1
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Tanno LK, Caminati M, Pouessel G, Senna G, Demoly P. Epidemiology of anaphylaxis: is the trend still going up? Curr Opin Allergy Clin Immunol 2023; 23:349-356. [PMID: 37548324 DOI: 10.1097/aci.0000000000000933] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
PURPOSE OF REVIEW To understand the current global scale of anaphylaxis and identify possible strategies to increase the accuracy of epidemiological data. RECENT FINDINGS Anaphylaxis mortality and morbidity statistics may gain new perspectives with the global implementation of the ICD-11. Improving the quality of epidemiological data related to anaphylaxis should clarify some areas of uncertainty about risk factors, leading to better targeting of strategies to protect those patients at risk, and support decision-making to facilitate health care planning and implementation of public health measures to prevent anaphylaxis. SUMMARY The true rate of anaphylaxis is unknown due to a number of factors, such as misdiagnosis, miscoding and undernotification. Moreover, there is lack of information about anaphylaxis epidemiology in many countries. Difficulties on collecting accurate and comparable data should be acknowledged and anaphylaxis data can vary widely. Currently, most robust data are derived from hospitalization datasets and national mortality databases. Anaphylaxis accounts for up to 0.26% of overall hospital admissions. It is suggested that the number of hospital admissions for anaphylaxis is increasing in many countries, both with respect to all-causes of anaphylaxis and by trigger, but the mortality rate remains low. However, there are still great challenges in capturing quality anaphylaxis mortality and morbidity statistics. Better understanding of anaphylaxis trends should clarify some areas of uncertainty about risk factors and prospect effective prevention strategies. As the knowledge derived from populations is key information for more realistic decision-making, the construction of the new section addressed to anaphylaxis in the ICD-11 will allow the collection of more accurate epidemiological data to support high quality management of patients, and to better facilitate health care planning to implement public health measures, reduce the morbidity and mortality attributable to anaphylaxis.
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Affiliation(s)
- Luciana Kase Tanno
- Division of Allergy, Department of Pulmonology, Allergy and Thoracic Oncology, University Hospital of Montpellier, Montpellier
- Desbrest Institute of Epidemiology and Public Health, UMR UA11 University of Montpellier - INSERM
- WHO Collaborating Centre on Scientific Classification Support, Montpellier, France
| | - Marco Caminati
- Asthma Center and Allergy Unit, University of Verona, Verona, Italy
| | - Guillaume Pouessel
- Department of Paediatrics, CH Roubaix
- Paediatric Pneumology and Allergology Unit, CHRU Lille, France
| | - Gianenrico Senna
- Asthma Center and Allergy Unit, University of Verona, Verona, Italy
- Department of Medicine, University of Verona, Verona, Italy
| | - Pascal Demoly
- Division of Allergy, Department of Pulmonology, Allergy and Thoracic Oncology, University Hospital of Montpellier, Montpellier
- Desbrest Institute of Epidemiology and Public Health, UMR UA11 University of Montpellier - INSERM
- WHO Collaborating Centre on Scientific Classification Support, Montpellier, France
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2
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De Moor R, Koroki Y, Wu DBC, Yu DY, Tohyama M, Ohyama C. A retrospective study on the incidence, management and risk factors of skin rash in patients with advanced prostate cancer in Japan. BMC Urol 2023; 23:73. [PMID: 37118710 PMCID: PMC10148545 DOI: 10.1186/s12894-023-01246-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 04/13/2023] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND Worldwide, prostate cancer (PC) is the second most diagnosed cancer and the fifth leading cause of cancer death in men. Hormonal therapies, commonly used for PC, are associated with a range of treatment-emergent adverse events (TEAEs). The population from Japan seems to be at higher risk of developing TEAEs of skin rash compared to the overall global population. This study was conducted to get a better insight into the incidence, management, and risk factors for skin rash during active treatment for advanced PC in Japan. METHODS A retrospective cohort of PC patients was identified and subsequently categorized, into non-metastatic and metastatic castration-resistant prostate cancer patients (nmCRPC and mCRPC), and metastatic castration-naïve prostate cancer patients (mCNPC). The analysis was based on a dataset from the Medical Data Vision (MDV) database. Descriptive statistics were determined, and a multivariate Cox proportional hazards model was used to the associated risk factors for the onset of rash. RESULTS Overall, 1,738 nmCRPC patients, 630 mCRPC patients, and 454 mCNPC patients were included in this analysis. The median age was 78 years old and similar across the three cohorts. The skin rash incidence was 19.97% for nmCRPC cohort, 28.89% for mCRPC cohort, and 28.85% for mCNPC cohort. The median duration of skin rash ranged from 29 to 42 days. Statistically significant risk factors for developing skin rash included a history of allergy or hypersensitivity (all cohorts), increased age (nmCRPC and mCRPC), a body mass index (BMI) of < 18.5 (nmCRPC and mCRPC), and a PSA level higher than the median (nmCRPC). Skin rash was commonly managed with systemic and topical corticosteroids which ranged from 41.76% to 67.03% for all cohorts. Antihistamines were infrequently used. CONCLUSION This study provides a better understanding of the real-world incidence, onset, duration, management and risk factors of skin rash in patients on active PC treatment in Japan. It was observed that approximately 20-30% of PC patients experience skin rash. Development of skin rash was associated with previous allergy or hypersensitivity, BMI of < 18.5, increased age and higher PSA levels, and was usually treated with corticosteroids.
