Stinging insect hypersensitivity: A practice parameter update 2011 - 11/08/11

Doi : 10.1016/j.jaci.2011.01.025

David B.K. Golden, MD : Chief Editor, John Moffitt, MD : Chief Editor, Richard A. Nicklas, MD : Chief Editor, Theodore Freeman, MD : Workgroup Contributor, David F. Graft, MD : Workgroup Contributor, Robert E. Reisman, MD : Workgroup Contributor, James M. Tracy, DO : Workgroup Contributor, David Bernstein, MD : Task Force Reviewer, Joann Blessing-Moore, MD : Task Force Reviewer, Linda Cox, MD : Task Force Reviewer, David A. Khan, MD : Task Force Reviewer, David M. Lang, MD : Task Force Reviewer, John Oppenheimer, MD : Task Force Reviewer, Jay M. Portnoy, MD : Task Force Reviewer, Christopher Randolph, MD : Task Force Reviewer, Diane E. Schuller, MD : Task Force Reviewer, Sheldon L. Spector, MD : Task Force Reviewer, Steven A. Tilles, MD : Task Force Reviewer, Dana Wallace, MD : Task Force Reviewer

Abstract

These parameters were developed by the Joint Task Force on Practice Parameters, representing the American Academy of Allergy, Asthma & Immunology (AAAAI); the American College of Allergy, Asthma & Immunology (ACAAI); and the Joint Council of Allergy, Asthma and Immunology.

The AAAAI and the ACAAI have jointly accepted responsibility for establishing “Stinging insect hypersensitivity: a practice parameter update II.” Because this document incorporated the efforts of many participants, no single individual, including those who served on the Joint Task Force, is authorized to provide an official AAAAI or ACAAI interpretation of these practice parameters. Any request for information about or an interpretation of these practice parameters by the AAAAI or the ACAAI should be directed to the Executive Offices of the AAAAI, the ACAAI, and the Joint Council of Allergy, Asthma and Immunology. This is a complete and comprehensive document at the current time. The medical environment is a changing environment, and not all recommendations will be appropriate for all patients. These parameters are not designed for use by pharmaceutical companies in drug promotion. The Joint Task Force understands that the cost of diagnostic tests and therapeutic agents is an important concern that may appropriately influence the work-up and treatment chosen for a given patient. The Joint Task Force recognizes that the emphasis of our primary recommendations regarding a medication may vary, for example, depending on third party payer issues and product patent expiration dates. However, since a given test or agent’s cost is so widely variable, and there is a paucity of pharmacoeconomic data, the Joint Task Force generally does not consider cost when formulating Practice Parameter recommendations. In extraordinary circumstances, when the cost benefit of an intervention is prohibitive as supported by pharmacoeconomic data, commentary may be provided.

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Key words : Insect hypersensitivity, anaphylaxis

Abbreviations used : AAAAI, ACAAI, VIT

Disclosure of potential conflict of interest: D. B. K. Golden is on the speakers’ bureau for ALK-Abelló and Novartis-Genentech. R. A. Nicklas is Committee Chair for the American College of Allergy, Asthma & Immunology (ACAAI). T. Freeman is a member of the Texas Medicare Contracted Managed Care Advisory Board, has reviewed various legal cases for the Texas Medical Board, and is a speaker for the ACAAI and the Texas AAI Society. D. F. Graft is a speaker for Teva and Merck, is an author of Up To Date, and is Chair of the ACAAI Insect Hypersensitivity Committee. J. M. Tracy has received research support from Novartis. J. Blessing-Moore is on the speakers’ bureau for Merck, Schering-Plough, Meda, AstraZeneca, and Novartis; has received research support from Meda and Novartis; and is a member of the American Thoracic Society, the American College of Asthma and Allergy, and the American College of Chest Physicians. L. Cox is a consultant for Genentech/Novartis, Hollister-Stier, and Stallergenes; has provided expert testimony on drug-related anaphylaxis treatment; and is on the Board of Directors for the ACAAI, BMCA, and FMA. D. A. Kahn is a speaker for AstraZeneca and Merck, has received research support from the Vanberg Family Foundation and Sellars Family Foundation, is Conjoint Board Review Chair for the ACAAI, and is a TAAIS past-president. D. M. Lang has received honoraria from or served as a consultant for GlaxoSmithKline, Sanofi-Aventis, Merck, AstraZeneca, Genentech/Novartis, and MedImmune; has received research support from Genentech/Novartis and GlaxoSmithKline; and is on the ACAAI Committee. J. Oppenheimer has received research support from AstraZeneca, Merck, and Genentech/Novartis and provided expert witness testimony in malpractice defense. S. L. Spector is a consultant for AstraZeneca, Merck/Schering, and Genentech; is on the Advisory Board for Novartis, Merck/Schering, and Genentech; is a speaker for AstraZeneca, Merck/Schering, and Genentech; has received honoraria from AstraZeneca, Merck/Schering, Sepracor, and Genentech; and has received research support from AstraZeneca, Amgen, Boehringer Ingelheim, GlaxoSmithKline, Novartis, Merck/Schering, Sepracor, Alcon, Genentech, and Pharmaxis. S. A. Tilles is a speaker for Alcon and Ista Pharmaceuticals; is on the Advisory Board for ALK-Abelló, Merck, and Stallergenes; has received research support from Alcon, Amgen, Amphestar, Astellos, Boehringer Ingelheim, Ception, Genentech, Icagen, MAP Pharma, Meda, Merck, Novartis, Roxane, and Sepracor; is Associate Editor of Allergy Watch and Annals of Allergy, Asthma and Immunology; and is a task force member for the Joint Task Force for Practice Parameters. D. Wallace is a speaker and advisor for Alcon, is a speaker for Merck and Sanofi-Aventis, and is President-Elect of ACAAI. The rest of the authors have declared that they have no conflict of interest.

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