Information updates

Updated and new ASCIA HAE resources

The ASCIA Hereditary Angioedema (HAE) Position Paper and Management Plan have been updated and are now available on the ASCIA website: www.allergy.org.au/hp/papers/hereditary-angioedema

The urgent updating of these documents is due to Takhzyro® (lanadelumab) being PBS listed for HAE from 1st December 2021.

We have also taken this opportunity to make other product related changes, including:

  • Removal of the product name ‘Firazyr’ as the current product is generic ‘Icatibant’.
  • A statement regarding Danazol (Azol) being discontinued in January 2020 in Australia.
  • Replacing the Berinert® order form with an updated version on page 25.  
  • Updating of the ASCIA HAE Management Plan on page 23 to include Takhzyro® (lanadelumab) and remove the product name ‘Firazyr’.

A new ASCIA HAE Frequently Asked Questions (FAQ) for patients, consumers and carers has been developed in October 2021 and is available on the ASCIA website www.allergy.org.au/patients/immunodeficiencies/hae

Updated ASCIA Adrenaline Injector Prescribing Guidelines and FAQ

ASCIA Adrenaline (Epinephrine) Injector Prescribing Guidelines and Frequently Asked Questions (FAQ) have been updated, and are now available on the ASCIA website:

Adrenaline Injectors FAQ Updated 12 January 2022

ASCIA Guidelines - Adrenaline (Epinephrine) Autoinjector Prescription Updated 12 January 2022

The main change is the inclusion of links to several publications that are consistent with ASCIA adrenaline injector dose recommendations (refer to weblinks below).

Other changes in the ASCIA Adrenaline Injectors FAQ are as follows:

  • Some of the FAQs have been reordered and expanded, to address the most common questions that we have received, including FAQs 1 and 2.
  • FAQ 3 includes dose recommendations and links to several publications that are consistent with ASCIA recommendations. These publications also support the use of a 500 microgram device to provide choice of dose for people over 50kg who may prefer a higher dose (500 microgram) and states that a 500 microgram device can potentially prevent the need for further doses of adrenaline.
  • FAQ 8 includes ‘Students and children may be prescribed EpiPen® or Anapen® devices, and schools and CEC services need to accept both devices. Therefore, staff in schools and CEC services should be trained on both device brands.’
  • FAQs 9 and 10 clarify that there are three steps to give EpiPen® and four steps to give Anapen®.
  • FAQ 13 includes ‘There is no evidence that injecting the second dose of adrenaline into the same thigh is a problem. The most important thing is to give another dose of adrenaline (after 5 minutes) if symptoms persist, and phone an ambulance.’

The main changes in the ASCIA Adrenaline Injector Prescription Guidelines are as follows:

  • Addition of These guidelines should be used in conjunction with clinical judgement, with consideration of issues that include training on a new device and preference of device from the patient or their carer.’
  • Inclusion of ‘It is important to specify brand and tick box on PBS prescription to ensure that brand is not substituted’ on the first and last page andEnsure correct ASCIA Action Plan is provided for the brand of prescribed device’.
  • A reordering of the dose recommendations to be on page 2, in a more prominent location than in the previous version.
  • Links to several publications that support ASCIA dose recommendations, and the use of a 500 microgram device to provide choice of dose for people over 50kg who may prefer a higher dose (500 microgram) ) and a statement that a 500 microgram device can potentially prevent the need for further doses of adrenaline.
  • Colour coding of the prescription guide recommendations to make them easier to follow.
  • Replacement of the definitions with a link to clinical definitions in the ASCIA Guidelines for Acute Management of Anaphylaxis.

ASCIA adrenaline injector dose recommendations are based on expert consensus and standard practice by ASCIA members, which vary to the product information. These doses are consistent with the Acute Anaphylaxis Clinical Care Standard for Australia, Australian Prescriber Anaphylaxis wallchart, Australian Immunisation Handbook and international recommendations from the World Allergy Organisation (WAO), Canada and the UK (refer to weblinks below).

https://www.safetyandquality.gov.au/standards/clinical-care-standards/acute-anaphylaxis-clinical-care-standard

https://www.nps.org.au/australian-prescriber/articles/anaphylaxis-emergency-management-for-health-professionals

https://immunisationhandbook.health.gov.au/resources/handbook-tables/doses-of-intramuscular-11000-adrenaline-for-anaphylaxis 

https://www.worldallergyorganizationjournal.org/article/S1939-4551(20)30375-6/fulltext

https://www.resuscitationjournal.com/article/S0300-9572(21)00150-7/fulltext

https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-2-vaccine-safety/page-4-early-vaccine-reactions-including-anaphylaxis.html#shr-pg0

https://onlinelibrary.wiley.com/doi/full/10.1111/cea.14055

 

COVID-19 vaccines are safe for people with allergies, including children

From 10 January 2022 in Australia, and from 17 January 2022 in New Zealand, all children from five years of age are eligible for COVID-19 vaccination. The approval of mRNA COVID-19 vaccines in children aged from 5 to 16 years has been made following careful evaluation of the available data supporting safety and efficacy.