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Affiliation(s)
- Raf De Moor
- Integrated Market Access, Janssen Pharmaceutical K.K., 3 Chome-5-2 Nishikanda, Tokyo, 101-0065, Japan.
| | - Yosuke Koroki
- Medical Affairs, Janssen Pharmaceutical K.K., Tokyo, Japan
| | - David Bin-Chia Wu
- Janssen Pharmaceutical Companies of Johnson and Johnson, Asia Pacific Regional Office, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- School of Pharmacy, Monash University Malaysia, Bandar Suwnay, Malaysia
| | - Dae Young Yu
- Janssen Pharmaceutical Companies of Johnson and Johnson, Asia Pacific Regional Office, Singapore, Singapore
| | - Mikiko Tohyama
- Department of Dermatology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Chikara Ohyama
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
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3
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Tanno LK, Demoly P. Food allergy in the World Health Organization's International Classification of Diseases (ICD)-11. Pediatr Allergy Immunol 2022; 33:e13882. [PMID: 36433855 PMCID: PMC9828038 DOI: 10.1111/pai.13882] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 10/25/2022] [Accepted: 10/28/2022] [Indexed: 11/17/2022]
Abstract
There are increasing global data regarding the prevalence of food allergy and food-induced anaphylaxis. However, knowledge in morbidity and mortality epidemiological data is still not optimal, and international comparable standards remain poorly accessed. This information could in turn support better clinical practice and possibly prevent future severe reactions and avoidable fatalities. The International Classification of Diseases (ICD) is the standard diagnostic tool used for epidemiology, health management, and clinical purposes supported by the World Health Organization (WHO). It is also used to determine health care payment and reimbursement of providers and health care services in hospitals. Thanks to the academic and technical efforts under the ALLERGY in ICD-11 initiative the pioneer "Allergy and hypersensitivity conditions" section has been built under the "Disorders of the Immune System" chapter of the ICD-11. The "Food hypersensitivity" (FH) subsection is classified under the "Complex allergic or hypersensitivity conditions" section and "Food-induced anaphylaxis" is under the "Anaphylaxis" section. In order to inform the development of strategies to reduce preventable FHs/food allergies, the burden of disease in different healthcare settings and patient populations and their common etiologies need to be understood. Besides, greater specificity regarding clinical conditions and services delivered will provide payers, policy makers, and providers with better information to make major refinements to countries payment and reimbursement systems, including the design and implementation of pay-for-performance program.The new classification addressed to FHs will enable the collection of more accurate epidemiological data to support quality management of patients with FHs/food allergies, and better facilitate health care planning and decision-making and public health measures to prevent and reduce their morbidity and mortality. The improved logic and standardized definitions through the ICD-11 (and other WHO classifications) will also facilitate international comparisons of quality care and the sharing of best practice globally.
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Affiliation(s)
- Luciana Kase Tanno
- Division of Allergy, Department of Pneumology, Allergology and Oncology, University Hospital of Montpellier, Montpellier, France.,Institut Desbrest d'Epidémiologie et de Santé Publique, UMR UA-11, University of Montpellier - INSERM, Montpellier, France.,WHO Collaborating Centre on Scientific Classification Support, Montpellier, France
| | - Pascal Demoly
- Division of Allergy, Department of Pneumology, Allergology and Oncology, University Hospital of Montpellier, Montpellier, France.,Institut Desbrest d'Epidémiologie et de Santé Publique, UMR UA-11, University of Montpellier - INSERM, Montpellier, France.,WHO Collaborating Centre on Scientific Classification Support, Montpellier, France
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4
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Abstract
PURPOSE OF REVIEW To understand the current global epidemiological data of anaphylaxis and identify potential strategies to improve patients' care and prevention. RECENT FINDINGS Anaphylaxis mortality and morbidity statistics (MMS) may gain new perspectives with the implementation of the International Classification of Diseases (ICD)-11 in the forthcoming years. Improving the quality of epidemiological data related to anaphylaxis should clarify some areas of uncertainty about risk factors, leading to better targeting of strategies to protect those patients at risk, and support decision-making to facilitate healthcare planning and implementation of public health measures to prevent anaphylaxis. SUMMARY Anaphylaxis is a complex noncommunicable diseases with adverse impact on health-related quality of life of patients and their carriers and a significant proportion of deaths may be preventable. It requires an integrated holistic plan to improve quality of healthcare and gathering accurate and comparable epidemiological data is key. Morbidity related to anaphylaxis seems to be increasing worldwide whereas mortality of anaphylaxis appears to be low and stable, but this still has great challenges in capturing quality anaphylaxis MMS. Improving the quality of epidemiological data related to anaphylaxis should clarify some areas of uncertainty about risk factors, leading to better targeting of strategies to protect those patients at risk. As knowledge derived from populations is key information for more realistic decision-making, the construction of the new section addressed to anaphylaxis in the ICD-11 will allow the collection of more accurate epidemiological data to support quality management of patients, and better facilitate healthcare planning to implement public health measures to prevent and reduce the morbidity and mortality attributable to these conditions.
