American College of Allergy, Asthma & Immunology Annual Scientific Meeting. November 6-10 PROGRAM GUIDE. Georgia. Atlanta. acaai.

Transcription

1 American College of Allergy, Asthma & Immunology 2014 Annual Scientific Meeting November 6-10 PROGRAM GUIDE Atlanta Georgia acaai.org

2 le ump b a l P vai rless A w i No 25g A 2 in a A M M I X E Z I Visit Visit ffor or full PI, samples samples,, and mone moneyy sa saving ving coupons coupons.., jg ( ), Indicaations for Use EpiCeram Controlled Release Skin Barrier Emulsion is to be used to treat dry skin conditions and to manage and relieve the burning and itching associated with various types of dermatoses, including atopic dermatitis, irritant contact dermatitis, and radiation dermatitis. EpiCeram helps to relieve dry, waxy skin by maintaining a moist wound and skin environment, which is beneficial to the healing process. Contraindications EpiCeram Controlled Release Skin Barrier Emulsion is contraindicated in persons with known hypersensitivity to any of the components of the formulation. reach of children. Follo o w directions for use. If condition does not improve within 10 to 14 days, consult a physician. Instructions for Use Apply in a thin layer to the affected skin areas two times per day (or as needed) and massage gently into the skin. If the skin is broken, cover EpiCeram Controlled Release Skin Barrier Emulsion with a dressing of choice. How Supplied EpiCeram Controlled Release Skin Barrier Emulsion is supplied as follows: NDC : 90 gram tube NDC : 225 gram airless pump Store at 15 C to 30 C (59 F to 86 F). Do not freeze. Rx only Prescription cription Medicaal Device; Federral Law restricts this device to sale by or on the order of a physician.

3 Welcome American College of Allergy, Asthma & Immunology Faces and Facets of Allergy and Immunology November 6-10 Georgia World Congress Center Atlanta, Georgia Officers and Board of Regents Michael B. Foggs, MD, FACAAI President Richard W. Weber, MD, FACAAI Immediate Past President James L. Sublett, MD, FACAAI President-Elect Bryan L. Martin, DO, FACAAI Vice-President Bradley E. Chipps, MD, FACAAI Treasurer Stanley M. Fineman, MD, MBA, FACAAI Past Immediate Past President Leonard Bielory, MD, FACAAI Warner W. Carr, MD, FACAAI Chitra Dinakar, MD, FACAAI Gregory W. Bensch, MD, FACAAI Tao T. Le, MD, MHS, FACAAI Maeve E. O Connor, MD, FACAAI Curtis W. Hedberg, MD, FACAAI Rohit K. Katial, MD, FACAAI Christopher C. Randolph, MD, FACAAI FIT Representatives: Monica Bhagat, MD ( 14), Andrew Nickels, MD ( 15) Speaker of the House: Kathleen R. May, MD, FACAAI ( 14) Executive Medical Director: Bobby Q. Lanier, MD, FACAAI Alliance President: Margaret Quel 1

4 ACAAI Premier Partners The American College of Allergy, Asthma and Immunology recognizes the indispensable role that health care companies play in furthering the mission of the College. ACAAI would like to thank the following companies for their generous support of this year s Annual Scientific Meeting. DIAMOND $500,000 and above Teva Respiratory PLATINUM $300,000 $499,999 Mylan Specialty L.P. GOLD $100,000 $299,999 Baxter Healthcare Meda Pharmaceuticals Inc. Merck Shire Sunovion Pharmaceuticals Inc. SILVER $50,000 $99,999 AstraZeneca Genentech Novartis Salix Pharmaceuticals, Inc. Sanofi US OTHER CONTRIBUTORS Aerocrine ALK, Inc. Allergy & Asthma Network Boehringer Ingelheim Pharmaceuticals, Inc. Boston Scientific BR Surgical, LLC CSL Behring European Academy of Allergy and Clinical Immunology GlaxoSmithKline GREER Lincoln Diagnostics, Inc. Novartis Pharmaceuticals Corporation PuraCap Pharmaceutical LLC SmartPractice 2

5 Table of Contents Page Greetings From the Officers Greetings From the Alliance Fundraiser Corporate Supporters Commercial Supporters Special Announcements Evaluation, Credit Claim and Certificate System Education Information Maintenance of Certification Daily Events Committee Meetings Workshops Thursday Conference Friday Annual Literature Review Friday General Sessions Town Hall Meeting Saturday General Sessions Saturday ACAAI Awards Ceremony and President s Welcome Reception Sunday Meet the Professor Breakfasts Sunday General Sessions Sunday Concurrent Sessions Sunday Programs Monday Meet the Professor Breakfasts Monday Annual Business Meeting Page Monday General Sessions Monday Concurrent Sessions Office Administrators Practice Management Course Advanced Practice Health Care Providers Course Allied Health Professionals Course Poster Session Plenary and Symposia Faculty Faculty Index CME/CPD Committee Disclosures Special Events Named Lectures ACAAI Past Presidents Distinguished Fellows ACAAI Foundation Alliance Program Fellows-in-Training Travel Grant Recipients Product Theater Exhibits Index of Exhibits Index of Exhibitors Exhibit Hall Map Georgia World Congress Center Maps This Conference is Paper-Lite In an effort to be environmentally responsible, ACAAI is reducing the amount of paper we use at our annual meeting. Electronic program materials and online materials will replace paper and will be accessible online before, during and after the program. Visit acaai2014.conferencespot.org or snap the QR code for a menu of online materials. ONLINE MATERIALS 3

