BACKGROUND: The association between asthma and anaphylaxis remains poorly understood. OBJECTIVE: To ascertain, in a managed care organization in northern California, the association of asthma and asthma severity with future risk of anaphylactic shock and other selected allergy diagnoses. METHODS: Using electronic data and validated algorithms, we assembled a cohort of 526,406 patients who met the criteria for asthma between 1996 and 2006 and a referent cohort (with no utilization for asthma) individually matched on age, sex, and race/ethnicity. In each cohort, 54% of patients were female and 55% were white; their mean (SD) age was 24 (20) years. The main outcome measures were anaphylactic shock (caused by an adverse food reaction, caused by serum, or other/idiopathic), allergic urticaria, anaphylaxis after sting(s), and angioedema. RESULTS: The incidence of anaphylactic shock was 109.0 per 100,000 person-years in the asthma cohort and 19.9 per 100,000 person-years in the referent cohort. After adjustment for age, sex, race/ethnicity, comorbidities, and immunotherapy, asthma was associated with a 5.2-fold (95% confidence interval, 4.7- to 5.6-fold) increased hazard of anaphylactic shock. Asthma was also significantly associated with an increased risk of the 3 selected allergy diagnoses, with hazard ratios of 1.4 to 1.9. A significant trend by severity of asthma was apparent for food-related and other/idiopathic anaphylactic shock and for anaphylaxis after sting(s). CONCLUSIONS: In this insured population, asthma was prospectively associated with increased risk of anaphylactic shock and other allergy diagnoses. However, the effect of asthma severity was not consistent across outcome measures.
BACKGROUND: The association between asthma and anaphylaxis remains poorly understood. OBJECTIVE: To ascertain, in a managed care organization in northern California, the association of asthma and asthma severity with future risk of anaphylactic shock and other selected allergy diagnoses. METHODS: Using electronic data and validated algorithms, we assembled a cohort of 526,406 patients who met the criteria for asthma between 1996 and 2006 and a referent cohort (with no utilization for asthma) individually matched on age, sex, and race/ethnicity. In each cohort, 54% of patients were female and 55% were white; their mean (SD) age was 24 (20) years. The main outcome measures were anaphylactic shock (caused by an adverse food reaction, caused by serum, or other/idiopathic), allergic urticaria, anaphylaxis after sting(s), and angioedema. RESULTS: The incidence of anaphylactic shock was 109.0 per 100,000 person-years in the asthma cohort and 19.9 per 100,000 person-years in the referent cohort. After adjustment for age, sex, race/ethnicity, comorbidities, and immunotherapy, asthma was associated with a 5.2-fold (95% confidence interval, 4.7- to 5.6-fold) increased hazard of anaphylactic shock. Asthma was also significantly associated with an increased risk of the 3 selected allergy diagnoses, with hazard ratios of 1.4 to 1.9. A significant trend by severity of asthma was apparent for food-related and other/idiopathic anaphylactic shock and for anaphylaxis after sting(s). CONCLUSIONS: In this insured population, asthma was prospectively associated with increased risk of anaphylactic shock and other allergy diagnoses. However, the effect of asthma severity was not consistent across outcome measures.
Authors: Michael M McNeil; Eric S Weintraub; Jonathan Duffy; Lakshmi Sukumaran; Steven J Jacobsen; Nicola P Klein; Simon J Hambidge; Grace M Lee; Lisa A Jackson; Stephanie A Irving; Jennifer P King; Elyse O Kharbanda; Robert A Bednarczyk; Frank DeStefano Journal: J Allergy Clin Immunol Date: 2015-10-06 Impact factor: 10.793
Authors: Kathleen E Walsh; Sarah L Cutrona; Sarah Foy; Meghan A Baker; Susan Forrow; Azadeh Shoaibi; Pamala A Pawloski; Michelle Conroy; Andrew M Fine; Lise E Nigrovic; Nandini Selvam; Mano S Selvan; William O Cooper; Susan Andrade Journal: Pharmacoepidemiol Drug Saf Date: 2013-09-05 Impact factor: 2.890
Authors: F Estelle R Simons; Ledit R F Ardusso; M Beatrice Bilò; Yehia M El-Gamal; Dennis K Ledford; Johannes Ring; Mario Sanchez-Borges; Gian Enrico Senna; Aziz Sheikh; Bernard Y Thong Journal: World Allergy Organ J Date: 2011-02-23 Impact factor: 4.084