Global Trends in Anaphylaxis Epidemiology and Clinical Implications

Turner, Paul J.; Campbell, Dianne; Motosue, Megan S.; Campbell, Ronna L.

doi:10.1016/j.jaip.2019.11.027

Cited by 176 publications

(181 citation statements)

References 72 publications

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“…However, this should not be the reason to refrain from epinephrine therapy, and in hindsight, our patient should have been administered epinephrine immediately once anaphylaxis was suspected. In addition, there is a lack of evidence to support the efficacy of glucocorticoids and antihistamines, including H1-and H2-antihistamines, in the management of anaphylaxis [30,31]. Therefore, given that these therapies could delay the timely administration of epinephrine, it should be emphasized to administer epinephrine as first-line therapy [30][31][32].…”

Section: Resultsmentioning

confidence: 99%

“…In addition, there is a lack of evidence to support the efficacy of glucocorticoids and antihistamines, including H1-and H2-antihistamines, in the management of anaphylaxis [30,31]. Therefore, given that these therapies could delay the timely administration of epinephrine, it should be emphasized to administer epinephrine as first-line therapy [30][31][32]. Furthermore, omalizumab, but not benralizumab and mepolizumab, induced a late-phase anaphylactic reaction, 6 h after administration.…”

Section: Resultsmentioning

confidence: 99%

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Anaphylaxis to three humanized antibodies for severe asthma: a case study

Jingo

Harada

Nishioki

et al. 2020

Allergy Asthma Clin Immunol

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Background: Omalizumab, mepolizumab, benralizumab, and dupilumab are the currently available biologics used to treat asthma in Japan. Anaphylaxis following treatment with mepolizumab or benralizumab is considered rare. Case presentation: We report the case of a 35-year-old woman with severe asthma, who experienced anaphylaxis following the administration of benralizumab, mepolizumab, and omalizumab, separately. The therapy with biologics was chosen to avoid the repeated use of systemic corticosteroids for asthma exacerbations. The mechanisms underlying anaphylaxis caused by these three biologics remain unclear. The patient's asthma symptoms and lung function improved after treatment with bronchial thermoplasty. Conclusions: To our knowledge, this is the first report of an asthmatic patient developing anaphylaxis after commencement of benralizumab, mepolizumab, and omalizumab therapy. These three biologics should be administered carefully, and patients should be monitored for anaphylaxis.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Anaphylaxis to three humanized antibodies for severe asthma: a case study

Jingo

Harada

Nishioki

et al. 2020

Allergy Asthma Clin Immunol

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“…Mortality associated with anaphylaxis has decreased as time has gone by due to diverse reasons, mainly because of a more accurate diagnosis and better access to treatment. Currently, global mortality is reported as 0.5 to 1 case per million, in which food represents the most frequent trigger, and the pediatric population is the most affected group [10].…”

Section: Discussionmentioning

confidence: 99%

Physicians’ knowledge regarding epinephrine underuse in anaphylaxis

Pimentel-Hayashi

Rodríguez

Moreno-Laflor

et al. 2020

Asia Pacific Allergy

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Background: Anaphylaxis is a life-threating hypersensitivity reaction. Epinephrine underuse in patients with anaphylaxis could lead to poor outcomes. There is evidence that the epinephrine use in such patients could be as low as 8%. Objective: To assess the percentage of physicians who know that epinephrine is the first-line treatment in anaphylaxis. The secondary objective was to assess knowledge gaps regarding anaphylaxis diagnosis and treatment that could lead to epinephrine underuse. Methods: We performed an online survey for physicians in Mexico City, using a 10-item questionnaire assessing anaphylaxis knowledge. We obtained measures of central tendency for statistical analysis, such as frequency, 95% confidence interval, as well as the chi-square test for comparing the groups. Results: A total of 196 surveys were considered for analysis. Of all the participants, 96.44% were able to correctly diagnose an anaphylaxis case with cutaneous, respiratory, and cardiovascular symptoms. Fifty-two percent correctly diagnosed anaphylaxis without cutaneous symptoms. The 72.4% of the respondents chose epinephrine as the first-line treatment, 42.3% correctly answered that there is no absolute contraindication to giving epinephrine, and 20.9% ignored whether there was any contraindication for its use. Only 38.3% of participants answered that during discharge they would prescribe an autoinjector. Regarding the administration route, 63.4% answered that the first dose of epinephrine is applied intramuscularly and 50% of the participants chose the correct dose of epinephrine. Only 2.6% of the participants answered all 10 questions correctly. Conclusion: There is still some difficulty recognizing anaphylaxis without cutaneous symptoms. Even though two-thirds of physicians identified that epinephrine is the treatment of choice, only 49.5% would have used intramuscular epinephrine as first-line treatment. We found a low percentage of epinephrine ampule prescription and knowledge of the correct dose. These findings can account for epinephrine underuse when dealing with anaphylaxis in the real clinical practice.

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“…It is the most common cause of potentially life-threatening allergic reactions (anaphylaxis), which are an increasing cause of hospitalizations globally. 1 Anaphylaxis is an IgE-mediated hypersensitivity reaction involving the release of preformed mediators from mast cells and basophils, 2 many of which have known cardiovascular effects. 2,3 However, the pathophysiology of anaphylaxis remains poorly understood, 2 and severe anaphylaxis is unpredictable and initially, often difficult to distinguish from more mild reactions.…”

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confidence: 99%

Cardiovascular changes during peanut-induced allergic reactions in human subjects

Ruíz-García¹,

Bartra²,

Alvarez³

et al. 2021

Journal of Allergy and Clinical Immunology

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The funders of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication. Disclosure of potential conflict of interest: M. H. Shamji has received grants from ALK-Abell o, Regeneron, Merck, ASIT Biotech.sa, and the Immune Tolerance Network and has received personal fees from ASIT Biotech.sa, ALK-Abell o, Allergopharma, and UCB. E. N.

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Global Trends in Anaphylaxis Epidemiology and Clinical Implications

Cited by 176 publications

References 72 publications

Anaphylaxis to three humanized antibodies for severe asthma: a case study

Anaphylaxis to three humanized antibodies for severe asthma: a case study

Physicians’ knowledge regarding epinephrine underuse in anaphylaxis

Cardiovascular changes during peanut-induced allergic reactions in human subjects

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