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Affiliation(s)
- Luciana Kase Tanno
- Hospital Sírio Libanês, São Paulo, Brazil
- University Hospital of Montpellier, Montpellier, and Desbret Institute of Epidemiology and Public Health, University of Montpellier, Montpellier, France
- WHO Collaborating Center for Classification Scientific Support, Paris, France
| | - Pascal Demoly
- University Hospital of Montpellier, Montpellier, and Desbret Institute of Epidemiology and Public Health, University of Montpellier, Montpellier, France
- WHO Collaborating Center for Classification Scientific Support, Paris, France
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5
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Tanno LK, Chalmers R, Jacob R, Kostanjsek N, Bierrenbach AL, Martin B, Molinari N, Annesi‐Maesano I, Papadopoulos NG, Sanchez‐Borges M, Rosenwasser LJ, Ansontegui I, Ebisawa M, Sisul JC, Jares E, Gomez M, Agache I, Muraro A, Wong GWK, Thien F, Pawankar R, Mahr TA, Sublett JL, Lang DM, Casale T, Demoly P. Global implementation of the world health organization's International Classification of Diseases (ICD)-11: The allergic and hypersensitivity conditions model. Allergy 2020; 75:2206-2218. [PMID: 32578235 DOI: 10.1111/all.14468] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 06/03/2020] [Accepted: 06/08/2020] [Indexed: 12/21/2022]
Abstract
The International Classification of Diseases (ICD) provides a common language for use worldwide as a diagnostic and classification tool for epidemiology, clinical purposes and health management. Since its first edition, the ICD has maintained a framework distributing conditions according to topography, with the result that some complex conditions, such as allergies and hypersensitivity disorders (A/H) including anaphylaxis, have been poorly represented. The change in hierarchy in ICD-11 permitted the construction of the pioneer section addressed to A/H, which may result in more accurate mortality and morbidity statistics, including more accurate accounting for mortality due to anaphylaxis, strengthen classification, terminology and definitions. The ICD-11 was presented and adopted by the 72nd World Health Assembly in May 2019, and the implementation is ongoing worldwide. We here present the outcomes from an online survey undertaken to reach out the allergy community worldwide in order to peer review the terminology, classification and definitions of A/H introduced into ICD-11 and to support their global implementation. Data are presented here for 406 respondents from 74 countries. All of the subsections of the new A/H section of the ICD-11 had been considered with good accuracy by the majority of respondents. We believe that, in addition to help during the implementation phase, all the comments provided will help to improve the A/H classification and to increase awareness by different disciplines of what actions are needed to ensure more accurate epidemiological data and better clinical management of A/H patients.
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Affiliation(s)
- Luciana Kase Tanno
- Hospital Sírio‐Libanês São Paulo Brazil
- University Hospital of Montpellier Montpellier France
- INSERM UMR‐S 1136 IPLESP Equipe EPAR Sorbonne Université Paris France
- WHO Collaborating Centre on Scientific Classification Support Montpellier France
- ICD‐11 Medical and Scientific Advisory Committee WHO Geneva Switzerland
| | - Robert Chalmers
- ICD‐11 Medical and Scientific Advisory Committee WHO Geneva Switzerland
- Centre for Dermatology University of Manchester Manchester UK
| | - Robert Jacob
- Classifications, Terminologies and Standards World Health Organization Geneva Switzerland
| | - Nenad Kostanjsek
- Classifications, Terminologies and Standards World Health Organization Geneva Switzerland
| | - Ana Luiza Bierrenbach
- Hospital Sírio‐Libanês São Paulo Brazil
- Sanas Epidemiology and Research São Paulo Brazil
- Teaching Research Institute (IEP) Hospital Sírio Libanês São Paulo Brazil
| | - Bryan Martin
- Medicine and Pediatrics The Ohio State University in Columbus Columbus OH USA
| | | | | | - Nikolaos G. Papadopoulos
- Centre for Paediatrics and Child Health Institute of Human Development University of Manchester Manchester UK
- Department of Allergy 2nd Pediatric Clinic University of Athens Athens Greece
| | - Mario Sanchez‐Borges
- Allergy and Clinical Immunology Department Centro Medico Docente La Trinidad Caracas Venezuela
| | - Lanny J. Rosenwasser
- Division of Immunology Research Department of Pediatrics Children's Mercy Hospitals & Clinics Kansas City MO USA
| | - Ignacio Ansontegui
- Department of Allergy and Immunology Hospital Quirónsalud Bizkaia Erandio Bilbao Spain
| | - Motohiro Ebisawa
- Clinical Research Center for Allergy and Rheumatology Sagamihara National Hospital Sagamihara Japan
| | - Juan Carlos Sisul
- Latinalerican Society of Allergy, Asthma and Immunology Villarica Paraguay
- American College of Allergy, Asthma and Immunology Arlington Heights IL USA
| | - Edgardo Jares
- LIBRA Foundation and CMP SA Buenos Aires Buenos Aires Argentina
| | - Maximiliano Gomez
- Research & Education Fundación Ayre Allergy & Asthma Unit Hospital San Bernardo Catholic University of Salta Salta Argentina
| | | | - Antonella Muraro
- Department of Women and Child Health Food Allergy Referral Centre Veneto Region Padua General University Hospital Padua Italy
