Anaphylaxis occurs when IgE antibodies are involved, and areas of the body that are not in direct contact with the food become affected and show symptoms. Those with asthma or an allergy to peanuts, tree nuts, or seafood are at greater risk for anaphylaxis. Causes
Although sensitivity levels vary by country, the most common food allergies are allergies to milk, eggs, peanuts, tree nuts, fish, shellfish, soy, and wheat. These are often referred to as "the big eight". Allergies to seeds—especially sesame—seem to be increasing in many countries. Sesame will join “the big eight” as a priority allergen in the United States by 2023. An example of an allergy more common to a particular region is that to rice in East Asia where it forms a large part of the diet.One of the most common food allergies is a sensitivity to peanuts, a member of the bean family. Peanut allergies may be severe, but children with peanut allergies sometimes outgrow them. Tree nuts, including almonds, brazil nuts, cashews, coconuts, hazelnuts, macadamia nuts, pecans, pistachios, pine nuts, and walnuts, are also common allergens. Affected individuals may be sensitive to one particular tree nut or to many different ones. Peanuts and seeds, including sesame seeds and poppy seeds, can be processed to extract oils, but trace amounts of protein may be present, and elicit an allergic reaction.Egg allergies affect about one in 50 children but are frequently outgrown by children when they reach age five.
Ponesimod, sold under the brand name Ponvory, is a medication for the treatment of multiple sclerosis (MS).The most common side effects include upper respiratory tract infection, hepatic transaminase elevation, and hypertension.Ponesimod was approved for medical use in the United States in March 2021 and in the European Union in June 2021. Clinical trials
In a 2009–2011 Phase II clinical trial including 464 MS patients, ponesimod treatment resulted in fewer new active brain lesions than placebo, measured during the course of 24 weeks.In a 2010–2012 Phase II clinical trial including 326 patients with psoriasis, 46 or 48% of patients (depending on dosage) had a reduction of at least 75% Psoriasis Area and Severity Index (PASI) score compared to placebo in 16 weeks. The approval is already applied for in 2020.In a 2015–2019 Phase III randomised, double-blind clinical trial of 1133 adult patients with relapsing MS, those under ponesimod treatment showed a 30% reduction in annual relapse rate and a significantly reduced number of new inflammatory lesions on brain MRI by 56% compared to those taking teriflunomide. Adverse effects
Common adverse effects in studies were temporary bradycardia (slow heartbeat), usually at the beginning of the treatment, dyspnoea (breathing difficulties), and increased liver enzymes (without symptoms). No significant increase of infections was observed under ponesimod therapy. QT prolongation is detectable but was considered to be too low to be of clinical importance in a study. Mechanism of action
Like fingolimod, which is already approved for the treatment of MS, ponesimod blocks the sphingosine-1-phosphate receptor.