COVID-19 vaccines available in Australia and New Zealand are safe for people with allergies, including children:

  • There is no evidence that people with allergic conditions such as asthma, hay fever (allergic rhinitis), food allergy or insect sting allergy are at any greater risk of vaccine allergy compared to the general population.
  • Unlike some other vaccines, there is no food, gelatin or latex in the COVID-19 vaccines that are currently available, and they are not grown in eggs.
  • If a person has had an allergic reaction to another vaccine, this does not mean that they will also be allergic to the COVID-19 vaccine.

Further information is available at https://www.allergy.org.au/patients/ascia-covid-19-vaccination-faq 

Vaccination is an important way to reduce the risk of developing infectious diseases which can easily spread. This includes COVID-19, which is caused by infection with the SARS-CoV-2 coronavirus.

Immunity occurs after the vaccine stimulates a person’s immune system to make antibodies (immunoglobulins) and COVID-19 specific T cells, to help protect the body from future infections. This means that if a person is vaccinated, they will be less likely to get COVID-19. Even if a person does get infected, it is likely to be a milder illness.

 

Responding to an anaphylaxis emergency when there is limited access to an ambulance

ASCIA is aware that there is limited access to ambulances in some regions, due to issues related to the latest COVID-19 outbreaks, and in rural or remote settings. 

ASCIA's advice for people having anaphylaxis and their carers is as follows:

  1. Follow the ASCIA Action Plan for Anaphylaxis.
  2. Give an adrenaline (epinephrine) injector (EpiPen or Anapen) without delay. 
  3. Always call 000 (AU) or 111 (NZ) after giving adrenaline and take advice regarding emergency management.

Further adrenaline (if available) should be given when:

  • There is no response after five minutes.
  • Signs and symptoms of anaphylaxis continue to progress.
  • Signs and symptoms improve and then become worse again.

When there is limited or no access to an ambulance:

  • The person who has been called to help should communicate with emergency services and arrange for themselves or another responsible person to transport the person to a hospital or other medical facility.
  • Two people should ideally travel with the person having anaphylaxis, one to drive and the other to monitor their health.
  • Where possible, do not allow the person who is having anaphylaxis to walk or stand as this may make their symptoms worse.* 

*For safety and legal reasons the person having anaphylaxis needs to be seated in a vehicle so that they can wear a seatbelt. The seatbelt may need to be adjusted so that it is snug over the chest and lap if the seat is:

  • Reclined to make them as flat as possible.
  • Pushed back to allow space to elevate their legs. 

When there is limited access to an ambulance, people who are at risk of anaphylaxis, and their carers should also consider:

  • Taking extra care to reduce the risk of allergic reactions.
  • Always carrying two prescribed adrenaline injectors with you everywhere.
  • Discussing a plan before you are in an emergency situation.
  • Checking where the nearest hospital is located if you are going away on holidays.
  • If a third adrenaline injector is available, giving it 5 minutes after the second dose, if needed.

Patient and carer support is available from:

Allergy & Anaphylaxis Australia www.allergyfacts.org.au

Allergy New Zealand www.allergy.org.nz

ASCIA anaphylaxis information is available at www.allergy.org.au/anaphylaxis  

ASCIA's Plans for 2022

As the end of another challenging year is approaching, we thank ASCIA members and supporters for your highly valued contributions throughout the past year.

Despite the uncertainties during 2021, ASCIA has become an even stronger and more resilient organisation, with increased members, supporters, reach and recognition.

Highlights from 2021 include:

ASCIA’s plans for 2022 include:

  • Hosting of the ASCIA 2022 Hybrid Conference from Tuesday 30 August to Friday 2 September at the Melbourne Convention and Exhibition Centre. https://ascia2022.com/
  • Launch of the ASCIA Immunodeficiency Strategy for Australia and New Zealand on Friday 25 March 2022. nationalimmunodeficiencystrategy.org.au/
  • Hosting of ASCIA Allergy and Immunodeficiency Advanced Training Days in June 2022.
  • Continued advocacy, including new submissions for food and drug allergy challenge MBS item numbers.
  • Further expansion of ASCIA online resources and e-training courses.
  • Further expansion of the AIFA research grant program.
  • Continued expansion of the National Allergy Strategy.

We hope that the New Year brings happiness, health and success for you and your families. 

Kind regards, 

Professor Michaela Lucas
ASCIA President

Jill Smith
ASCIA CEO

ASCIA gratefully acknowledges the generous support of all sponsors listed on the ASCIA website www.allergy.org.au/about-ascia/sponsors 

ASCIA Generic Action and First Aid Plans for Anaphylaxis now include QR codes

With the widespread use of QR codes, and two brands of adrenaline (epinephrine) injector devices now available, a QR code has been added to the generic version of the red ASCIA Action Plan for Anaphylaxis and the generic version of the orange ASCIA First Aid Plan for Anaphylaxis. 