| | - Gary W. K. Wong
- Department of Pediatrics Chinese University of Hong Kong Hong Kong China
| | - Francis Thien
- Faculty of Medicine, Nursing and Health Sciences Monash University Clayton Vic Australia
- Department of Respiratory Medicine Eastern Health Box Hill Vic. Australia
| | - Ruby Pawankar
- Department of Pediatrics Nippon Medical School Tokyo Japan
| | - Todd A. Mahr
- Pediatric Allergy and Clinical Immunology Gundersen Health System in La Crosse La Crosse WI USA
| | - James L. Sublett
- Family Allergy & Asthma Louisville KY USA
- Department of Pediatrics Section of Allergy & Immunology University of Louisville School of Medicine Louisville KY USA
| | - David M. Lang
- Department of Allergy and Clinical Immunology Respiratory Institute Cleveland Clinic OH USA
| | - Thomas Casale
- Morsani College of Medicine University of South Florida Tampa FL USA
| | - Pascal Demoly
- University Hospital of Montpellier Montpellier France
- INSERM UMR‐S 1136 IPLESP Equipe EPAR Sorbonne Université Paris France
- WHO Collaborating Centre on Scientific Classification Support Montpellier France
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6
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Tanno LK, Simons FER, Sanchez-Borges M, Cardona V, Moon HB, Calderon MA, Sisul JC, Muraro A, Casale T, Demoly P. Applying prevention concepts to anaphylaxis: A call for worldwide availability of adrenaline auto-injectors. Clin Exp Allergy 2019; 47:1108-1114. [PMID: 28856836 DOI: 10.1111/cea.12973] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- L K Tanno
- Hospital Sírio Libanês, São Paulo, Brazil.,University Hospital of Montpellier, Montpellier, France.,Sorbonne Universités, UPMC Paris 06, UMR-S 1136, IPLESP, Equipe EPAR, Paris, France
| | - F E R Simons
- Section of Allergy & Clinical Immunology, Department of Pediatrics & Child Health, University of Manitoba, Winnipeg, Canada
| | - M Sanchez-Borges
- Allergy and Clinical Immunology Department, Centro Medico Docente La Trinidad, Caracas, Venezuela
| | - V Cardona
- Allergy Section, Department of Internal Medicine, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - H-B Moon
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan, Seoul, Korea
| | - M A Calderon
- Section of Allergy and Clinical Immunology, Imperial College London, National Heart and Lung Institute, Royal Brompton Hospital, London, UK
| | - J C Sisul
- Latinalerican Society of Allergy, Asthma and Immunology, Villarica, Paraguay.,American College of Allergy, Asthma and Immunology, Villarica, Paraguay
| | - A Muraro
- European Academy of Allergy and Clinical Immunology, Padua, Italy.,Department of Women and Child Health, Food Allergy Referral Centre Veneto Region, Padua General University Hospital, Padua, Italy
| | - T Casale
- American Academy of Allergy Asthma and Immunology, Tampa, FL, USA.,Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - P Demoly
- University Hospital of Montpellier, Montpellier, France.,Sorbonne Universités, UPMC Paris 06, UMR-S 1136, IPLESP, Equipe EPAR, Paris, France
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7
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Tanno LK, Chalmers R, Bierrenbach AL, Simons FER, Martin B, Molinari N, Annesi-Maesano I, Worm M, Cardona V, Papadopoulos NG, Sanchez-Borges M, Rosenwasser LJ, Ansontegui I, Ebisawa M, Sisul JC, Jares E, Gomez M, Agache I, Hellings P, Muraro A, Thien F, Pawankar R, Sublett JL, Casale T, Demoly P. Changing the history of anaphylaxis mortality statistics through the World Health Organization's International Classification of Diseases-11. J Allergy Clin Immunol 2019; 144:627-633. [PMID: 31229269 DOI: 10.1016/j.jaci.2019.05.013] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 04/14/2019] [Accepted: 05/03/2019] [Indexed: 02/06/2023]
Abstract
We review the history of the classification and coding changes for anaphylaxis and provide current and perspective information in the field. In 2012, an analysis of Brazilian data demonstrated undernotification of anaphylaxis-related deaths because of the difficulties of coding using the International Classification of Diseases, 10th Revision. This work triggered strategic international actions supported by the Joint Allergy Academies and the International Classification of Diseases World Health Organization (WHO) leadership to update the classification of allergic disorders for the International Classification of Diseases, 11th Revision (ICD-11), which resulted in construction of the pioneer "Allergic and hypersensitivity conditions" chapter. The usability of the new framework has been tested by evaluating the same data published in 2012 from the ICD-11 perspective. Coding accuracy was much improved, reaching 95% for definite anaphylaxis. As the results were provided to the WHO Mortality Reference Group, coding rules have been changed, allowing anaphylaxis to be recorded as an underlying cause of death in official mortality statistics. The mandatory use of ICD-11 from January 2022 for documenting cause of death could have 2 immediate consequences: (1) the reported number of anaphylaxis-related deaths might increase because of more appropriate coding and (2) the cross-sectional and longitudinal mortality data generated might ultimately lead to a better understanding of anaphylaxis epidemiology and improved health policies directed at reducing anaphylaxis-related mortality.
