{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T03:39:38Z","timestamp":1792381178723,"version":"4.4.0"},"reference-count":33,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","jaci-inpractice.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Allergy and Clinical Immunology: In Practice"],"published-print":{"date-parts":[[2026,10]]},"DOI":"10.1016\/j.jaip.2026.09.023","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T23:47:11Z","timestamp":1791244031000},"update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["Biologic Injection-Related Pain in Severe Asthma, Its Impact on Treatment Aversion, and Pain-Relief Approach: A Multicenter Observational Study"],"prefix":"10.1016","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6546-6376","authenticated-orcid":false,"given":"Takeshi","family":"Matsumoto","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megumi","family":"Aizawa-Abe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Yamamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akiko","family":"Iri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Fujiki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Kusakabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emi","family":"Nakayama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayuko","family":"Tashima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chikara","family":"Ito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kodai","family":"Miyamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reina","family":"Kitagawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusei","family":"Fukushima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihiro","family":"Noda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masanori","family":"Azuma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuya","family":"Ueda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kensaku","family":"Aihara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jaip.2026.09.023_bib1","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1111\/j.1398-9995.2004.00772.x","article-title":"Benefits of omalizumab as add-on therapy in patients with severe persistent asthma who are inadequately controlled despite best available therapy (GINA 2002 step 4 treatment): INNOVATE","volume":"60","author":"Humbert","year":"2005","journal-title":"Allergy"},{"key":"10.1016\/j.jaip.2026.09.023_bib2","doi-asserted-by":"crossref","first-page":"1198","DOI":"10.1056\/NEJMoa1403290","article-title":"Mepolizumab treatment in patients with severe eosinophilic asthma","volume":"371","author":"Ortega","year":"2014","journal-title":"N Engl J Med"},{"key":"10.1016\/j.jaip.2026.09.023_bib3","doi-asserted-by":"crossref","first-page":"2128","DOI":"10.1016\/S0140-6736(16)31322-8","article-title":"Benralizumab, an anti-interleukin-5 receptor \u03b1 monoclonal antibody, as add-on treatment for patients with severe, uncontrolled, eosinophilic asthma (CALIMA): a randomised, double-blind, placebo-controlled phase 3 trial","volume":"388","author":"FitzGerald","year":"2016","journal-title":"Lancet"},{"key":"10.1016\/j.jaip.2026.09.023_bib4","doi-asserted-by":"crossref","first-page":"2486","DOI":"10.1056\/NEJMoa1804092","article-title":"Dupilumab efficacy and safety in moderate-to-severe uncontrolled asthma","volume":"378","author":"Castro","year":"2018","journal-title":"N Engl J Med"},{"key":"10.1016\/j.jaip.2026.09.023_bib5","doi-asserted-by":"crossref","first-page":"1800","DOI":"10.1056\/NEJMoa2034975","article-title":"Tezepelumab in adults and adolescents with severe, uncontrolled asthma","volume":"384","author":"Menzies-Gow","year":"2021","journal-title":"N Engl J Med"},{"key":"10.1016\/j.jaip.2026.09.023_bib6","first-page":"1012","article-title":"Influenza vaccination and self-reported reasons for not receiving influenza vaccination among Medicare beneficiaries aged > or =65 years--United States, 1991-2002","volume":"53","year":"2004","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"10.1016\/j.jaip.2026.09.023_bib7","doi-asserted-by":"crossref","first-page":"341","DOI":"10.4269\/ajtmh.2003.68.341","article-title":"Fear of injections in young adults: prevalence and associations","volume":"68","author":"Nir","year":"2003","journal-title":"Am J Trop Med Hyg"},{"key":"10.1016\/j.jaip.2026.09.023_bib8","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.2147\/PPA.S517466","article-title":"Disease impact and perception of biologics in adults with type 2 inflammation respiratory disease: international survey