6 PLEASE JOIN US FOR A PRODUCT THEATER LUNCH PRESENTATION AT THE 2014 ACAAI Annual Scientific Meeting THE LATEST INFORMATION IN THERAPY FOR Asthma, COPD, and Exercise-Induced Bronchospasm Saturday November 8, :35 PM 1:30 PM Georgia World Congress Center Hall A1, Product Theater #1 Atlanta, Georgia Gregory W. Bensch, MD Assistant Professor Allergy & Immunology Residency Program Co-Partner of Bensch Research Associates Stockton, California A Complimentary Lunch Will Be Served If you are licensed in any state or other jurisdiction or are an employee or contractor of any organization or governmental entity that limits or prohibits meals from pharmaceutical companies, please identify yourself so that you (and we) are able to comply with such requirements. Your name, the value, and purpose of any educational item, meal, or other items of value you received may be reported as required by state or federal law. Once reported, this information may be publicly accessible. Thank you for your cooperation. This is a promotional event. CME/CE credit will not be available for this session. In compliance with PhRMA guidelines, spouses or other guests are not permitted to attend company-sponsored programs. This promotional educational activity is brought to you by Teva Respiratory and is not certified for continuing medical education. The speakers are presenting on behalf of Teva Respiratory and must present information in compliance with FDA requirements applicable to Teva Respiratory. The Product Theater content and views expressed therein do not necessarily reflect the views, policies or position of the American College of Allergy, Asthma & Immunology. Sponsored by Teva Respiratory 2014 RESP-40359

7 Greetings From the Officers Michael B. Foggs, MD, FACAAI President General Information Over the past year, beginning with the theme of the 2013 Annual Scientific Meeting, New Frontiers in Allergy and Immunology: From Bench to Clinic, I have attempted to emphasize the value of our specialty to the public and to stress the importance of allergists stepping outside of our comfort zones and beginning to embrace more immunological disorders that we have been already trained to diagnose and manage. New realities in the Dr. Foggs medical marketplace make it necessary for us to better demonstrate the breadth and depth of our training and value within the new health care paradigm. The 2014 Annual Scientific Meeting will facilitate our being better able to accomplish this goal. During these tumultuous times, College leadership has seriously deliberated the future of the College and deeply contemplated how to make it a better organization so that it can better serve its members and society. I am pleased to announce that the College is moving forward. Within the next year there will be growing evidence to substantiate this fact. The dedication of the College officers, Board of Regents and the College administration has resulted in many hours devoted to revamping several facets of the College s infrastructure in a manner that will greatly benefit its members. A number of initiatives will be rolled out over the ensuing months that I think will make you proud to be a College member. These innovations will make it easier for allergists to overcome some of the growing pressures and obstacles that now threaten the survival of the specialty of allergy-immunology as we know it today. Vision 2020 will usher in many of these changes and innovations. The Vision 2020 rubric has dual meaning, expressing the fact that the College leadership has sharpened its vision regarding the future and announcing that we plan to achieve many auspicious and laudable goals by the year Be sure to visit the ACAAI booth to learn more about this initiative. The College is fighting for the practicing allergist on all fronts. The 2014 Annual Scientific Meeting is symbolic of the College s ongoing efforts to lead practicing allergists into the future and remain the go to organization for the practicing allergist. I know that you find this to be a very worthwhile and meaningful meeting. President-Elect, James Sublett, MD, FACAAI, has put together an outstanding meeting, focusing on the exciting theme Faces and Facets of Allergy & Immunology. Don t miss Thursday s all-day program, D-Day for Skin Deep Allergies, which will focus on skin allergies and patch testing. The Symposia put together by Bryan Martin, DO, FACAAI are outstanding. The Meet the Professor programs put together by Bradley Chipps, MD, FACAAI, are exciting as are the workshops assembled by Luz Fonacier, MD, FACAAI. And don t forget the famous FIT Bowl. Much thought and work has been put into these programs by these colleagues and their committees. You will also find the entertainment at our annual Fundraising Dinner both charming and exciting. This year s dinner features the great seven-time Grammy winner, Al Jarreau. Known as one of the greatest jazz singers alive, this is an event you won t want to miss. Welcome to Atlanta for a wonderful experience! Photo 2014, Kevin C. Rose / AtlantaPhotos.com 5

8 Professional Education. Advocacy. Public Education. Practice Parameters. Publications and Annals. World-Class Events. The College has a crystal clear vision about where it s headed A set date by which it plans to achieve its goals

9 Greetings From the Officers James L. Sublett, MD, FACAAI President-Elect and Program Chairman General Information Welcome to Atlanta for the 71st ACAAI Annual Scientific Meeting. I am excited to present the focus of this year s meeting Faces and Facets of Allergy and Immunology. We, the practicing allergists and our staff, our patients and the diseases we treat, serve as the muses for this meeting. As allergists/immunologists practicing in Dr. Sublett the 21st century, we are truly holistic specialists. Instead of focusing on one organ of the human body, we focus on the entire immune system. Imagine if you will a mirror ball. All of the facets on a mirror ball reflect out like a prism to the different areas we are involved in. We treat diseases ranging from the very common (allergic rhinitis and asthma) to the exceedingly rare (primary immune deficiency) and a variety in between (atopic and contact dermatitis, urticaria, food, stinging insect and drug allergy), which include various organ systems (respiratory tract, eyes, skin, gastrointestinal) in patients from infancy to the elderly. Additionally, we are faced with the changing health care delivery system and challenges of the business side of running our clinics and practices. The entire meeting is packed with valuable workshops, symposia and plenaries addressing a wide array of topics including COPD and asthma; overlap syndrome; immunotherapy; climate change; emerging allergy treatments and the unique challenges we face in treating all age demographics. All of the topics include compelling clinical information and research that you can apply and take back home to better treat your patients. Thursday s compelling full day conference, D-Day for Skin Deep Allergies kicks-off our meeting. Experts will discuss improved patch testing, consensus and controversies of guidelines, and treatment breakthroughs for common allergies. The Great Raft Debate: The Allergy Epidemic a Root Cause Analysis will be held on Saturday, moderated by William K. Dolen, MD, FACAAI and Maeve E. O Connor MD, FACAAI. The five star line-up of debaters features: Stanley J. Szefler, MD, FACAAI, Jay M. Portnoy, MD, FACAAI, Thomas A.E. Platts-Mills, MD, FACAAI, Dennis Ownby, MD, FACAAI, and David Peden, MD, FACAAI. You will not want to miss this stimulating discussion, which is always a crowd pleaser. New this year, are three special workshops presented by scientists from the Atlanta-based Centers for Disease Control and Prevention (CDC). We are saving some of the best for last this year, as the meeting ends with a compelling presentation on Monday from the world s experts in food allergy. We will learn about oral and sublingual immunotherapy for food allergy treatment and the use of allergen components in diagnosis. If you visualize that mirror ball again, imagine how the allergy specialty reflects out to business and clinical staff and non-physician providers. This meeting has been designed with you in mind too. Designated workshops shed light on complex areas to educate you on the latest so you too can better help patients. I hope to see you on Saturday evening when we acknowledge the accomplishments of our fellow colleagues during the awards ceremony, which will be followed by the President s Welcome Reception. The College will also be inducting a record number of Fellows. We are thrilled to see more than double the number of new Fellows than in the previous years. On Sunday, the legendary seven time Grammy Award winner, Al Jarreau, will be headlining the Fundraising Dinner. He is one of the few artists to win Grammys in three different categories: jazz, pop and R&B and is sure to entertain us. This year s meeting will provide you with the knowledge and expertise you need to improve the faces and facets of allergy and asthma in your practice. Again, welcome to Atlanta. 7