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Affiliation(s)
- Luciana Kase Tanno
- Hospital Sírio-Libanês, São Paulo, Brazil; University Hospital Montpellier, Montpellier, France; Sorbonne Université, INSERM UMR-S 1136, Paris, France; World Health Organization Collaborating Centre on Scientific Classification Support, Montpellier, France; ICD-11 Medical and Scientific Advisory Committee, World Health Organization, Geneva, Switzerland.
| | - Robert Chalmers
- ICD-11 Medical and Scientific Advisory Committee, World Health Organization, Geneva, Switzerland; Centre for Dermatology, University of Manchester, Manchester, United Kingdom
| | - Ana Luiza Bierrenbach
- Hospital Sírio-Libanês, São Paulo, Brazil; Sanas Epidemiology and Research and the Teaching Research Institute (IEP), Hospital Sírio Libanês, São Paulo, Brazil
| | - F Estelle R Simons
- Section of Allergy and Clinical Immunology, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Bryan Martin
- Medicine and Pediatrics, Ohio State University, Columbus, Ohio
| | | | | | - Margitta Worm
- Division of Allergy and Immunology, Department of Dermatology and Allergy, Charité, Universitätsmedizin Berlin, Berlin, Germany
| | - Victoria Cardona
- Internal Medicine Department, Allergy Section, Hospital Vall d'Hebron, Barcelona, Spain
| | - Nikolaos G Papadopoulos
- Centre for Paediatrics and Child Health, Institute of Human Development, University of Manchester, Manchester, United Kingdom; Department of Allergy, 2nd Pediatric Clinic, University of Athens, Athens, Greece
| | - Mario Sanchez-Borges
- Allergy and Clinical Immunology Department, Centro Medico Docente La Trinidad, Caracas, Venezuela
| | - Lanny J Rosenwasser
- Department of Pediatrics, Division of Immunology Research, Children's Mercy Hospitals and Clinics, Kansas City, Mo
| | - Ignacio Ansontegui
- Department of Allergy and Immunology, Hospital Quirónsalud Bizkaia Erandio, Bilbao, Spain
| | - Motohiro Ebisawa
- Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Japan
| | - Juan Carlos Sisul
- Past President of the Latin-American Society of Allergy, Asthma and Immunology, Asunción, Paraguay
| | - Edgardo Jares
- LIBRA Foundation and CMP SA Buenos Aires, Buenos Aires, Argentina
| | - Maximiliano Gomez
- Research and Education, Fundación Ayre, Allergy and Asthma Unit, Hospital San Bernardo, Catholic University of Salta, Salta, Argentina
| | | | - Peter Hellings
- ENT Clinical Department, University Hospital Leuven, Leuven, Belgium; Laboratory of Clinical Immunology, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - Antonella Muraro
- Food Allergy Referral Centre Veneto Region, Department of Women and Child Health, Padua General University Hospital, Padua, Italy
| | - Francis Thien
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Australia; Department of Respiratory Medicine, Eastern Health, Boxhill, Australia
| | | | - James L Sublett
- Family Allergy & Asthma and the Section of Allergy and Immunology, Department of Pediatrics, University of Louisville School of Medicine, Louisville, Ky
| | - Thomas Casale
- Morsani College of Medicine, University of South Florida, Tampa, Fla
| | - Pascal Demoly
- University Hospital Montpellier, Montpellier, France; Sorbonne Université, INSERM UMR-S 1136, Paris, France
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8
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Are outcome measures in allergic diseases relevant for the WHO's International Classification of Diseases in allergology? Curr Opin Allergy Clin Immunol 2019; 19:198-203. [DOI: 10.1097/aci.0000000000000524] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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9
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Bechara R, Maillere B, Joseph D, Weaver RJ, Pallardy M. Identification and characterization of a naïve
CD
8+ T cell repertoire for benzylpenicillin. Clin Exp Allergy 2019; 49:636-643. [DOI: 10.1111/cea.13338] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 12/18/2018] [Accepted: 01/09/2019] [Indexed: 02/02/2023]
Affiliation(s)
- Rami Bechara
- Inflammation Chimiokines et Immunopathologie INSERM, Fac de pharmacie Univ.Paris‐Sud Université Paris‐Saclay Châtenay‐Malabry France
| | | | - Delphine Joseph
- BioCIS, Univ Paris‐Sud, CNRS Université Paris‐Saclay Châtenay‐Malabry France
| | | | - Marc Pallardy
- Inflammation Chimiokines et Immunopathologie INSERM, Fac de pharmacie Univ.Paris‐Sud Université Paris‐Saclay Châtenay‐Malabry France
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10
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11
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Adults and children with anaphylaxis in the emergency room: why it is not recognized? Curr Opin Allergy Clin Immunol 2018; 18:377-381. [DOI: 10.1097/aci.0000000000000469] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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12
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Tanno LK, Demoly P. How can the World Health Organization’s International Classification of Diseases (ICD)-11 change the clinical management of anaphylaxis? Expert Rev Clin Immunol 2018; 14:783-786. [DOI: 10.1080/1744666x.2018.1520094] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Luciana K Tanno
- Hospital Sírio Libanês, São Paulo, Brazil
- INSERM, IPLESP, University Hospital of Montpellier, Montpellier and Sorbonne Université, Paris, France
| | - Pascal Demoly
- INSERM, IPLESP, University Hospital of Montpellier, Montpellier and Sorbonne Université, Paris, France
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13
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Tanno LK, Torres MJ, Castells M, Demoly P. What can we learn in drug allergy management from World Health Organization's international classifications? Allergy 2018; 73:987-992. [PMID: 29105793 DOI: 10.1111/all.13335] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2017] [Indexed: 12/13/2022]
Abstract
Drug hypersensitivity reactions (DHRs) represent growing health problem worldwide, affecting more than 7% of the general population, and represent an important public health problem. However, knowledge in DHRs morbidity and mortality epidemiological data is still not optimal and international comparable standards remain poorly accessed. Institutional databases worldwide increasingly use the WHO International Classification of Diseases (ICD) system to classify diagnoses, health services utilization, and death data. The misclassification of disorders in the ICD system contributes to a lack of ascertainment and recognition of their importance for healthcare planning and resource allocation. It also hampers clinical practice and prevention actions. To further inform the allergy community and to ensure that the revision process is transparent as advised in the WHO ICD-11 revision agenda, we report the advances and use of the pioneering "Drug hypersensitivity" subsection of ICD-11 and implementation in the WHO International Classification of Health Interventions (ICHI). The new classification addressed to DHRs will enable the collection of more accurate epidemiological data to support quality management of patients with drug allergies and better facilitate healthcare planning and decision-making and public health measures to prevent and reduce the morbidity and mortality attributable to DHRs.
