana Sofia; Pinto, Paula LeiriaOmalizumab is approved as third-line therapy for patients older than 12 years with antihistamine-refractory chronic spontaneous urticaria. The authors present the case of an eight-year-old boy with a history of migratory maculopapular skin lesions, arthralgias, and conjunctival hyperemia. Laboratory findings were unremarkable. Skin biopsy was consistent with urticaria. Treatment with oral betamethasone and quadruple dose of bilastine was initiated, with clinical resolution of arthralgias and conjunctival hyperemia, but no improvement in skin lesions. After five months of illness, the patient developed several side effects of corticosteroids and was started on cyclosporine, with no clinical response after four weeks of treatment. At this point, he was started on off-label omalizumab 300 mg every four weeks, and corticosteroid therapy was discontinued after one month of treatment. After the third administration of omalizumab, the boy achieved complete clinical resolution. Omalizumab may be an effective and safe treatment for antihistamine-refractory chronic spontaneous urticaria in pediatric age.