Updated grading system for systemic allergic reactions: Joint Statement of the World Allergy Organization Anaphylaxis Committee and Allergen Immunotherapy Committee
Paul Turner, Ignacio J. Ansotegui, Dianne E. Campbell, Victòria Cardona, Stuart Carr, Adnan Ćustović, Stephen R. Durham, Motohiro Ebisawa, Mário Geller, Alexei Gonzalez‐Estrada, Paul A. Greenberger, Elham Hossny, Carla Irani, Agnes Sze Yin Leung, Michael Levin, Antonella Muraro, John Oppenheimer, José António Ortega Martell, Guillaume Pouessel, Manuel J. Rial, Gianenrico Senna, Luciana Kase Tanno, Dana Wallace, Margitta Worm, Mário Morais‐Almeida
Abstract
There is a lack of consensus over the description and severity assignment of allergic adverse reactions to immunotherapy, although there seems to be a consensus at least in terms of using the World Allergy Organization (WAO) grading systems to describe local adverse events for Sublingual Immunotherapy (SLIT) and Systemic Allergic Reactions (SARs) to Subcutaneous Immunotherapy (SCIT) amongst the major national/regional allergy societies. In this manuscript, we propose a modification of the previous WAO Grading system for SARs, which aligns with the newly-proposed Consortium for Food Allergy Research (CoFAR) Grading Scale for Systemic Allergic Reactions in Food Allergy (version 3.0). We hope this can facilitate a unified grading system appropriate to SARs due to allergen immunotherapy, independent of allergen and route of administration, and across clinical and research practice.