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Affiliation(s)
- L. K. Tanno
- Hospital Sírio Libanês; São Paulo Brazil
- University Hospital of Montpellier; Montpellier France
- UMR-S 1136, IPLESP, Equipe EPAR; Sorbonne Universités; UPMC Paris 06; Paris France
| | - M. J. Torres
- Allergy Unit; IBIMA-Regional University Hospital of Malaga, UMA; Malaga Spain
| | - M. Castells
- Division of Rheumatology, Immunology and Allergy; Department of Medicine; Brigham and Women's Hospital; Harvard Medical School; Boston MA USA
| | - P. Demoly
- University Hospital of Montpellier; Montpellier France
- UMR-S 1136, IPLESP, Equipe EPAR; Sorbonne Universités; UPMC Paris 06; Paris France
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Tanno LK, Bierrenbach AL, Simons FER, Cardona V, Thong BYH, Molinari N, Calderon MA, Worm M, Chang YS, Papadopoulos NG, Casale T, Demoly P. Critical view of anaphylaxis epidemiology: open questions and new perspectives. ALLERGY, ASTHMA, AND CLINICAL IMMUNOLOGY : OFFICIAL JOURNAL OF THE CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY 2018; 14:12. [PMID: 29632547 PMCID: PMC5883526 DOI: 10.1186/s13223-018-0234-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 02/01/2018] [Indexed: 11/18/2022]
Abstract
In contrast to the majority of allergic or hypersensitivity conditions, worldwide anaphylaxis epidemiological data remain sparse with low accuracy, which hampers comparable morbidity statistics. Data can differ widely depending on a number of variables. In the current document we reviewed the forms on which anaphylaxis has been defined and classified; and how it can affect epidemiological data. With regards to the methods used to capture morbidity statistics, we observed the impact of the anaphylaxis coding utilizing the World Health Organization's International Classification of Diseases. As an outcome and depending on the anaphylaxis definition, we extracted the cumulative incidence, which may not reflect the real number of new cases. The new ICD-11 anaphylaxis subsection developments and critical view of morbidity statistics data are discussed in order to reach new perspectives on anaphylaxis epidemiology.
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Affiliation(s)
- Luciana Kase Tanno
- Hospital Sírio Libanês, São Paulo, Brazil
- University Hospital of Montpellier, Montpellier, France
- Sorbonne Université, INSERM, IPLESP, 75013 Paris, France
- Division of Allergy, Department of Pulmonology, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, 371, av. du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France
| | - Ana Luiza Bierrenbach
- Sanas Epidemiology and Research, São Paulo, Brazil
- Teaching Research Institute (IEP), Hospital Sírio Libanês, São Paulo, Brazil
| | - F. Estelle R. Simons
- Section of Allergy & Clinical Immunology, Department of Pediatrics & Child Health, University of Manitoba, Winnipeg, Canada
| | - Victoria Cardona
- Allergy Section, Department of Internal Medicine, Hospital Universitari Vall d’Hebron, Barcelona, Spain
| | - Bernard Yu-Hor Thong
- Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore, Singapore
| | | | - Moises A. Calderon
- Section of Allergy and Clinical Immunology, Imperial College London, National Heart and Lung Institute, Royal Brompton Hospital, London, UK
| | - Margitta Worm
- Allergie-Centrum-Charité, Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany
| | - Yoon-Seok Chang
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Gyeonggi-do South Korea
| | - Nikolaos G. Papadopoulos
- Centre for Paediatrics and Child Health Institute of Human Development, University of Manchester, Manchester, UK
- Department of Allergy, 2nd Pediatric Clinic, University of Athens, Athens, Greece
| | - Thomas Casale
- American Academy of Allergy Asthma and Immunology, and Morsani College of Medicine, University of South Florida, Tampa, FL USA
| | - Pascal Demoly
- University Hospital of Montpellier, Montpellier, France
- Sorbonne Université, INSERM, IPLESP, 75013 Paris, France
| | - on behalf the Joint Allergy Academies
- Hospital Sírio Libanês, São Paulo, Brazil
- University Hospital of Montpellier, Montpellier, France
- Sorbonne Université, INSERM, IPLESP, 75013 Paris, France
- Sanas Epidemiology and Research, São Paulo, Brazil
- Teaching Research Institute (IEP), Hospital Sírio Libanês, São Paulo, Brazil
- Section of Allergy & Clinical Immunology, Department of Pediatrics & Child Health, University of Manitoba, Winnipeg, Canada
- Allergy Section, Department of Internal Medicine, Hospital Universitari Vall d’Hebron, Barcelona, Spain
- Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore, Singapore
- IMAG, UMR 5149, DIM CHRU de Montpellier, Montpellier, France
- Section of Allergy and Clinical Immunology, Imperial College London, National Heart and Lung Institute, Royal Brompton Hospital, London, UK
- Allergie-Centrum-Charité, Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Gyeonggi-do South Korea
- Centre for Paediatrics and Child Health Institute of Human Development, University of Manchester, Manchester, UK
- Department of Allergy, 2nd Pediatric Clinic, University of Athens, Athens, Greece
- American Academy of Allergy Asthma and Immunology, and Morsani College of Medicine, University of South Florida, Tampa, FL USA
- Division of Allergy, Department of Pulmonology, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, 371, av. du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France
