Updating the CoFAR Grading Scale for Systemic Allergic Reactions in Food Allergy.
Updating the CoFAR Grading Scale for Systemic Allergic Reactions in Food Allergy.
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DOI：
10.1016/j.jaci.2021.12.789
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发表时间：
2022-06
影响因子：
14.2
通讯作者：
Wood, Robert A.
中科院分区：
文献类型：
--
作者：
Chinthrajah, R. Sharon;Jones, Stacie M.;Kim, Edwin H.;Sicherer, Scott H.;Shreffler, Wayne;Lanser, Bruce J.;Atri, Negin;Babineau, Denise C.;Adelman, Daniel C.;Iqbal, Ahmar;Limb, Susan L.;Spergel, Amanda K. Rudman;Togias, Alkis;Wood, Robert A.
免疫疗法作为食物过敏的有效治疗是有希望的。其他食物过敏治疗方法也在开发中。然而，治疗期间以及口服食物激发（OFC）期间的不良过敏事件（AE）很常见，报告不标准。需要一个更细致入微的分级量表来创建一个全面和通用的系统来对食物过敏临床试验的AE及其严重程度进行分类。从2012年食品过敏研究联盟（CoFAR）分级量表和世界过敏组织（WAO）分级系统开始，我们与行业合作伙伴合作开发了CoFAR全身性过敏反应分级量表3.0版，并提供专家意见。修订后的CoFAR全身过敏反应分级量表有5个严重程度递增的级别，范围从全身性荨麻疹、局部血管性水肿、鼻炎和腹痛（1级）至死亡（5级）。根据相关器官系统在每个级别内对全身反应进行进一步分类。轻度单系统反应与轻度多系统反应不同。下呼吸道症状根据对治疗的反应分级;那些对标准治疗难治的症状（例如，需要>3个剂量的IM肾上腺素、连续IV肾上腺素输注、连续沙丁胺醇雾化）和需要机械通气的呼吸损害被归类为4级、危及生命的反应。在CoFAR中心之外普遍和一致地使用修订后的CoFAR分级量表，可以在食物过敏临床试验中更好地进行数据汇总和安全性比较。更新后的CoFAR分级量表不仅提供了反应等级的更精细跟踪，还提供了涉及的器官系统和对治疗的反应，从而可以在研究之间进行安全性比较。
Immunotherapy is promising as an efficacious treatment for food allergy. Other food allergy treatments are also under development. However, adverse allergic events (AE) during treatment, as well as during oral food challenges (OFC) are common and reporting is not standardized. A more nuanced grading scale is needed to create a comprehensive and universal system to categorize AEs and their severity for food allergy clinical trials. Starting with the 2012 Consortium for Food Allergy Research (CoFAR) Grading Scale and the World Allergy Organization (WAO) Grading System, we developed the CoFAR Grading Scale for Systemic Allergic Reactions, Version 3.0, in collaboration with industry partners with expert opinion. The revised CoFAR Grading Scale for Systemic Allergic Reactions has five levels of increasing severity, ranging from generalized urticaria, localized angioedema, rhinitis, and abdominal pain (Grade 1) to death (Grade 5). Systemic reactions are further categorized within each grade by relevant organ system. Mild, single-system reactions are differentiated from mild, multi-system reactions. Lower respiratory symptoms are graded based on response to therapy; those that are refractory to standard treatment (e.g., requiring >3 doses of IM epinephrine, continuous IV epinephrine infusion, continuous albuterol nebulization) and respiratory compromise requiring mechanical ventilation are classified as Grade 4, life-threatening reactions. Universal and consistent use of the revised CoFAR Grading Scale beyond the CoFAR centers would allow for better data aggregation and safety comparisons in clinical trials for food allergy. The updated CoFAR Grading Scale provides more granular tracking of not only the grade of reactions, but the organ systems involved and the response to treatment, allowing for safety comparisons between studies.
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影响因子：
158.5
作者：
Leung, DYM;Sampson, HA;Shanahan, WR
通讯作者：
Shanahan, WR
DOI：
10.1016/j.jaip.2020.02.010
发表时间：
2020-06
期刊：
The journal of allergy and clinical immunology. In practice
影响因子：
--
作者：
Sicherer SH;Warren CM;Dant C;Gupta RS;Nadeau KC
通讯作者：
Nadeau KC
影响因子：
14.2
作者：
Schneider, Lynda C.;Rachid, Rima;Umetsu, Dale T.
通讯作者：
Umetsu, Dale T.
影响因子：
14.2
作者：
Savage, Jessica H.;Courneya, Jean-Paul;Sterba, Patricia M.;MacGlashan, Donald W.;Saini, Sarbjit S.;Wood, Robert A.
通讯作者：
Wood, Robert A.
DOI：
10.1056/nejmoa1200435
发表时间：
2012-07-19
期刊：
The New England journal of medicine
影响因子：
--
作者：
Burks AW;Jones SM;Wood RA;Fleischer DM;Sicherer SH;Lindblad RW;Stablein D;Henning AK;Vickery BP;Liu AH;Scurlock AM;Shreffler WG;Plaut M;Sampson HA;Consortium of Food Allergy Research (CoFAR)
通讯作者：
Consortium of Food Allergy Research (CoFAR)