The QR code links to a new ASCIA webpage www.allergy.org.au/hp/anaphylaxis/how-to-give-injector which includes instructions for both EpiPen® and Anapen® . Please note that the generic versions with QR codes are not intended to replace the device specific plans for EpiPen® and Anapen®

The generic ASCIA plans with QR codes are now available on the ASCIA website in several locations and have been updated in ASCIA anaphylaxis e-training courses:

www.allergy.org.au/hp/anaphylaxis/ascia-action-plan-for-anaphylaxis

www.allergy.org.au/hp/ascia-plans-action-and-treatment

www.allergy.org.au/hp/anaphylaxis/first-aid-for-anaphylaxis

The generic versions of ASCIA plans have been available for several years, for the following reasons:

  • To enable translations, generic orange ASCIA First Aid Plan for Anaphylaxis were introduced in 2012.
  • To prepare for the situation where other brands of adrenaline injector devices may have been introduced at short notice, due to supply issues, generic red ASCIA Action Plans for Anaphylaxis were introduced in 2018.
  • To provide a illustrative training tool, without being brand specific, generic red ASCIA Action Plans for Anaphylaxis and orange ASCIA First Aid Plan for Anaphylaxis have been used in ASCIA anaphylaxis e-training courses since 2018.

Adding the QR code to the generic ASCIA plans provides additional information to ‘refer to device label’ for instructions. Even if people don’t use the QR code, having the code in a prominent location may highlight the fact that people can ‘refer to device label’ for instructions.

ASCIA Food Allergy e-training

ASCIA Food Allergy e-training for Health Professionals has been substantially updated and the new course is available from 30 November 2021.

First developed in 2011, the latest version is for suitable for medical practitioners, nurses and dietitians.

The following six modules are included:

Module 1: Food Allergy Overview

Module 2: Diagnosis, Management and Prevention of Food Allergy

Module 3: Cow’s Milk (Dairy) Allergy

Module 4: Other Conditions Related to Food Allergy

Module 5: The Role of Dietitians in Managing Food Allergy

Module 6: Final Assessment

Thank you to ASCIA members and the ASCIA team who undertook the extensive review and editing of the course over the past few years. 

Register or go to the course here

The learning outcomes for this course are:

  • Differentiate between food allergy and other adverse reactions to foods, including food intolerances.
  • Understand the role of medical practitioners and dietitians in the diagnosis and management of food allergy.
  • Identify appropriate specialised formula choices for infants with food allergy.

This course has received support from the National Allergy Strategy and ASCIA gratefully acknowledges all of the generous supporters of ASCIA education resources, as listed on the ASCIA website https://www.allergy.org.au/about-ascia/sponsors 

New ASCIA Chronic Rhinosinusitis Position Paper

Chronic Rhinosinusitis (CRS) is one of the most common chronic conditions worldwide, with a significant health-economic impact.  CRS is generally subclassified into two dominant subgroups:

  • CRS with Nasal Polyps (CRSwNP), and
  • RS sine (without) NP (CRSsNP).

CRS with Nasal Polyps (CRSwNP) is a Type 2 (T2) inflammatory disorder and has a significant impact on quality of life which is further reduced if other atopic diseases and asthma are also present. Whilst intranasal corticosteroids (INCS) and saline irrigation are safe and effective for long term use in patients, many patients with CRSwNP remain suboptimally controlled and require surgical management.  As new medical therapies are becoming available, a rational approach to appropriate, equitable, and cost-effective treatment is required.

A Position Paper has been developed to provide an overview of CRSwNP and provide a framework for management that includes newer biological therapies. It is available at www.allergy.org.au/hp/papers/crswnp 

This Position Paper was developed by the Australasian Society of Clinical Immunolgy and Allergy (ASCIA) and the Australian Society of Otolaryngology Head & Neck Surgery (ASOHNS) Working Party, comprising: A/Prof Raewyn Campbell, Prof Richard Harvey, Prof Connie Katelaris AM (Chair), Prof Michaela Lucas, Dr Kathryn Patchett, A/Prof Janet Rimmer and Prof Ray Sacks.

 

 

More Articles ...

Mod ASCIA Member
Donate to AIFA
go to NAS website
About ASCIA

ASCIA is the peak professional body of clinical immunology and allergy in Australia and New Zealand
ASCIA promotes and advances the study and knowledge of allergy and other immune diseases

Quick Links

About ASCIA

ASCIA is a registered trademark of the Australasian Society of Clinical Immunology and Allergy. All content is subject to copyright for the Australasian Society of Clinical Immunology and Allergy. Read more...

The content for the website is developed and approved by ASCIA Committee and ASCIA Working Party Members. Read more...

Disclaimer I Privacy

The ASCIA website is intended for use by ASCIA members, health professionals and the general public. The content provided is for education, communication and information purposes only and is not intended to replace or constitute medical advice or treatments. Read more...

ASCIA respects your privacy. Read our privacy policy here...

Sponsors | Advertising

ASCIA does not endorse products from sponsoring organisations, nor is it influenced by sponsoring organisations with regard to the content of education programs and websites. 

The ASCIA website does not accept advertising. Any link to a third-party website does not imply any endorsement by ASCIA.

Accreditiation

healthdirect

This website is certified by Health On the Net Foundation. Click to verify. This site complies with the HONcode standard for trustworthy health information: verify here.