New consensus report aims to improve anaphylaxis treatment worldwide

A groundbreaking consensus report on anaphylaxis – the severe reaction some people experience from bee stings, peanut butter exposures, medications, and the like – has been released by the Global Allergy and Asthma Excellence Network (GA2LEN) and recently published in The Journal of Allergy and Clinical Immunology.

The report, developed by an international panel of leading medical experts and patient advocacy organizations, aims to standardize the often-differing definitions of anaphylaxis and teach people how to recognize and manage the condition.

"Many people, including young children and adults, carry epinephrine-injectors (aka epi-pens) to self-treat if an emergency occurs. Many others do not. Likewise, our sprawling medical system, from first responders to hospital emergency staff, does not consistently follow guidelines for diagnosing and treating anaphylaxis. This is partly because no uniform guidelines are used internationally to define, recognize and treat anaphylaxis. That's what this report seeks to address," says Tim Dribin, MD, an emergency medicine expert at Cincinnati Children's and the study's co-chair who devoted a year to leading the group that produced the new standards.

This tool includes updated clinical criteria to help diagnose anaphylaxis, criteria for using and dosing intramuscular epinephrine, and much more. Importantly, this is the first tool to include distinct infant findings to improve anaphylaxis management in young children."

Tim Dribin, MD, emergency medicine expert at Cincinnati Children's

Burden of anaphylaxis

Anaphylaxis is a constant burden to patients and caregivers around the world. At any moment, thousands of people encounter situations that could cause severe allergic reactions, with symptoms including hives, swollen lips and tongue, difficulty breathing, wheezing, vomiting, and passing out. While fatalities are rare, successful outcomes require rapid recognition and treatment.

Epinephrine is the only proven anaphylaxis treatment to reduce the risk of hospitalization and death. However, only 21% of children and 7% of adults experiencing anaphylaxis receive epinephrine in the community. Additionally, epinephrine underuse in emergency departments is well-documented.

Expert collaboration

The new report reflects the efforts of a 46-member panel of experts from 14 countries and seven medical specialties. The findings have received endorsements from 34 medical and patient advocacy organizations. The National Institutes of Health, the U.S. Food and Drug Administration, and the European Medicines Agency all participated in the study.

"The clinical support tool is a game-changer in anaphylaxis management," says Hugh Sampson, MD, an internationally renowned food allergy and anaphylaxis expert at Mount Sinai School of Medicine and the study's chair. "By improving the rate of epinephrine use, we can significantly reduce the risk of severe reactions and fatalities, ultimately saving lives. The report will also be instrumental for advancing cutting edge research to improve the care and outcomes of patients with anaphylaxis."

"I believe the elements of this report will help ensure that patients around the world receive timely and appropriate treatment, potentially saving lives," says Antonella Muraro, MD, PhD, an internationally renowned pediatric allergist at the University of Padova in Italy and the study's co-chair. "The report will be invaluable to first responders, emergency department providers, hospital providers, and allergists, as well as researchers trying to better understand and manage this serious and burdensome condition."

Key highlights of the report

1. Unified Definition: The report introduces a new, widely agreed upon definition of anaphylaxis, emphasizing its potential to cause death and detailing the involved organ systems. This definition is designed to be easily understood by healthcare professionals and the general public to promote improved awareness of anaphylaxis.
2. Educational Overview: An innovative educational tool for healthcare professionals from different medical fields, training backgrounds, and experience levels. The overview provides essential information on recognizing and managing anaphylaxis, including common causes, symptoms, timely treatment with epinephrine, and key concepts for managing life-threatening reactions.
3. Clinical Support Tool: A new clinical support tool will help healthcare providers diagnose and treat anaphylaxis. This tool includes updated clinical criteria, indications, and dosing for intramuscular epinephrine and common findings from the different anaphylaxis organ systems. It is the first tool to include distinct infant findings to improve anaphylaxis management in young children, benefiting healthcare providers not accustomed to caring for children.