World Allergy Organization Systemic Allergic Reaction Grading System: Is a Modification Needed?
World Allergy Organization Systemic Allergic Reaction Grading System: Is a Modification Needed?
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DOI：
10.1016/j.jaip.2016.11.009
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发表时间：
2017-01-01
影响因子：
9.4
通讯作者：
Lockey, Richard F.
中科院分区：
文献类型：
--
作者：
Cox, Linda S.;Sanchez-Borges, Mario;Lockey, Richard F.
对于包括过敏反应在内的全身过敏反应（SARs）的严重程度，尚无普遍接受的分级系统。虽然过敏反应的共识定义于2005年建立，但将反应定义为过敏反应所需的体征和症状在研究和临床实践中的应用并不一致。因此，很难比较和评价调查、临床实践和试验以及药物警戒数据的安全性结果。2010年，世界过敏组织（World Allergy Organization， WAO）提出了一个统一的分级系统，对过敏原免疫疗法SARs进行分类。分级系统的基础是所涉及的器官系统和反应的严重程度。最终评分由医生/卫生保健专业人员在活动结束后决定。虽然2010年WAO分级系统是为了对过敏原免疫疗法SARs进行分类而开发的，但经过适当的修改，它可以用于对任何原因的SARs进行分类。本次论坛的目的是提出对2010年世界气象组织SAR分级系统的修改建议，使其适用于任何原因导致的所有SAR。修改后的分级系统允许对不太严重的非典型肺炎进行分类，这些非典型肺炎可能在临床试验和监测研究中被低估或高估，具体取决于不良事件报告的规定标准。拟议修改的SAR分级系统的普遍使用将允许在不同的场地和处理方案之间进行更好的安全性比较。(C) 2016年美国过敏、哮喘与免疫学学会（J Allergy clinimmunol practice 2017;5:58-62）
There is no universally accepted grading system to classify the severity of systemic allergic reactions (SARs), including anaphylaxis. Although a consensus definition for anaphylaxis was established in 2005, the signs and symptoms required to define a reaction as anaphylaxis are inconsistently applied in research and clinical practice. As a result, it is difficult to compare and evaluate safety outcomes in surveys, clinical practice and trials, and pharmacovigilance data. In 2010, the World Allergy Organization (WAO) proposed a uniform grading system to classify allergen immunotherapy SARs. The basis of the grading system is the organ system(s) involved and reaction severity. The final grade is determined by the physician/health care professional after the event is over. Although the 2010 WAO grading system was developed to classify allergen immunotherapy SARs, with appropriate modifications, it can be used to classify SARs from any cause. The purpose of this Rostrum is to present a proposed modification of the 2010 WAO SAR grading system that will make it applicable to all SARs due to any cause. The modified grading system allows for classification of less severe SARs, which may be underreported or overreported in clinical trials and surveillance studies, depending on the criteria specified for adverse event reporting. The universal use of the proposed modified SAR grading system will allow for better safety comparisons across different venues and treatment protocols. (C) 2016 American Academy of Allergy, Asthma & Immunology (J Allergy Clin Immunol Pract 2017;5:58-62)