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11 Atlanta, the seat of the government for over 125 years, has captivating historical homes which are enhanced by this city s cosmopolitan and modern charm. Properties that housed Atlanta's pioneers and Civil War heroes pass on some important lessons of American history. Be sure to visit these sites during your stay and take time to savor the Southern culture and hospitality. Mrs. Quel Greetings From the Alliance On this, the 60th anniversary of the Alliance of the ACAAI, all of our efforts have been focused on presenting a meeting filled with memorable moments. Don t miss our events as outlined below and we hope you have a wonderful time The Hospitality Suite will be housed in the charming glassenclosed Atrium of the Omni Hotel at CNN Center. Not only will you be treated to a delicious daily breakfast, but each morning you will also be entertained with a variety of events: Friday a lecture regarding the Margaret Mitchell House, especially important since this year marks the 75th anniversary of the movie based on her famous novel, Gone With The Wind. This event will be made unique with a display of private GWTW memorabilia courtesy of Mrs. Charlotte Meadows. The next program on Saturday will highlight charming Chef Ticha and although it is early in the day, she will tempt our palates with the preparation a delicious dessert most of us are always ready for dessert. On Sunday, Mrs. Bonnie Miles, Virginia Master Naturalist and former Alliance president, will provide us with an important and fascinating environmental talk. The ACAAI KIDS will be delighted by the Atlanta Zoo Mobile: Saturday s program will surely entertain and educate your children about a variety of critters found in the wild. All of the above events are listed by date and time in the Program Guide and Pocket Pal, the mini program provided to all spouses and guests. Please be sure to review them both and carry the Pocket Pal so you don t miss any of the fun. Annual Business Meeting & Luncheon Gone With The Wind is not the only anniversary we are celebrating, as this month also marks the 60th anniversary of Welcome to Alluring Atlanta! the Alliance of the ACAAI. After a careful search, we found a location near the Omni Hotel and arranged to have this completely to ourselves. On Sunday, Nov. 9th not only will we dine exclusively, but we will also be treated to charming special guests. This is a luncheon not to be missed please be sure to purchase your luncheon ticket in advance as seating is limited. Photo Contest Grand Finale This is the last chance to enter this wonderful event and our sincere thanks to the efforts of Barbara Finegold and Jeanne Zitt for creating such fun filled moments. It is the last opportunity to see your favorite photos on display throughout the meeting; these lovely images will be eligible to become part of future fundraising activities. Remember all proceeds benefit the Foundation of the ACAAI. Note-Worthy During this meeting we will unveil a new item for sale which displays a selection of your amazing photo entries: A small spiral notebook, both colorful and practical, with a selection of photos from past competitions on the outside and blank pages on the inside for notes. This booklet is attractive, useful and small enough to fit in a pocket or purse. The notebook will be available for a nominal fee at the Hospitality Suite as well as the ACAAI meeting registration desk and all proceeds will benefit the Foundation. Perhaps a future version will reveal selections from the 2014 contest entries. International Reception Barbara Finegold and Jeanne Zitt, along with host of volunteers will once again present the International Reception. It is an opportunity for our international guests to meet and greet ACAAI and Alliance Board and International Committee members on a more personal level. My thanks to President-Elect, Judy Fineman, the Alliance Board of Directors and Committee Chairs, along with our many volunteers and the College support staff who make our programs possible. Margaret Quel, Alliance President General Information 9

12 Sunday, November 9 Atlanta, Georgia Known as one of the greatest jazz singers alive, seven-time Grammy Award winner Al Jarreau is one of the very few artists to ever win a Grammy in three categories: jazz, pop and R&B. Two of these were German Grammys, showcasing the inter - national following he has. With several hit songs, such as We re in this Love Together, Mornin, After All, Your Song and Tell Me What I Gotta Do, he received his own star on the "Hollywood Walk of Fame" in March A singer since the age of four, Al Jarreau continues to tour extensively worldwide. He will release his 23rd album, later this summer, nearly 40 years after his first compilation debuted. Net proceeds from the event will be donated to the ACAAI Foundation to support Fellows-in-Training Program Relief Grants, Young Faculty Support Awards and other Foundation programs. 7:00 pm: Reception 8:00 pm: Plated Dinner 9:30 pm: Performance Physician Tickets: Physician Tables: Corporate Tables: $250 each $2,300 each $10,000 each

