Disease burden and unmet need for acute allergic reactions – A patient perspective
(2024) In World Allergy Organization Journal 17(4).- Abstract
Background: Acute allergic reactions (AARs) occur shortly after exposure to an allergen, and the severity is on a continuum. Systemic corticosteroids (CS) are mainstay treatment of moderate to severe AARs, whereas those at risk of the most severe AARs (ie, anaphylaxis) are also recommended prescription of epinephrine autoinjectors. There is limited research on the impact of AARs not fulfilling the criteria for anaphylaxis. We have characterized a sample with a history of moderate to severe AARs and evaluated their self-reported disease burden (ie, daily life impact, anxiety, and treatment impediments). Methods: Survey study of adults with experience of AARs treated with CS. Participants recruited from a web-based panel and using social... (More)
Background: Acute allergic reactions (AARs) occur shortly after exposure to an allergen, and the severity is on a continuum. Systemic corticosteroids (CS) are mainstay treatment of moderate to severe AARs, whereas those at risk of the most severe AARs (ie, anaphylaxis) are also recommended prescription of epinephrine autoinjectors. There is limited research on the impact of AARs not fulfilling the criteria for anaphylaxis. We have characterized a sample with a history of moderate to severe AARs and evaluated their self-reported disease burden (ie, daily life impact, anxiety, and treatment impediments). Methods: Survey study of adults with experience of AARs treated with CS. Participants recruited from a web-based panel and using social media were asked to complete a questionnaire related to their allergy and experience of AARs. The results were summarized for the whole sample and across subgroups with and without prescription of epinephrine. Results: The final study sample included 387 participants (80% women, mean age 41), of which 129 (33%) had at some point been prescribed epinephrine. The most common symptoms were respiratory (80%) and skin (78%) manifestations, and the mean (standard deviation, SD) self-rated severity score (scale from 0 [very mild] to 10 [very severe]) of the most recent AAR was 6.1 (2.0). More than 80% had experience of AARs interrupting daily activities and 50% of AARs that had limited work/studies or participation in leisure activities. Most of the respondents reported some degree of anxiety related to AARs and 43% had feared for their lives. Moreover, difficulties swallowing allergy medicine at an AAR was experienced by 26% and not having the medicine available when needed by 66%. Participants with prescription of epinephrine experienced more severe AARs than those without such prescription (mean [SD] severity 6.8 [2.1] vs 5.8 [1.8], p < 0.0001); however, also those without epinephrine prescription reported considerable anxiety and impact on daily life and to a similar degree as those with prescription. Conclusions: In this sample, subjects with experience of AARs treated with CS showed a considerable disease burden with anxiety and interruption on daily life, as well as problems related to access to, and swallowing of, medication. Although respondents with epinephrine prescription had more severe disease, a high disease burden was also evident among those without epinephrine. The study increases the knowledge of people with moderate to severe AARs, a patient population that has previously been underrepresented in the research literature.
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- author
- Andersson, Emelie ; Löfvendahl, Sofia ; Olofsson, Sara ; Wahlberg, Karin ; Bjermer, Leif LU ; Tornling, Göran ; Janson, Christer and Hjelmgren, Jonas
- organization
- publishing date
- 2024-04
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Acute allergic reactions, Allergy, Anaphylaxis, Corticosteroids, Disease burden
- in
- World Allergy Organization Journal
- volume
- 17
- issue
- 4
- article number
- 100896
- publisher
- BioMed Central (BMC)
- external identifiers
-
- pmid:38576826
- scopus:85189488951
- ISSN
- 1939-4551
- DOI
- 10.1016/j.waojou.2024.100896
- language
- English
- LU publication?
- yes
- id
- 92a30abe-5804-4800-8773-79efc64b42c7
- date added to LUP
- 2024-04-23 15:20:40
- date last changed
- 2024-11-20 13:25:00
@article{92a30abe-5804-4800-8773-79efc64b42c7,
abstract = {{<p>Background: Acute allergic reactions (AARs) occur shortly after exposure to an allergen, and the severity is on a continuum. Systemic corticosteroids (CS) are mainstay treatment of moderate to severe AARs, whereas those at risk of the most severe AARs (ie, anaphylaxis) are also recommended prescription of epinephrine autoinjectors. There is limited research on the impact of AARs not fulfilling the criteria for anaphylaxis. We have characterized a sample with a history of moderate to severe AARs and evaluated their self-reported disease burden (ie, daily life impact, anxiety, and treatment impediments). Methods: Survey study of adults with experience of AARs treated with CS. Participants recruited from a web-based panel and using social media were asked to complete a questionnaire related to their allergy and experience of AARs. The results were summarized for the whole sample and across subgroups with and without prescription of epinephrine. Results: The final study sample included 387 participants (80% women, mean age 41), of which 129 (33%) had at some point been prescribed epinephrine. The most common symptoms were respiratory (80%) and skin (78%) manifestations, and the mean (standard deviation, SD) self-rated severity score (scale from 0 [very mild] to 10 [very severe]) of the most recent AAR was 6.1 (2.0). More than 80% had experience of AARs interrupting daily activities and 50% of AARs that had limited work/studies or participation in leisure activities. Most of the respondents reported some degree of anxiety related to AARs and 43% had feared for their lives. Moreover, difficulties swallowing allergy medicine at an AAR was experienced by 26% and not having the medicine available when needed by 66%. Participants with prescription of epinephrine experienced more severe AARs than those without such prescription (mean [SD] severity 6.8 [2.1] vs 5.8 [1.8], p < 0.0001); however, also those without epinephrine prescription reported considerable anxiety and impact on daily life and to a similar degree as those with prescription. Conclusions: In this sample, subjects with experience of AARs treated with CS showed a considerable disease burden with anxiety and interruption on daily life, as well as problems related to access to, and swallowing of, medication. Although respondents with epinephrine prescription had more severe disease, a high disease burden was also evident among those without epinephrine. The study increases the knowledge of people with moderate to severe AARs, a patient population that has previously been underrepresented in the research literature.</p>}},
author = {{Andersson, Emelie and Löfvendahl, Sofia and Olofsson, Sara and Wahlberg, Karin and Bjermer, Leif and Tornling, Göran and Janson, Christer and Hjelmgren, Jonas}},
issn = {{1939-4551}},
keywords = {{Acute allergic reactions; Allergy; Anaphylaxis; Corticosteroids; Disease burden}},
language = {{eng}},
number = {{4}},
publisher = {{BioMed Central (BMC)}},
series = {{World Allergy Organization Journal}},
title = {{Disease burden and unmet need for acute allergic reactions – A patient perspective}},
url = {{http://dx.doi.org/10.1016/j.waojou.2024.100896}},
doi = {{10.1016/j.waojou.2024.100896}},
volume = {{17}},
year = {{2024}},
}