ACAAI’s two new yardsticks on managing eosinophilic esophagitis and cough published

Reviewed by Emily Henderson, B.Sc.Dec 21 2022

Beginning in 2016, the American College of Allergy, Asthma and Immunology (ACAAI) began developing a series of yardsticks to help practitioners better understand the range of treatments available for allergic conditions.

Two new yardsticks, Clinical Guidance for the Use of Dupilumab in Eosinophilic Esophagitis: A Yardstick and Yardstick for Managing Cough. Part 1: in Adults and Adolescent Patients >14 years of age have been published in Annals of Allergy, Asthma and Immunology, ACAAI's scientific journal. Part 2 of the Managing Cough yardstick will be published in the coming months. ACAAI Yardsticks differ from Practice Parameters in several ways:

Yardsticks:
• Are chosen by the College's Yardstick Task Force and ratified by the Board of Regents. Usually, two yardsticks are published each year. No pharmaceutical support is accepted for yardsticks.
• Are developed by College experts and others.
• Provide practical, concise, evidence-based recommendations to assist with everyday clinical decision-making.
• Address important areas that are not included in other guidelines.
• Can reflect standards of care that do not meet "GRADE" criteria yet are based on evidence and best practice consensus.
• Can be rapidly updated to reflect new treatment options and reflect best practices that don't meet strict practice parameter criteria.

The eosinophilic esophagitis (EoE) yardstick provides interval guidance for the use of dupilumab for EoE based on expert opinion. The yardstick expands on the existing Joint Task Force-AGA guidelines published in 2020 providing specific clinical scenarios in which dupilumab, the first and only FDA-approved EoE treatment, may prove useful. It also summarizes a framework for shared decision making as the certainty of evidence for most recommendations for EoE treatments is low.

Standard, evidence-based approaches to diagnosing and managing acute, subacute and chronic cough in adults and adolescents older than 14 years of age are covered in part 1 of the cough yardstick. The diagnosis and management of cough in children is discussed in part 2. Coughs of undifferentiated duration are the single most common complaint for which patients of all ages seek medical care from primary care physicians in the ambulatory care setting in the United States. In the United States alone, it is estimated that consumers spend $6.8 billion annually for over-the-counter cough and cold remedies, many of which aren't effective, and can be harmful to young children.