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Time of India
08-07-2025
- Health
- Time of India
World Allergy Day 2025 – Decoding Anaphylaxis: The dos and don'ts of the life‑threatening allergy
Every year on World Allergy Day, the global health community turns its attention to allergies and their aftereffect. World Allergy Day is celebrated annually on July 8th to raise awareness about allergies and their impact. It's a joint initiative of the World Allergy Organization (WAO) and the World Health Organization (WHO). The day aims to educate the public and healthcare professionals about allergies, promote understanding of allergic diseases, and advocate for better resources and care for individuals with allergies. In 2025, the spotlight is firmly on anaphylaxis, the most severe kind of allergic reaction. Striking rapidly and affecting multiple body systems, anaphylaxis can escalate from hives to respiratory distress, cardiovascular collapse, or even fatality within minutes. Without rapid treatment, the consequences can be dire. Globally, 0.05–2% of people may experience anaphylaxis during their lifetime, with Emergency Department visits surging across age groups. The World Allergy Organization (WAO) has identified anaphylaxis as a fast-growing public health threat, with up to 5 million cases globally each year, and an estimated 8,000 deaths annually. Alarmingly, only 60% of countries guarantee access to epinephrine auto-injectors – life-saving devices critical in emergencies. Studies reveal that 52–60% of individuals at risk do not carry epinephrine, and in the UK, nearly one-third of children with serious food allergies remain unprescribed the critical EpiPen. On World Allergy Day, let's dive deep into the science of anaphylaxis, the vital dos for survival, the dangerous don'ts, and how to ensure readiness – because early action can make the difference between life and loss. What is Anaphylaxis ? Anaphylaxis is an acute, systemic allergic reaction that unfolds in two phases: an immune-driven release of histamine and mediators, followed by a late-phase inflammatory response that can intensify hours later. It's a swift allergic reaction triggered by allergens like foods (peanuts, shellfish), insect stings, medications, or latex that bind with IgE antibodies, triggering mast cell degranulation. It typically unfolds within minutes to hours. Symptoms encompass: Skin: hives, itching, swelling Respiratory: wheezing, throat tightness, difficulty breathing, breathlessness Cardiovascular: drop in blood pressure, dizziness, lightheadedness GI: nausea, vomiting, cramps Though less than 2% of people face anaphylaxis , hospital visits are steadily rising. Fatal outcomes are rare (< 0.5% in hospital cases), but the risk is high, especially when diagnosis or treatment is delayed. Critically, only epinephrine (adrenaline) halts this process – every second counts. The critical 'Dos' – immediate and effective response Use Epinephrine immediately: Inject intramuscular epinephrine (0.01 mg/kg, up to 0.5 mg adult dose) into the mid-thigh at the first sign of anaphylaxis. Early injection sharply reduces hospital admissions and fatalities. Request prescriptions for two auto-injectors and always carry them. Call emergency services: Use EMS even after epinephrine, as symptoms can recur in 30% of cases (biphasic reactions) within 1–72 hours. Monitoring at a hospital for at least 4–6 hours is standard; in severe cases, observation may extend to 24 hours. Educate your circle: Ensure family, caregivers, educators, and co-workers know how to recognize anaphylaxis and use auto-injectors. Advocacy for first-responder programs in high-risk public venues like schools, malls, and food courts is growing. Specialized follow-up: After an episode, consult an allergist for diagnosis, prevention planning, and consideration of immunotherapies – food or venom desensitization shows 80–98% effectiveness. The golden rule: Do use epinephrine IMMEDIATELY when anaphylaxis is suspected. It reverses airway swelling and increases blood pressure within minutes. The key 'Don'ts' – common and dangerous mistakes Don't wait for escalating symptoms: Delaying epinephrine sharply increases the risk of fatality and hospitalization. If in doubt, inject. Don't substitute with antihistamines alone: Antihistamines or steroids may help minor symptoms, but won't counter airway obstruction or shock – and are not substitutes for epinephrine. Don't assume one dose is enough: Up to 35% of patients need a second dose for symptom control. Don't skip preparations: Expired or absent auto-injectors, lack of an action plan, or ignorance among contacts can turn manageable scenarios deadly. When time is of the essence, avoiding these missteps can be just as important as taking action. Prevention and preparedness – Beyond the emergency hours Effective prevention complements rapid response. Know your triggers: Read labels carefully, inquire about ingredients in food, cosmetics, or industrial products, and avoid hidden allergens like 'natural flavor' or 'spices'. Maintain an action plan: Keep a personalized action plan ready to go. Work with an allergist to create a tailored plan – covering identification, emergency dosing, and follow-up steps. Training and awareness: Advocate for educational programs in schools and workplaces to train staff and implement clear protocols. Psychological readiness: Living with anaphylaxis risk can induce anxiety. Support groups and mental health resources improve resilience. Public policy matters: WAO and GA²LEN emphasize the need for widespread access to auto-injectors in public spaces – schools, dining venues, and transit hubs. Desensitization therapies: Under specialist care, allergy immunotherapy – venom immunotherapy or food desensitization – offers hope to reduce reactivity by 80–90% in select cases. Emerging innovations: The FDA's approval of Neffy, a needle-free epinephrine nasal spray, may help reduce injection hesitancy The final word Living with a risk of anaphylaxis carries a heavy emotional burden – for individuals and caregivers alike. To cope, seek psychological support – counseling, peer groups, or family therapy can help manage the chronic stress. Give community building a thought. Join support organizations like Anaphylaxis UK, and share stories for strength and solidarity. Empowerment through education often restores a sense of control – and that confidence matters when you're the one in crisis.