results","volume":"19","author":"Tal-Singer","year":"2025","journal-title":"Patient Prefer Adherence"},{"key":"10.1016\/j.jaip.2026.09.023_bib9","doi-asserted-by":"crossref","first-page":"818","DOI":"10.4187\/respcare.05905","article-title":"Adherence in asthma and COPD: new strategies for an old problem","volume":"63","author":"George","year":"2018","journal-title":"Respir Care"},{"key":"10.1016\/j.jaip.2026.09.023_bib10","first-page":"227","article-title":"Effect of lidocaine-prilocaine cream (EMLA\u00ae) on pain of intramuscular Fluzone\u00ae injection","volume":"45","author":"Taddio","year":"1992","journal-title":"Can J Hosp Pharm"},{"key":"10.1016\/j.jaip.2026.09.023_bib11","doi-asserted-by":"crossref","first-page":"267","DOI":"10.2310\/7060.2004.19101","article-title":"Topical vapocoolant quickly and effectively reduces vaccine-associated pain: results of a randomized, single-blinded, placebo-controlled study","volume":"11","author":"Mawhorter","year":"2004","journal-title":"J Travel Med"},{"key":"10.1016\/j.jaip.2026.09.023_bib12","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1046\/j.1365-2702.2002.00645.x","article-title":"An experimental study on the use of manual pressure to reduce pain in intramuscular injections","volume":"11","author":"Chung","year":"2002","journal-title":"J Clin Nurs"},{"key":"10.1016\/j.jaip.2026.09.023_bib13","doi-asserted-by":"crossref","first-page":"1514","DOI":"10.1016\/j.vaccine.2009.11.065","article-title":"A systematic review of measures for reducing injection pain during adult immunization","volume":"28","author":"Hogan","year":"2010","journal-title":"Vaccine"},{"key":"10.1016\/j.jaip.2026.09.023_bib14","doi-asserted-by":"crossref","DOI":"10.2147\/JAA.S590261","article-title":"Adherence to biologic therapies is associated with improved clinical outcomes and reduced healthcare resource utilization in patients with severe asthma in Japan","volume":"19","author":"Nagase","year":"2026","journal-title":"J Asthma Allergy"},{"key":"10.1016\/j.jaip.2026.09.023_bib15","doi-asserted-by":"crossref","first-page":"122","DOI":"10.2344\/0003-3006(2005)52[122:ASP]2.0.CO;2","article-title":"A survey of pain, pressure, and discomfort induced by commonly used oral local anesthesia injections","volume":"52","author":"Kaufman","year":"2005","journal-title":"Anesth Prog"},{"key":"10.1016\/j.jaip.2026.09.023_bib16","doi-asserted-by":"crossref","first-page":"63","DOI":"10.5582\/ddt.2025.01133","article-title":"Microneedle patch-enhanced palatal anesthesia with benzocaine: efficacy and safety in a randomized double-blind crossover trial","volume":"20","author":"Kiriishi","year":"2026","journal-title":"Drug Discov Ther"},{"key":"10.1016\/j.jaip.2026.09.023_bib17","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1111\/j.1600-0447.1983.tb09716.x","article-title":"The hospital anxiety and depression scale","volume":"67","author":"Zigmond","year":"1983","journal-title":"Acta Psychiatr Scand"},{"key":"10.1016\/j.jaip.2026.09.023_bib18","first-page":"183","article-title":"Health perception, pain, and disability as correlates of anxiety and depression symptoms in primary care patients","volume":"15","author":"Wu","year":"2002","journal-title":"J Am Board Fam Pract"},{"key":"10.1016\/j.jaip.2026.09.023_bib19","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1016\/j.jpain.2008.12.001","article-title":"Sex, gender, and pain: a review of recent clinical and experimental findings","volume":"10","author":"Fillingim","year":"2009","journal-title":"J Pain"},{"key":"10.1016\/j.jaip.2026.09.023_bib20","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1016\/j.pain.2011.11.026","article-title":"A systematic literature review of 10 years of research on sex\/gender and pain perception - part 2: do biopsychosocial factors alter pain sensitivity differently in women and men?","volume":"153","author":"Racine","year":"2012","journal-title":"Pain"},{"key":"10.1016\/j.jaip.2026.09.023_bib21","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1067\/mem.2001.119849","article-title":"Effect of age on acute pain perception of a standardized stimulus in the emergency department","volume":"38","author":"Li","year":"2001","journal-title":"Ann Emerg Med"},{"key":"10.1016\/j.jaip.2026.09.023_bib22","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1186\/s12891-019-2740-8","article-title":"Younger age is associated with greater pain expression among patients with knee or hip osteoarthritis scheduled for a joint arthroplasty","volume":"20","author":"Skog\u00f6 Nyvang","year":"2019","journal-title":"BMC