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Lessons of Drug Allergy Management Through the World Health Organization’s International Classification of Diseases (ICD)-11. CURRENT TREATMENT OPTIONS IN ALLERGY 2018. [DOI: 10.1007/s40521-018-0157-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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One voice for anaphylaxis in France: The vision of the centre of reference in rare diseases. REVUE FRANCAISE D ALLERGOLOGIE 2017. [DOI: 10.1016/j.reval.2017.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Tanno L, Demoly P. Anaphylaxis in France: Rate, characteristics and unmet needs. REVUE FRANCAISE D ALLERGOLOGIE 2017. [DOI: 10.1016/j.reval.2017.02.242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Tanno LK, Haahtela T, Calderon MA, Cruz A, Demoly P. Implementation gaps for asthma prevention and control. Respir Med 2017; 130:13-19. [PMID: 29206628 DOI: 10.1016/j.rmed.2017.07.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 06/29/2017] [Accepted: 07/07/2017] [Indexed: 12/22/2022]
Abstract
Asthma and allergic diseases can start in childhood and persist throughout life, but could also be manifested later, at any time for still misunderstood reasons. They are major chronic multifactorial respiratory diseases, for which prevention, early diagnosis and treatment is recognized as a priority for the Europe's public health policy and the United Nations. Given that allergy triggers (including infections, rapid urbanization leading to loss in biodiversity, pollution and climate changes) are not expected to change in a foreseeable future, it is imperative that steps are taken to develop, strengthen and optimize preventive and treatment strategies. Currently there are good treatments for asthma, several risk factors are known (e.g., allergies, rhinitis, tobacco smoke) and tools to control the disease have been developed. However, we are still uncertain how to prevent patients from developing asthma and allergic diseases. In this paper, we list the positive and negative experiences in this field as well as analyze the missing links in the process. This critical analysis will be the basis of setting-up an effective program for prevention and making, a process labeled as "implementation gaps".
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Affiliation(s)
- Luciana K Tanno
- Hospital Sírio Libanês, São Paulo, Brazil; Division of Allergy, Department of Pulmonology, University Hospital of Montpellier, Montpellier, and Pierre Louis Institute of Epidemiology and Public Health, Sorbonne Universités, Paris, France.
| | - Tari Haahtela
- Skin and Allergy Hospital, Helsinki University Central Hospital, FI-00029 Helsinki, Finland
| | - Moises A Calderon
- Section of Allergy and Clinical Immunology, Imperial College London, National Heart and Lung Institute, Royal Brompton Hospital, London, United Kingdom
| | - Alvaro Cruz
- ProAR-Núcleo de Excelência em Asma da Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Pascal Demoly
- Division of Allergy, Department of Pulmonology, University Hospital of Montpellier, Montpellier, and Pierre Louis Institute of Epidemiology and Public Health, Sorbonne Universités, Paris, France
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Pallardy M, Bechara R. Chemical or Drug Hypersensitivity: Is the Immune System Clearing the Danger? Toxicol Sci 2017; 158:14-22. [DOI: 10.1093/toxsci/kfx084] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
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Tanno LK, Molinari N, Bruel S, Bourrain JL, Calderon MA, Aubas P, Demoly P. Field-testing the new anaphylaxis' classification for the WHO International Classification of Diseases-11 revision. Allergy 2017; 72:820-826. [PMID: 27874204 DOI: 10.1111/all.13093] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2016] [Indexed: 12/30/2022]
Abstract
BACKGROUND To consolidate the new classification model addressed to the allergic and hypersensitivity conditions according to the International Classification of Diseases (ICD)-11 revision timeline, we here propose real-life application of quality assurance methodology to evaluate sensitivity and accuracy of the 'Anaphylaxis' subsection. METHODS We applied field-testing methodology by analysing all the consecutive inpatients' files documented as allergies from the University Hospital of Montpellier electronic database for the period of 1 year. The files clinically validated as being anaphylaxis were manually blind-coded under ICD-10 and current ICD-11 beta draft. The correspondence of coding and the impressions regarding sensibility were evaluated. RESULTS From all 2318 files related to allergic or hypersensitivity conditions, 673 had some of the anaphylaxis ICD-10 codes; 309 files (46%) from 209 patients had anaphylaxis and allergic or hypersensitivity comorbidities description. The correspondence between the two coders was perfect for 162 codes from all 309 entities (52.4%) (Cohen-kappa value 0.63) with the ICD-10 and for 221 codes (71.5%) (Cohen-kappa value 0.77) with the ICD-11. There was a high agreement regarding sensibility of the ICD-11 usability (Cohen-kappa value 0.75). CONCLUSION We here propose the first attempt of real-life application to validate the new ICD-11 'Anaphylaxis' subsection. Clearer was the improvement in accuracy reaching 71.5% of agreement when ICD-11 was used. By allowing all the relevant diagnostic terms for anaphylaxis to be included into the ICD-11 framework, WHO has recognized their importance not only to clinicians but also to epidemiologists, statisticians, healthcare planners and other stakeholders.