Medscape
15-05-2025
- Health
- Medscape
Tezepelumab Slashes Surgery Risk in Severe Nasal Polyposis
Tezepelumab (Tezspire) has shown significant clinical benefits in adults with severe chronic rhinosinusitis with nasal polyps (CRSwNP), including marked reductions in nasal congestion and polyp size and a near elimination of the need for surgical intervention. Findings from the phase 3 WAYPOINT trial were published in The New England Journal of Medicine and presented as a late-breaking oral presentation at the 2025 American Academy of Allergy, Asthma & Immunology/World Allergy Organization annual meeting. Chronic rhinosinusitis with NP is a chronic inflammatory disorder characterized by persistent inflammation of the nasal mucosa and the presence of benign growths (NP). These polyps can obstruct nasal airflow and lead to symptoms such as nasal congestion, loss of smell, rhinorrhea, facial pressure or pain, sleep disturbances, and a substantial reduction in quality of life. Standard therapies include intranasal or systemic corticosteroids, surgical resection, and more recently, biologic agents. Adults With Severe Nasal Polyposis Tezepelumab, developed by AstraZeneca in collaboration with Amgen, is a first-in-class human monoclonal antibody that targets thymic stromal lymphopoietin (TSLP), an upstream epithelial cytokine known to initiate and amplify various inflammatory pathways, including those involved in allergic and eosinophilic airway diseases. Preclinical and clinical data suggest that inhibiting TSLP could be an effective strategy for modulating inflammation in both upper and lower airway diseases. The WAYPOINT study was a randomized, double-blind, placebo-controlled, multicenter, parallel-group trial designed to assess the efficacy and safety of subcutaneous tezepelumab in adults with severe CRSwNP. Participants received either tezepelumab or placebo for a 52-week treatment period, followed by a posttreatment follow-up phase lasting 12-24 weeks. Reduction in Polyp Severity Treatment with tezepelumab resulted in a significant reduction in NP severity, as demonstrated by the co-primary endpoints in the phase 3 WAYPOINT trial. The NP score improved by −2.065 ( P < .0001), and use of systemic corticosteroids was reduced by 88% ( P < .0001) compared with placebo. Improvements in NP score were observed as early as week 4, while improvements in nasal congestion score were noted by week 2, the first posttreatment assessment. These effects were sustained through week 52. Significant and clinically meaningful improvements were also observed across all key secondary endpoints in the overall trial population. Tezepelumab was associated with a 98% reduction in the need for NP surgery ( P < .0001) and again an 88% reduction in systemic corticosteroid use ( P < .0001) compared with placebo. 'The WAYPOINT study confirms the efficacy of tezepelumab in reducing the need for further surgery, systemic corticosteroid use, improving SNOT-22 scores, and restoring olfactory function,' said Geoffrey Mortuaire, MD, PhD, head of the Department of ENT and Head and Neck Surgery at Lille University Hospital, Lille, France. 'The rapid and consistent treatment response observed in patients supports the potential for making tezepelumab more broadly available. We hope to see its approval for this indication in France soon.' Favorable Safety Profile Tezepelumab was generally well tolerated in patients with severe nasal polyposis and demonstrated a safety profile consistent with its current indication for severe asthma. The most frequently reported adverse events in the WAYPOINT study were COVID-19, nasopharyngitis, and upper respiratory tract infections. There were no clinically meaningful differences in safety outcomes between the tezepelumab and placebo groups. Tezepelumab is currently approved as add-on maintenance therapy for severe asthma in adults and adolescents aged 12 years or older who remain uncontrolled despite high-dose inhaled corticosteroids and additional maintenance therapy. It is approved in the United States, Europe, Japan, and nearly 60 countries worldwide. Regulatory applications for tezepelumab in severe nasal polyposis are currently under review by health authorities in several regions, according to AstraZeneca.