13 Corporate Supporters ACAAI appreciates the following promotional contributions from its corporate supporters. Aerocrine Supporter of a Product Theater. Allergy & Asthma Network Supporter of signage in the Omni hotel. AstraZeneca Supporter of a table at the fundraising dinner and advertisements in the Final Program Guide. Baxter Healthcare Supporter of a Non-CME Corporate Forum convention center window clings and hotel room mirror clings. Boehringer Ingelheim Pharmaceuticals, Inc. Supporter of the ACAAI Corporate Council. Boston Scientific Supporter of the ACAAI Corporate Council. CSL Behring Supporter of a Product Theater. European Academy of Allergy and Clinical Immunology Supporter of an advertisement in the Final Program Guide. Genentech Novartis Supporter of two tables at the fundraising dinner a Product Theater and the ACAAI Corporate Council. GlaxoSmithKline Supporter of the ACAAI Corporate Council. GREER Supporter of Friday s Fellows-in-Training Welcome Reception and two Product Theaters. Lincoln Diagnostics, Inc. Supporter of two tables at the fundraising dinner. Supporter of the Internet Café and an advertisement in the Final Program Guide. Meda Pharmaceuticals Inc. Supporter of a Non-CME Corporate Forum hotel room key hotel restaurant and lounge promotion refreshment breaks table at the fundraising dinner and the ACAAI Corporate Council. Merck Supporter of a Product Theater advertisement in the Final Program Guide and AllergyWatch and its placement on the ACAAI website. Mylan Specialty L.P. Supporter of the exhibit aisle markers floor clings in the convention center hotel room door hangers and the Anaphylaxis Roundtable. Novartis Pharmaceuticals Corporation Supporter of the ACAAI Corporate Council. PuraCap Pharmaceutical LLC Supporter of an advertisement in the Final Program Guide. Salix Pharmaceuticals, Inc. Supporter of the signage and video walls in the convention center. Sanofi US Supporter of the FIT Bowl hotel tent card and the ACAAI Corporate Council. Shire Supporter of the Hereditary Angioedema Campaign and the Allergist Locator. Sunovion Pharmaceuticals Inc. Supporter of the President s Private Dinner Board of Regents dinner COPD Member Survey and the ACAAI Corporate Council. Teva Respiratory Supporter of the ACAAI Corporate Council Nationwide Asthma Screening Program three Non-CME Corporate Forums a Product Theater Mobile App one table at the fundraising dinner electronic signage escalator clings hand sanitizer stations banners in the convention center smartphone charging stations WiFi in the convention center advertisements in the Final Program Guide and the ACAAI Member enewsletter. General Information 11

14 Commercial Supporters This activity is supported by independent educational grants from the following commercial supporters: ALK, Inc. Supporter of FIT Travel Grants. AstraZeneca Supporter of Workshops W-5 The Affordable Care Act and Asthma Control and W-10 Severe Asthma. Baxter Healthcare Supporter of the Saturday symposium on Optimizing Immunoglobulin Replacement Therapy and a vodcast of the symposium. BR Surgical, LLC In-kind support consisting of loaned durable equipment for Workshop W-16 Hands-On Session in Rhinolaryngoscopy. Genentech Novartis Supporter of FIT Travel Grants. Supporter of FIT Travel Grants. Meda Pharmaceuticals Inc. Supporter of the Friday Breakfast Symposium on Turbinates to Terminal Bronchioles: The One Airway Concept and Advancements in the Treatment of Asthmatics. Merck Supporter of the Meet the Professor Breakfasts and the ACAAI Foundation Young Faculty Award. Mylan Specialty L.P. Supporter of the FIT Program FIT Travel Grants and partial support of the Annual Literature Review. Shire Supporter of the Friday Symposium on Hereditary Angioedema: Clinical Case Challenge. SmartPractice Partial support of the Thursday Conference on Patch Testing. Take Your Meeting Mobile Target what you want to attend, learn and do at the ACAAI Annual Meeting with the ACAAI mobile app the app is free and the options are endless! View all the annual meeting info right at your fingertips: Schedule of events Exhibitor list and details Speakers, sponsors and more Download the free app today and maximize your time at the meeting. To download the app: Go to annualmeeting/acaai.org Or, plug acaai.org/apps into your mobile device s browser. This link automatically detects your device type and takes you to the right place. Or, snap the QR Code Supported by Teva Respiratory 12

15 SYMBICORT 160/4.5 for the maintenance treatment of COPD REV THE FEV 1 SYMBICORT offers something extra sustained* control with better breathing starting within 5 minutes each time 1-3 SYMBICORT is NOT a rescue medication and does NOT replace fast-acting inhalers to treat acute symptoms Mean percent change from baseline in FEV 1 was measured at day of randomization, months 6 and 12 3 FAST CONTROL Majority of FEV 1 improvement at 5 minutes each time in a subset of SUN Study patients taking SYMBICORT 160/4.5 (n=121) 1,4 SUSTAINED EFFECT SYMBICORT 160/4.5 significantly improved 1-hour postdose FEV 1 at 1 month and end of treatment compared to placebo, and improved predose FEV 1 averaged over the course of the study compared to placebo and formoterol, coprimary endpoints 1 REASSURING SENSE OF CONTROL in COPD clinical trials included nasopharyngitis, oral candidiasis, bronchitis, sinusitis, and upper respiratory tract infection * Sustained improvement in lung function was demonstrated in a 12-month efficacy and safety study. In a serial spirometry subset of patients taking SYMBICORT 160/4.5 1 improvement IMPORTANT SAFETY INFORMATION, INCLUDING BOXED WARNING WARNING: Long-acting beta 2 -adrenergic agonists (LABA), such as formoterol, one of the active ingredients in SYMBICORT, increase the risk of asthma-related death. A placebo-controlled study with another LABA (salmeterol) showed an increase in asthma-related deaths in patients receiving salmeterol. This finding with salmeterol is considered a class effect of LABA, including formoterol. Currently available data are inadequate to determine whether concurrent use of inhaled corticosteroids or other long-term asthma control drugs mitigates the increased risk of asthma-related death from LABA. Available data from controlled clinical trials suggest that LABA increase the risk of asthma-related hospitalization in pediatric and adolescent patients When treating patients with asthma, prescribe SYMBICORT only for patients not adequately controlled on a long-term asthma control medication, such as an inhaled corticosteroid or whose disease severity clearly warrants initiation of treatment with both an inhaled corticosteroid and LABA. Once asthma control is achieved and maintained, assess the patient at regular intervals and step down therapy (eg, discontinue SYMBICORT) if possible without loss of asthma control, and maintain the patient on a long-term asthma control medication, such as an inhaled corticosteroid. Do not use SYMBICORT for patients whose asthma is adequately controlled on low or medium dose inhaled corticosteroids Please see additional Important Safety Information and Brief Summary of full Prescribing Information, including Boxed WARNING, on following pages.

