The American Academy of Allergy, Asthma & Immunology (AAAAI) announced that it has partnered with the American College of Allergy, Asthma & Immunology (ACAAI) to provide new evidence-based guidelines on the diagnosis and management of anaphylaxis and atopic dermatitis. The new practice parameters were updated to inform allergists and health-care providers of the current best practices. The organizations—united under the Allergy Immunology Joint Task Force for Practice Parameters—outlined their recommendations on providing individualized care to patients at risk of severe allergic reactions through diagnostic evaluation, epinephrine treatment, and the use of beta blockers and angiotensin-converting enzyme inhibitors. They suggested that contacting emergency services may be unnecessary if patients experience prompt, complete, and durable response following the use of epinephrine autoinjections and have access to additional injectors; however, emergency services should be called if patients experience severe anaphylaxis and symptoms worsen or do not resolve. The task force also specified that the current National Institute of Allergy and Infectious Diseases/Food Allergy & Anaphylaxis Network or World Allergy Organization anaphylaxis criteria should be utilized to diagnose and treat anaphylaxis in pediatric patients. For atopic dermatitis, the task force advised physicians on the use of topical corticosteroids and topical calcineurin inhibitors in patients with uncontrolled atopic dermatitis, crisaborole 2% ointment for patients with mild-to-moderate atopic dermatitis, and dupilumab in patients aged 6 months and older and tralokinumab in patients aged 12 years and older with moderate-to-severe refractory disease. They noted that this patient population should avoid elimination diets, immunosuppressants, systemic corticosteroids, topical antibiotics for those with atopic dermatitis without infections, and bleach baths for those with mild disease. “We regularly update our practice parameters. When physicians and their staff are aware of updated guidance, it means patients are getting the best, most appropriate care,” concluded Jay Lieberman, MD, Co-Chair of the Allergy Immunology Joint Task Force for Practice Parameters.
January 10, 2024