Musculoskelet Disord"},{"key":"10.1016\/j.jaip.2026.09.023_bib23","doi-asserted-by":"crossref","first-page":"M180","DOI":"10.1093\/gerona\/56.3.M180","article-title":"Age-associated differences in responses to noxious stimuli","volume":"56","author":"Edwards","year":"2001","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"10.1016\/j.jaip.2026.09.023_bib24","doi-asserted-by":"crossref","first-page":"2562","DOI":"10.1016\/j.jaip.2024.04.061","article-title":"Patient-reported outcomes in asthma","volume":"12","author":"Mosnaim","year":"2024","journal-title":"J Allergy Clin Immunol Pract"},{"key":"10.1016\/j.jaip.2026.09.023_bib25","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1016\/j.anai.2023.07.017","article-title":"Real-world severe asthma biologic administration and adherence differs by biologic: CHRONICLE study results","volume":"131","author":"Ledford","year":"2023","journal-title":"Ann Allergy Asthma Immunol"},{"key":"10.1016\/j.jaip.2026.09.023_bib26","doi-asserted-by":"crossref","first-page":"4703","DOI":"10.1016\/S0264-410X(01)00225-0","article-title":"Safety and immunogenicity of varying dosages of trivalent inactivated influenza vaccine administered by needle-free jet injectors","volume":"19","author":"Jackson","year":"2001","journal-title":"Vaccine"},{"key":"10.1016\/j.jaip.2026.09.023_bib27","first-page":"51","article-title":"Real-world biologic use patterns in severe asthma, 2015-2021: the CLEAR study","volume":"16","author":"Tran","year":"2025","journal-title":"Pragmat Obs Res"},{"key":"10.1016\/j.jaip.2026.09.023_bib28","doi-asserted-by":"crossref","DOI":"10.5812\/aapm.38293","article-title":"Ice reduces needle-stick pain associated with local anesthetic injection","volume":"6","author":"Mahshidfar","year":"2016","journal-title":"Anesth Pain Med"},{"key":"10.1016\/j.jaip.2026.09.023_bib29","doi-asserted-by":"crossref","first-page":"8082","DOI":"10.1016\/j.vaccine.2020.11.005","article-title":"Cooling to reduce the pain associated with vaccination: a systematic review","volume":"38","author":"Hall","year":"2020","journal-title":"Vaccine"},{"key":"10.1016\/j.jaip.2026.09.023_bib30","doi-asserted-by":"crossref","first-page":"e341","DOI":"10.4317\/jced.62351","article-title":"Effect of precooling on the assessment of pain during local anesthesia in adults: a systematic review and meta-analysis","volume":"17","author":"de Andrade","year":"2025","journal-title":"J Clin Exp Dent"},{"key":"10.1016\/j.jaip.2026.09.023_bib31","doi-asserted-by":"crossref","first-page":"73","DOI":"10.7547\/87507315-88-2-73","article-title":"Clinical comparison of preinjection anesthetics","volume":"88","author":"Plotkin","year":"1998","journal-title":"J Am Podiatr Med Assoc"},{"key":"10.1016\/j.jaip.2026.09.023_bib32","doi-asserted-by":"crossref","DOI":"10.1016\/j.pupt.2022.102130","article-title":"Reduction in asthma exacerbation rate after mepolizumab treatment initiation in patients with severe asthma: a real-world database study in Japan","volume":"75","author":"Nagase","year":"2022","journal-title":"Pulm Pharmacol Ther"},{"key":"10.1016\/j.jaip.2026.09.023_bib33","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1016\/j.alit.2024.10.009","article-title":"Effectiveness of benralizumab in the Tokyo Asthma Study (TOAST): a real-world prospective interventional trial","volume":"74","author":"Masaki","year":"2025","journal-title":"Allergol Int"}],"container-title":["The Journal of Allergy and Clinical Immunology: In Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2213219826008123?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2213219826008123?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T02:50:45Z","timestamp":1792378245000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2213219826008123"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":33,"alternative-id":["S2213219826008123"],"URL":"https:\/\/doi.org\/10.1016\/j.jaip.2026.09.023","relation":{},"ISSN":["2213-2198"],"issn-type":[{"value":"2213-2198","type":"print"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Biologic Injection-Related Pain in Severe Asthma, Its Impact on Treatment Aversion, and Pain-Relief Approach: A Multicenter Observational Study","name":"articletitle","label":"Article Title"},{"value":"The Journal of Allergy and Clinical Immunology: In Practice","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jaip.2026.09.023","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 American Academy of Allergy, Asthma & Immunology","name":"copyright","label":"Copyright"}]}}