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17 SUSTAINED EFFECT OVER 12 MONTHS Improvement in 1-hour postdose FEV 1 over the 12-month study Mean change from baseline in FEV 1 (ml) Baseline* 0 Day of 1 Randomization Months 9 12 End of Treatment EXPRESS SCRIPTS NATIONAL PREFERRED FORMULARY I N F O R B O T H C O P D A N D A A P SYMBICORT IS ON P R I O N P D I R I C A A T E T E D S E P A T I T H M A, T N S 5 SUN: A 12-month efficacy and safety study SYMBICORT 160/4.5 significantly improved 1-hour postdose FEV 1 at 1 month and end of treatment compared to placebo, and improved predose FEV 1 averaged over the course of the study compared to placebo and formoterol, coprimary endpoints 1 COMPARATOR ARMS: Mean improvement in 1-hour postdose FEV 1 (ml/%) over 12 months. Month 1: SYMBICORT 160/4.5 mcg (220 ml/21%), formoterol 4.5 mcg (170 ml/17%), placebo (10 ml/1%). Month 6: SYMBICORT 160/4.5 mcg (220 ml/21%), formoterol 4.5 mcg (190 ml/18%), placebo (30 ml/3%). End of treatment: SYMBICORT 160/4.5 mcg (200 ml/20%), formoterol 4.5 mcg (170 ml/17%), placebo (10 ml/1%). SYMBICORT 160/4.5 mcg (n=494), formoterol 4.5 mcg (n=495), placebo (n=479). * Baseline is defined as the predose FEV 1 value on the day of randomization. Month 12, last observation carried forward. Administered as 2 inhalations twice daily. SYMBICORT. Close monitoring is warranted in patients with a change in vision or history of increased intraocular pressure, glaucoma, or cataracts In rare cases, patients on inhaled corticosteroids may present with systemic eosinophilic conditions SYMBICORT should be used with caution in patients with convulsive disorders, thyrotoxicosis, diabetes mellitus, ketoacidosis, and in patients who are unusually responsive to sympathomimetic amines Beta-adrenergic agonist medications may produce hypokalemia and hyperglycemia in some patients clinical trials included nasopharyngitis, headache, upper respiratory tract infection, pharyngolaryngeal pain, sinusitis, influenza, back pain, nasal congestion, stomach discomfort, vomiting, and oral candidiasis clinical trials included nasopharyngitis, oral candidiasis, bronchitis, sinusitis, and upper respiratory tract infection SYMBICORT should be administered with caution to patients being treated with MAO inhibitors or tricyclic antidepressants, or within 2 weeks of discontinuation of such agents Beta-blockers may not only block the pulmonary effect of beta-agonists, such as formoterol, but may produce severe bronchospasm in patients with asthma ECG changes and/or hypokalemia associated with nonpotassium-sparing diuretics may worsen with concomitant beta-agonists. Use caution with the coadministration of SYMBICORT INDICATIONS SYMBICORT is indicated for the treatment of asthma in patients 12 years and older (also see Boxed WARNING) SYMBICORT 160/4.5 is indicated for the maintenance treatment of airflow obstruction in patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema SYMBICORT is NOT indicated for the relief of acute bronchospasm References: 1. Rennard SI, Tashkin DP, McElhattan J, et al. Efficacy and tolerability of budesonide/formoterol in one hydrofluoroalkane pressurized metered-dose inhaler in patients with chronic obstructive pulmonary disease: results from a 1-year randomized controlled clinical trial. Drugs. 2009;69(5): SYMBICORT [package insert]. Wilmington, DE: AstraZeneca; Data on File, , AZPLP. 4. Data on File, , AZPLP Express Scripts Preferred Drug List. SYMBICORT is a registered trademark of the AstraZeneca group of companies AstraZeneca. All rights reserved /14 15

