TOPLINE

Among patients with a history of Hymenoptera venom-induced allergic reactions, those taking lipid-lowering medications had roughly twice the odds of severe anaphylaxis compared with those not taking these medications.

METHODOLOGY

• Researchers retrospectively reviewed charts of 778 patients (mean age, 42 years; 44% men) with a history consistent with a systemic reaction to a Hymenoptera sting seen at six allergy clinics in Canada, the US, and Germany to determine whether lipid‑lowering medications affected the severity of Hymenoptera venom-induced anaphylaxis.
• Among the full cohort, 518 patients had confirmed Hymenoptera allergy, verified by a positive venom skin test and/or Hymenoptera-specific serum immunoglobulin E levels (> 0.35 kU/L).
• The use of lipid-lowering medications was recorded from medication lists documented at the time of allergy consultation.
• The severity of reactions was graded using the Brown Severity Scale; grades 1 and 2 were combined into a 'mild-moderate' category, and grade 3 indicated severe life-threatening reactions.

TAKEAWAY

• Overall, 111 patients (14%) were taking one or more lipid-lowering medications: 110 were on statins, 11 were on ezetimibe, and one was on fenofibrate.
• The use of lipid-lowering medications was associated with twofold higher odds of severe anaphylaxis than nonuse (adjusted odds ratio [aOR], 2.0; P = .0036).
• This association was consistent among patients with confirmed Hymenoptera allergy (aOR, 2.0; P = .012) and in analysis that included cardiovascular disease as an additional covariate (aOR, 2.0; P = .0035).

IN PRACTICE

"Patients with a history of Hymenoptera venom allergy who are prescribed LLM [lipid-lowering medications] should be considered as higher risk for severe anaphylaxis. Clinicians should consider proactive risk mitigation strategies, including individualized approaches to venom immunotherapy (such as consideration of modified buildup protocols, pre-medication, and/or extended treatment duration), intensive patient education on anaphylaxis management, and ready access to self-administered epinephrine" the authors wrote.

SOURCE

Peter Vadas, MD, PhD, with the University of Toronto, Toronto, Canada, was the corresponding author of the study, which was published online on August 28 in The Journal of Allergy and Clinical Immunology: In Practice.

LIMITATIONS

Medication use was recorded from the list at the time of allergy consultation; therefore, the researchers could not confirm the patient's adherence to their medications or the duration of use prior to the sting reaction. Moreover, details regarding the timing, sequence, and consistency of acute anaphylaxis treatment were not uniformly recorded across centers.

DISCLOSURES

The study was supported by the Kerzner Family Fund, and the authors reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.