Anaphylaxis knowledge gaps and future research priorities: A consensus report - 03/03/22
, David Schnadower, MD, MPH a, Julie Wang, MD b, Carlos A. Camargo, MD, DrPH c, Kenneth A. Michelson, MD, MPH d, Marcus Shaker, MD, MSc e, Susan A. Rudders, MD, MS f, David Vyles, DO, MS g, David B.K. Golden, MD h, Jonathan M. Spergel, MD, PhD i, Ronna L. Campbell, MD, PhD j, Mark I. Neuman, MD, MPH d, Peter S. Capucilli, MD k, Michael Pistiner, MD, MMSc l, Mariana Castells, MD, PhD m, Juhee Lee, MD i, David C. Brousseau, MD, MS g, Lynda C. Schneider, MD f, Amal H. Assa’ad, MD n, Kimberly A. Risma, MD, PhD n, Rakesh D. Mistry, MD, MS o, Dianne E. Campbell, FRACP, PhD p, q, Margitta Worm, MD r, Paul J. Turner, FRCPCH, PhD s, John K. Witry, MS t, Yin Zhang, MS u, v, Brad Sobolewski, MD, MEd a, Hugh A. Sampson, MD bAbstract |
Background |
Despite a better understanding of the epidemiology, pathogenesis, and management of patients with anaphylaxis, there remain knowledge gaps. Enumerating and prioritizing these gaps would allow limited scientific resources to be directed more effectively.
Objective |
We sought to systematically describe and appraise anaphylaxis knowledge gaps and future research priorities based on their potential impact and feasibility.
Methods |
We convened a 25-member multidisciplinary panel of anaphylaxis experts. Panelists formulated knowledge gaps/research priority statements in an anonymous electronic survey. Four anaphylaxis themed writing groups were formed to refine statements: (1) Population Science, (2) Basic and Translational Sciences, (3) Emergency Department Care/Acute Management, and (4) Long-Term Management Strategies and Prevention. Revised statements were incorporated into an anonymous electronic survey, and panelists were asked to rate the impact and feasibility of addressing statements on a continuous 0 to 100 scale.
Results |
The panel generated 98 statements across the 4 anaphylaxis themes: Population Science (29), Basic and Translational Sciences (27), Emergency Department Care/Acute Management (24), and Long-Term Management Strategies and Prevention (18). Median scores for impact and feasibility ranged from 50.0 to 95.0 and from 40.0 to 90.0, respectively. Key statements based on median rating for impact/feasibility included the need to refine anaphylaxis diagnostic criteria, identify reliable diagnostic, predictive, and prognostic anaphylaxis bioassays, develop clinical prediction models to standardize postanaphylaxis observation periods and hospitalization criteria, and determine immunotherapy best practices.
Conclusions |
We identified and systematically appraised anaphylaxis knowledge gaps and future research priorities. This study reinforces the need to harmonize scientific pursuits to optimize the outcomes of patients with and at risk of anaphylaxis.
Le texte complet de cet article est disponible en PDF.Key words : Allergy, anaphylaxis, basic science, emergency department, feasibility, impact, population science, research, translational science
Abbreviations used : AIT, ED, NIAID/FAAN
Plan
| This study was supported by the Division of Emergency Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio. The project described was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health (NIH) (award no. 2UL1TR001425-05A1). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. The project described was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under (award no. 2KL2TR001426-05A1). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. |
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| Disclosure of potential conflict of interest: T. E. Dribin receives funding from the National Institutes of Health (NIH). D. Schnadower receives funding from the NIH. C. A. Camargo has consulted for Bryn Pharma and Kaleo. J. Wang receives research support from the National Institute of Allergy and Infectious Diseases (NIAID), Aimmune, DBV Technologies, and Regeneron and consultancy fees from Aimmune, ALK Abello, DBV Technologies, and Genentech. K. A. Michelson receives funding from AHRQ. M. Shaker has been involved in research supported by DBV Technologies, is a member of the Joint Task Force on Practice Parameters, and serves as an editorial board member for the Journal of Allergy and Clinical Immunology: In Practice, Annals of Allergy, Asthma, and Immunology, and the Journal of Food Allergy. D. B. K. Golden has received financial support from Aquestive, Sandoz, ALK-Abelló, Genentech, Stallergenes Greer, Novartis, Allergy Therapeutics, and UpToDate. J. M. Spergel has grant support from DBV Technology, AImmune, and NIH and has consulted for Kaleo. R. L. Campbell has consulted for Bryn Pharma, been a peer reviewer for EB Medicine, and an author for UpToDate. M. I. Neuman is an author for UpToDate and serves as an editorial board member of Pediatrics. M. Pistiner has served on advisory boards of DBV Technologies, Kaleo, and Novartis; has received research funding from Kaleo, National Peanut Board, and Egg Nutrition Center; has received Program funding from DBV Technologies; and is cofounder of AllergyHome and Allergy Certified Training. M. Castells is the BWH PI for the PIONEER BluPrint clinical trial for Indolent Systemic Mastocytosis. D. C. Brousseau receives funding from the NIH and the Maternal & Child Health Bureau (MCHB). L. C. Schneider has received research support from Regeneron Pharmaceuticals, DBV Technologies, Pfizer, and Genentech; has consulted for Aimmune Therapeutics and DBV Technologies; and is on the Medical Advisory Board of FARE (Food Allergy Research and Education), scientific advisory boards for BioThea Pharmaceuticals, Inc, and Ukko, and DSMB for Alladapt Immunotherapeutics. A. H. Assa’ad has received research grants from NIH, Aimmune, DBV Technologies, Astellas, ABBVIE, and Sanofi. R. D. Mistry receives funding from the NIAID. D. E. Campbell reports grants from the National Health and Medical Research Council of Australia (paid to institution), funding for sponsor-led studies from Nestle Health Sciences (paid to institution), part-time salary from DBV Technologies, part-time salary from Sydney Children’s Hospitals Network, and consulting fees from AllerGenis and Westmead Fertility Centre. M. Worm has received fees for serving on advisory boards from Regeneron Pharmaceuticals, Aimmune, LEO Pharma, ALK, Eli Lilly, Abbvie, Mylan, Novartis Sanofi, and Pfizer and consulvuting fees from Aimmune, ALK, DBV, LEO Pharma, Mylan, Sanofi, and Novartis. P. J. Turner reports grants from the UK Medical Research Council, National Institute for Health Research (NIHR)/Imperial Biomedical Research Centre (BRC), UK Food Standards Agency, and JM Charitable Foundation and personal fees from UK Food Standards Agency, Aimmune Therapeutics, Allergenis, and ILSI Europe, outside the submitted work. H. A. Sampson receives funding to his institution for grants from the NIH/NIAID and has received consulting fees from DBV Technologies, S.A., N-Fold Therapeutic, LLC, and Siolta, Inc, and stock options from DBV Technologies and N-Fold Therapeutics. The rest of the authors declare that they have no relevant conflicts of interest. |
Vol 149 - N° 3
P. 999-1009 - mars 2022 Retour au numéro
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