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19 observed carefully for any evidence of systemic corticosteroid effects. Particular care should be taken in observing patients postoperatively or during periods of stress for evidence of inadequate adrenal response. It is possible that systemic corticosteroid effects such as hypercorticism and adrenal suppression (including adrenal crisis) may appear in a small number of patients, particularly when budesonide is administered at higher than recommended doses over prolonged periods of time. If such effects occur, the dosage of SYMBICORT should be reduced slowly, consistent with accepted procedures for reducing systemic corticosteroids and for management of asthma symptoms. Drug Interactions With Strong Cytochrome P450 3A4 Inhibitors Caution should be exercised when considering the coadministration of SYMBICORT with ketoconazole, and other known strong CYP3A4 inhibitors (e.g., ritonavir, atazanavir, clarithromycin, indinavir, itraconazole, nefazodone, nelfinavir, saquinavir, telithromycin) because adverse effects related to increased systemic exposure to budesonide may occur [see DRUG INTERACTIONS and CLINICAL PHARMACOLOGY in full Prescribing Information (12.3)]. Paradoxical Bronchospasm and Upper Airway Symptoms As with other inhaled medications, SYMBICORT can produce paradoxical bronchospasm, which may be life threatening. If paradoxical bronchospasm occurs following dosing with SYMBICORT, it should be treated immediately with an inhaled, short-acting bronchodilator, SYMBICORT should be discontinued immediately, and alternative therapy should be instituted. Immediate Hypersensitivity Reactions Immediate hypersensitivity reactions may occur after administration of SYMBICORT, as demonstrated by cases of urticaria, angioedema, rash, and bronchospasm. Cardiovascular and Central Nervous System Effects Excessive beta-adrenergic stimulation has been associated with seizures, angina, hypertension or hypotension, tachycardia with rates up to 200 beats/min, arrhythmias, nervousness, headache, tremor, palpitation, nausea, dizziness, fatigue, malaise, and insomnia [see OVERDOSAGE]. Therefore, SYMBICORT, like all products containing sympathomimetic amines, should be used with caution in patients with cardiovascular disorders, especially coronary insufficiency, cardiac arrhythmias, and hypertension. Formoterol, a component of SYMBICORT, can produce a clinically significant cardiovascular effect in some patients as measured by pulse rate, blood pressure, and/or symptoms. Although such effects are uncommon after administration of formoterol at recommended doses, if they occur, the drug may need to be discontinued. In addition, beta-agonists have been reported to produce ECG changes, such as flattening of the T wave, prolongation of the QTc interval, and ST segment depression. The clinical significance of these findings is unknown. Fatalities have been reported in association with excessive use of inhaled sympathomimetic drugs. Reduction in Bone Mineral Density Decreases in bone mineral density (BMD) have been observed with long-term administration of products containing inhaled corticosteroids. The clinical significance of small changes in BMD with regard to long-term consequences such as fracture is unknown. Patients with major risk factors for decreased bone mineral content, such as prolonged immobilization, family history of osteoporosis, post menopausal status, tobacco use, advanced age, poor nutrition, or chronic use of drugs that can reduce bone mass (e.g., anticonvulsants, oral corticosteroids) should be monitored and treated with established standards of care. Since patients with COPD often have multiple risk factors for reduced BMD, assessment of BMD is recommended prior to initiating SYMBICORT and periodically thereafter. If significant reductions in BMD are seen and SYMBICORT is still considered medically important for that patient s COPD therapy, use of medication to treat or prevent osteoporosis should be strongly considered. Effects of treatment with SYMBICORT 160/4.5, SYMBICORT 80/4.5, formoterol 4.5, or placebo on BMD was evaluated in a subset of 326 patients (females and males 41 to 88 years of age) with COPD in the 12-month study. BMD evaluations of the hip and lumbar spine regions were conducted at baseline and 52 weeks using dual energy x-ray absorptiometry (DEXA) scans. Mean changes in BMD from baseline to end of treatment were small (mean changes ranged from g/cm 2 ). ANCOVA results for total spine and total hip BMD based on the end of treatment time point showed that all geometric LS Mean ratios for the pairwise treatment group comparisons were close to 1, indicating that overall, bone mineral density for total hip and total spine regions for the 12 month time point were stable over the entire treatment period. Effect on Growth Orally inhaled corticosteroids may cause a reduction in growth velocity when administered to pediatric patients. Monitor the growth of pediatric patients receiving SYMBICORT routinely (e.g., via stadiometry). To minimize the systemic effects of orally inhaled corticosteroids, including SYMBICORT, titrate each patient s dose to the lowest dosage that effectively controls his/her symptoms [see DOSAGE AND ADMINISTRATION and USE IN SPECIFIC POPULATIONS]. Glaucoma and Cataracts Glaucoma, increased intraocular pressure, and cataracts have been reported in patients with asthma and COPD following the long-term administration of inhaled corticosteroids, including budesonide, a component of SYMBICORT. Therefore, close monitoring is warranted in patients with a change in vision or with history of increased intraocular pressure, glaucoma, and/or cataracts. Effects of treatment with SYMBICORT 160/4.5, SYMBICORT 80/4.5, formoterol 4.5, or placebo on development of cataracts or glaucoma were evaluated in a subset of 461 patients with COPD in the 12-month study. Ophthalmic examinations were conducted at baseline, 24 weeks, and 52 weeks. There were 26 subjects (6%) with an increase in posterior subcapsular score from baseline to maximum value (>0.7) during the randomized treatment period. Changes in posterior subcapsular scores of >0.7 from baseline to treatment maximum occurred in 11 patients (9.0%) in the SYMBICORT 160/4.5 group, 4 patients (3.8%) in the SYMBICORT 80/4.5 group, 5 patients (4.2%) in the formoterol group, and 6 patients (5.2%) in the placebo group. Eosinophilic Conditions and Churg-Strauss Syndrome In rare cases, patients on inhaled corticosteroids may present with systemic eosinophilic conditions. Some of these patients have clinical features of vasculitis consistent with Churg-Strauss syndrome, a condition that is often treated with systemic corticosteroid therapy. These events usually, but not always, have been associated with the reduction and/or withdrawal of oral corticosteroid therapy following the introduction of inhaled corticosteroids. Physicians should be alert to eosinophilia, vasculitic rash, worsening pulmonary symptoms, cardiac complications, and/or neuropathy presenting in their patients. A causal relationship between budesonide and these underlying conditions has not been established. Coexisting Conditions SYMBICORT, like all medications containing sympathomimetic amines, should be used with caution in patients with convulsive disorders or thyrotoxicosis and in those who are unusually responsive to sympathomimetic amines. Doses of the related beta 2 -adrenoceptor agonist albuterol, when administered intravenously, have been reported to aggravate preexisting diabetes mellitus and ketoacidosis. Hypokalemia and Hyperglycemia Beta-adrenergic agonist medications may produce significant hypokalemia in some patients, possibly through intracellular shunting, which has the potential to produce adverse cardiovascular effects [see CLINICAL PHARMACOLOGY in full Prescribing Information (12.2)]. The decrease in serum potassium is usually transient, not requiring supplementation. Clinically significant changes in blood glucose and/or serum potassium were seen infrequently during clinical studies with SYMBICORT at recommended doses. ADVERSE REACTIONS Long-acting beta 2-adrenergic agonists, such as formoterol one of the active ingredients in SYMBICORT, increase the risk of asthma-related death. Currently available data are inadequate to determine whether concurrent use of inhaled corticosteroids or other long-term asthma control drugs mitigates the increased risk of asthma-related death from LABA. Available data from controlled clinical trials suggest that LABA increase the risk of asthma-related hospitalization in pediatric and adolescent patients. Data from a large placebo-controlled US study that compared the safety of another longacting beta 2-adrenergic agonist (salmeterol) or placebo added to usual asthma therapy showed an increase in asthma-related deaths in patients receiving salmeterol [see WARNINGS AND PRECAUTIONS]. Systemic and inhaled corticosteroid use may result in the following: - Candida albicans infection [see WARNINGS AND PRECAUTIONS] - Pneumonia or lower respiratory tract infections in patients with COPD [see WARNINGS AND PRECAUTIONS] - Immunosuppression [see WARNINGS AND PRECAUTIONS] - Hypercorticism and adrenal suppression [see WARNINGS AND PRECAUTIONS] - Growth effects in pediatric patients [see WARNINGS AND PRECAUTIONS] - Glaucoma and cataracts [see WARNINGS AND PRECAUTIONS] Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. SYMBICORT (budesonide/formoterol fumarate dihydrate) Inhalation Aerosol 2 Clinical Trials Experience in Asthma Patients 12 years and older The overall safety data in adults and adolescents are based upon 10 active- and placebo-controlled clinical trials in which 3393 patients ages 12 years and older (2052 females and 1341 males) with asthma of varying severity were treated with SYMBICORT 80/4.5 or 160/4.5 mcg taken two inhalations once or twice daily for 12 to 52 weeks. In these trials, the patients on SYMBICORT had a mean age of 38 years and were predominantly Caucasian (82%). The incidence of common adverse events in Table 1 below is based upon pooled data from three 12-week, double-blind, placebo-controlled clinical studies in which 401 adult and adolescent patients (148 males and 253 females) age 12 years and older were treated with two inhalations of SYMBICORT 80/4.5 or SYMBICORT 160/4.5 twice daily. The SYMBICORT group was composed of mostly Caucasian (84%) patients with a mean age of 38 years, and a mean percent predicted FEV 1 at baseline of 76 and 68 for the 80/4.5 mcg and 160/4.5 mcg treatment groups, respectively. Control arms for comparison included two inhalations of budesonide HFA metered dose inhaler (MDI) 80 or 160 mcg, formoterol dry powder inhaler (DPI) 4.5 mcg, or placebo (MDI and DPI) twice daily. Table 1 includes all adverse events that occurred at an incidence of 3% in any one SYMBICORT group and more commonly than in the placebo group with twice-daily dosing. In considering these data, the increased average duration of patient exposure for SYMBICORT patients should be taken into account, as incidences are not adjusted for an imbalance of treatment duration. Table 1 Adverse reactions occurring at an incidence of 3% and more commonly than placebo in the SYMBICORT groups: pooled data from three 12-week, double-blind, placebo-controlled clinical asthma trials in patients 12 years and older Treatment* SYMBICORT Budesonide Formoterol Placebo Adverse Event 80/4.5 mcg 160/4.5 mcg 80 mcg 160 mcg 4.5 mcg N = 277 N =124 N =121 N = 109 N = 237 N = 400 % % % % % % Nasopharyngitis Headache Upper respiratory tract infection Pharyngolaryngeal pain Sinusitis Influenza Back pain Nasal congestion Stomach discomfort Vomiting Oral Candidiasis Average Duration of Exposure (days) * All treatments were administered as two inhalations twice daily. Long-term safety - asthma clinical trials in patients 12 years and older Long-term safety studies in adolescent and adult patients 12 years of age and older, treated for up to 1 year at doses up to 1280/36 mcg/day (640/18 mcg twice daily), revealed neither clinically important changes in the incidence nor new types of adverse events emerging after longer periods of treatment. Similarly, no significant or unexpected patterns of abnormalities were observed for up to 1 year in safety measures including chemistry, hematology, ECG, Holter monitor, and HPA-axis assessments. Clinical Trials Experience in Chronic Obstructive Pulmonary Disease The incidence of common adverse events in Table 2 below is based upon pooled data from two double-blind, placebocontrolled clinical studies (6 and 12 months in duration) in which 771 adult COPD patients (496 males and 275 females) 40 years of age and older were treated with SYMBICORT 160/4.5, two inhalations twice daily. Of these patients 651 were treated for 6 months and 366 were treated for 12 months. The SYMBICORT group was composed of mostly Caucasian (93%) patients with a mean age of 63 years, and a mean percent predicted FEV 1 at baseline of 33%. Control arms for comparison included two inhalations of budesonide HFA (MDI) 160 mcg, formoterol (DPI) 4.5 mcg or placebo (MDI and DPI) twice daily. Table 2 includes all adverse events that occurred at an incidence of 3% in the SYMBICORT group and more commonly than in the placebo group. In considering these data, the increased average duration of patient exposure to SYMBICORT should be taken into account, as incidences are not adjusted for an imbalance of treatment duration. Table 2 Adverse reactions occurring at an incidence of 3% and more commonly than placebo in the SYMBICORT group: pooled data from two double-blind, placebo-controlled clinical COPD trials Treatment* SYMBICORT Budesonide Formoterol Placebo 160/4.5 mcg 160 mcg 4.5 mcg N = 771 N = 275 N = 779 N = 781 Adverse Event % % % % Nasopharyngitis Oral candidiasis Bronchitis Sinusitis Upper respiratory tract infection viral Average Duration of Exposure (days) * All treatments were administered as two inhalations twice daily. Lung infections other than pneumonia (mostly bronchitis) occurred in a greater percentage of subjects treated with SYMBICORT 160/4.5 compared with placebo (7.9% vs. 5.1%, respectively). There were no clinically important or unexpected patterns of abnormalities observed for up to 1 year in chemistry, haematology, ECG, ECG (Holter) monitoring, HPA-axis, bone mineral density and ophthalmology assessments. Postmarketing Experience The following adverse reactions have been reported during post-approval use of SYMBICORT. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. Some of these adverse reactions may also have been observed in clinical studies with SYMBICORT. Cardiac disorders: angina pectoris, tachycardia, atrial and ventricular tachyarrhythmias, atrial fibrillation, extrasystoles, palpitations Endocrine disorders: hypercorticism, growth velocity reduction in pediatric patients Eye disorders: cataract, glaucoma, increased intraocular pressure Gastrointestinal disorders: oropharyngeal candidiasis, nausea Immune system disorders: immediate and delayed hypersensitivity reactions, such as anaphylactic reaction, angioedema, bronchospasm, urticaria, exanthema, dermatitis, pruritus Metabolic and nutrition disorders: hyperglycemia, hypokalemia Musculoskeletal, connective tissue, and bone disorders: muscle cramps Nervous system disorders: tremor, dizziness Psychiatric disorders: behavior disturbances, sleep disturbances, nervousness, agitation, depression, restlessness Respiratory, thoracic, and mediastinal disorders: dysphonia, cough, throat irritation Skin and subcutaneous tissue disorders: skin bruising Vascular disorders: hypotension, hypertension DRUG INTERACTIONS In clinical studies, concurrent administration of SYMBICORT and other drugs, such as short-acting beta 2 -agonists, intranasal corticosteroids, and antihistamines/decongestants has not resulted in an increased frequency of adverse reactions. No formal drug interaction studies have been performed with SYMBICORT.

