Disability Weights Measurement for 17 Diseases in Japan: A Survey Based on Medical Professionals

When judging a population’s health to determine disability-adjusted life years, disability weight is a tool for measuring the severity of disability caused by a disease. However, previous studies have pointed out that surveys targeting ordinary citizens produce unclear disability weight values. Therefore, in an attempt to obtain clearer estimations, we conduct a paper-based questionnaire survey of medical professionals—nurses with over ten years of experience—believed to have extensive knowledge of diseases and experience in patient care. We find that disability weight estimations based on the survey of medical professionals presents higher values than those based on a survey of ordinary citizens using the same estimation approach, especially for non-terminal-stage diseases. This suggests that medical-professionals-based surveys may correct the underestimated disability weights of non-terminal diseases (e.g., early stage of cancers and mellitus) found through ordinary-citizens-based surveys. Moreover, we illustrate that depressive disorder and early-stage cancers have almost the same health loss since their disability weights are similar. While regulating policy, it is recommended that more attention be paid to non-terminal diseases and depression

Efficacy and safety of omalizumab in adult patients with wheat-dependent exercise-induced anaphylaxis: Reduction of in vitro basophil activation and allergic reaction to wheat

Background: In patients with wheat-dependent exercise-induced anaphylaxis (WDEIA), anaphylactic shock occurs frequently, therefore avoidance of wheat products is recommended. We aimed to evaluate efficacy and safety of long-term omalizumab treatment for adult patients with WDEIA. Methods: In this phase 2, multicentre single-arm trial, 20 adult patients with WDEIA were enrolled (UMIN 000019250). All patients were administered 150–600 mg of omalizumab subcutaneously and evaluations (basophil activation and blood examination) were performed at regular intervals during administration period (0–48 weeks) and observation period (48–68 weeks). Primary endpoint was proportion of the patients who achieved a basophil activation rate below 10% with fractionated wheat preparations, and secondary endpoint was proportion of the patients with no allergic reactions after wheat products ingestion. Results: During the omalizumab treatment, more than 80% of the patients achieved the basophil activation rate less than 10% against all fractionated wheat preparations, and 68.8% of the patients who achieved the primary endpoint experienced no allergic reaction. During the observation period, the proportion of the patients who achieved a basophil activation rate below 10% decreased gradually, and the proportion of patients with positive allergic reactions increased gradually thereafter and reached maximum of 46.7%. Severe adverse events were not observed during the study. Conclusions: Long-term omalizumab treatment is safe and effective for adult patients with WDEIA when assessed by basophil activation rate with wheat allergens as well as allergic reactions after lifting of restrictions on wheat intake. However, this is not enough to achieve desensitization