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Affiliation(s)
- L. K. Tanno
- Hospital Sírio Libanês; São Paulo Brazil
- University Hospital of Montpellier; Montpellier France
- UPMC Paris 06; UMR-S 1136; IPLESP; Equipe EPAR; Sorbonne Universités; Paris France
| | - N. Molinari
- IMAG UMR 5149; DIM CHRU de Montpellier; Montpellier France
| | - S. Bruel
- University Hospital of Montpellier; Montpellier France
| | | | - M. A. Calderon
- Section of Allergy and Clinical Immunology; Imperial College London; National Heart and Lung Institute; Royal Brompton Hospital; London UK
| | - P. Aubas
- University Hospital of Montpellier; Montpellier France
| | - P. Demoly
- University Hospital of Montpellier; Montpellier France
- UPMC Paris 06; UMR-S 1136; IPLESP; Equipe EPAR; Sorbonne Universités; Paris France
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Tanno LK, Simons FER, Annesi-Maesano I, Calderon MA, Aymé S, Demoly P. Fatal anaphylaxis registries data support changes in the who anaphylaxis mortality coding rules. Orphanet J Rare Dis 2017; 12:8. [PMID: 28086972 PMCID: PMC5237226 DOI: 10.1186/s13023-016-0554-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 12/13/2016] [Indexed: 02/01/2023] Open
Abstract
Anaphylaxis is defined as a severe life-threatening generalized or systemic hypersensitivity reaction. The difficulty of coding anaphylaxis fatalities under the World Health Organization (WHO) International Classification of Diseases (ICD) system is recognized as an important reason for under-notification of anaphylaxis deaths. On current death certificates, a limited number of ICD codes are valid as underlying causes of death, and death certificates do not include the word anaphylaxis per se. In this review, we provide evidences supporting the need for changes in WHO mortality coding rules and call for addition of anaphylaxis as an underlying cause of death on international death certificates. This publication will be included in support of a formal request to the WHO as a formal request for this move taking the 11th ICD revision.
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Affiliation(s)
- Luciana Kase Tanno
- Hospital Sírio Libanês, São Paulo, Brazil. .,University Hospital of Montpellier, Montpellier, France. .,Sorbonne Universités, UPMC Paris 06, UMR-S 1136, IPLESP, Equipe EPAR, 75013, Paris, France.
| | - F Estelle R Simons
- Section of Allergy & Clinical Immunology, Department of Pediatrics & Child Health, University of Manitoba, Winnipeg, Canada
| | | | - Moises A Calderon
- Section of Allergy and Clinical Immunology, National Heart and Lung Institute, Royal Brompton Hospital, Imperial College London, London, UK
| | | | - Pascal Demoly
- University Hospital of Montpellier, Montpellier, France.,Sorbonne Universités, UPMC Paris 06, UMR-S 1136, IPLESP, Equipe EPAR, 75013, Paris, France
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Tanno LK, Sublett JL, Meadows JA, Calderon M, Gross GN, Casale T, Demoly P. Perspectives on the International Classification of Diseases, 11th Revision, developments in allergy clinical practice in the United States. Ann Allergy Asthma Immunol 2016; 118:127-132. [PMID: 28010916 DOI: 10.1016/j.anai.2016.11.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 11/03/2016] [Accepted: 11/08/2016] [Indexed: 11/25/2022]
Affiliation(s)
- Luciana Kase Tanno
- Hospital Sírio Libanês, São Paulo, Brazil; University Hospital of Montpellier, Montpellier, France; Sorbonne Universités, Paris, France.
| | - James L Sublett
- Family Allergy & Asthma, Louisville, Kentucky; Section of Allergy & Immunology, Department of Pediatrics, University of Louisville School of Medicine, Louisville, Kentucky
| | | | - Moises Calderon
- Section of Allergy and Clinical Immunology, Imperial College London, National Heart and Lung Institute, Royal Brompton Hospital, London, United Kingdom
| | - Garry N Gross
- Department of Medicine, University of Texas Southwestern Medical School, Dallas, Texas
| | - Thomas Casale
- Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Pascal Demoly
- University Hospital of Montpellier, Montpellier, France; Sorbonne Universités, Paris, France
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Chang YS. Advances in technology are changing the future of medicine. Asia Pac Allergy 2016; 6:137-8. [PMID: 27489784 PMCID: PMC4967612 DOI: 10.5415/apallergy.2016.6.3.137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 07/26/2016] [Indexed: 01/01/2023] Open
Affiliation(s)
- Yoon-Seok Chang
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam 13620, Korea
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