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21 Special Announcements ACAAI Booth Stop by the ACAAI booth, located on Level Four of the Georgia World Congress Center, on Saturday and Sunday from 9:00 am 4:00 pm to learn more about ongoing College programs and Vision Admission by Badge Only Admission to all meeting rooms and the exhibit area will be by badge only. This rule will be strictly enforced by security guards at all entrances. Note: Children under 12 are not admitted to the Scientific Sessions or the exhibit area. Alliance Hospitality Suite The Alliance Hospitality Suite located in the Atrium Terrace (Atrium Terrace Level South Tower) of the Omni Hotel at CNN Center will be open to registered spouses and guests only from 8:00 10:30 am, Friday through Monday. Awards Ceremony and President s Welcome Reception The College invites all registrants to the ACAAI Awards Ceremony and President s Welcome Reception on Saturday at the Omni Hotel at CNN Center. The Awards Ceremony will begin at 7:00 pm and will be held in the International Ballroom Salons DE (Level M2 North Tower). ACAAI will recognize the 2014 Award recipients and formally welcome our newly-approved Fellows. Award recipients include ACAAI s Distinguished Fellow, International Distinguished Fellow, Distinguished Service, Woman in Allergy, Young Faculty Support, and Clemens Von Pirquet awards. Finally, we ll introduce this year s recipient of the College s prestigious Gold Headed Cane Award. The President s Welcome Reception will be held in the Grand Ballroom (Level M4 North Tower) at the Omni Hotel at CNN Center, from 7:45 9:00 pm. It s the perfect place to catch up with old friends, make new acquaintances and meet the ACAAI President, President-Elect and the Alliance President. Badge Designations Blue Member Physicians Purple Non member Physicians Green Nurses/Allied Health Lime Fellows in Training/Residents Orange Non-Physicians Red Technical Exhibitors Teal Spouses/Guests Lt Orange Press Fuchsia Staff Replacement badges $10.00 each Capturing of NPI Numbers As part of the healthcare reform legislation signed into law in March 2010, the Physician Payment Sunshine Act requires medical device, biologic, and drug companies to publicly disclose gifts and payments made to physicians, beginning on August 1, To help our 2014 ACAAI Annual Scientific Meeting exhibitors and industry partners in fulfilling the mandatory reporting provisions of the Sunshine Act, ACAAI is requesting U.S. healthcare provider attendees to supply their 10-digit NPI (National Provider Identifier) number when registering for the 2014 Annual Scientific Meeting. The NPI will be imbedded in the bar code data on the attendee s badge it will NOT be printed on the badge. Exhibitors can download the NPI information by scanning the badge through a lead retrieval system so that they can record and track any reportable transactions. For more information on the capturing of the NPI number; please visit Registration.aspx. Child Care Services Please contact the concierge at the hotel at which you are staying for a list of bonded independent babysitters and babysitting agencies. Note: Children under 12 are not admitted to the Scientific Sessions or the exhibit area. Coat & Baggage Check A complimentary coat and baggage check is located in Room A401 at the Georgia World Congress Center. Hours: 7:30 am 5:30 pm, Thursday 7:00 am 6:30 pm, Friday 7:00 am 7:30 pm, Saturday 6:00 am 6:30 pm, Sunday 6:30 am 5:30 pm, Monday Disclaimer The primary purpose of the ACAAI Annual Scientific Meeting is educational. Information, as well as technologies, products and/or services discussed, are intended to inform participants about the knowledge, techniques and experiences of specialists who are willing to share such information with colleagues. A diversity of professional opinions exists in the specialty and the views of the ACAAI disclaim any and all liability for damages to any individual attending this conference and for all claims which may result from the use of information, technologies, products and/or services discussed at the conference. General Information 19

22 Special Announcements Doctors Job Fair Looking for new opportunities, an associate for your group, or a buyer for your practice? The Doctors Job Fair brings together all interested parties seeking or offering professional opportunities. This unique program is scheduled from 12:30 3:30 pm, Sunday, in Hall A-1 of the Georgia World Congress Center. Representatives of clinics, groups and physicians offices looking for associates, will be among those conducting interviews, which will be held in private, draped booths. DVD-ROM The Literature Review Course, Thursday Conference, and selected Plenary Sessions and Symposia will be captured and placed on an interactive DVD. Visit the Conference Recordings sales desk located outside the Sidney Marcus Auditorium (Level Four) of the Georgia World Congress Center to learn more about this exciting opportunity and order your copy at the special on-site discounted rate. (Sorry, no personal audio or video recorders will be allowed in the meeting rooms.) Exhibit Hall More than 85 technical and scientific exhibitors in 181 booths are displaying their latest products in Hall A-1 of the Georgia World Congress Center during the convention. ACAAI appreciates the support of its exhibitors and urges all registrants to visit the displays. Exhibit hours are: Hours: 3:00 pm 6:00 pm, Friday 9:45 am 4:00 pm, Saturday 9:45 am 4:00 pm, Sunday First Aid Office at Georgia World Congress Center A First Aid Station is located in Hall A-3 Lobby (behind escalators) during the following hours: Hours: 7:30 am 5:30 pm, Wednesday 6:30 am 6:30 pm, Thursday 6:30 am 6:30 pm, Friday 5:30 am 7:30 pm, Saturday 6:00 am 10:00 pm, Sunday 6:00 am 10:00 pm, Monday Closest Hospitals Crawford Long Hospital of Emory University (1.6 miles) 550 Peachtree Street, Atlanta, GA Main 404 / ER 404 / Closest Walk-in Clinic SmartCare Urgent Care (10.15 miles) 4400 Peachtree Rd NE, Atlanta, GA 404 / Closest Pharmacy CVS Pharmacy (0.52 miles) 12 Broad Street SW, Atlanta, GA 404 / Foundation Display The Foundation of the ACAAI is proud to recognize those individuals who have generously contributed to the Foundation. A list of donors can be found on the Foundation Honor Display in Building A on Level Three of the Georgia World Congress Center. Internet Café Visit the Internet Café to access the internet and send and retrieve . The Internet Café is located in Building A, Level Three Lobby of the Georgia World Congress Center and is complimentary to all meeting registrants. Supported by Mobile App Maximize your time at the meeting with the free ACAAI Annual Scientific Meeting mobile app. To download, plug into your mobile device s browser, scan the QR Code or search for ACAAI in your app store. Supported by Teva Respiratory Networking Goes Viral with #ACAAI Be a part of the Annual Meeting conversation! Use hashtag #ACAAI in your meeting-related tweets and follow the College@ACAAI. Also, share Facebook posts from facebook.com/theacaai. 20