Information updates

With widespread cases of COVID-19 in Australia and New Zealand, treating allergic rhinitis (hay fever) and/or asthma regularly and correctly is important for the following reasons:

• To avoid hay fever and/or asthma symptoms being mistaken for symptoms due to respiratory infections, including COVID-19. 

• To maintain good health by ensuring that hay fever and/or asthma are well controlled, using nasal sprays, inhalers and other medications as prescribed and directed by the treating doctor.  

• To reduce coughing and sneezing, which can spread respiratory infections (such as COVID-19, colds and influenza).

If a person's hay fever and/or asthma symptoms occur, despite treatments being used regularly and correctly, and their most recent COVID-19 rapid antigen test result is negative (based on testing at least 1-2 times each week, in regions where tests are readily available), they should:

• Be allowed to attend their school, early children's education/care centre, other institution or workplace; and 

• See their doctor as soon as possible to check if their hay fever and/or asthma treatments need to be modified. 

Further information:

www.allergy.org.au/patients/allergic-rhinitis-hay-fever-and-sinusitis

www.allergy.org.au/members/covid-19

AbbVie announced on 22 January 2022 that RINVOQ® (upadacitinib), a Janus Kinase 1 (JAK1) inhibitor, has been listed on the Pharmaceutical Benefits Scheme (PBS) for Australian patients living with severe atopic dermatitis (eczema), which can affect their whole body, face or hands.

Atopic dermatitis is a chronic inflammatory skin condition caused by an overactive immune system and is one of the most common and severe forms of eczema. Approximately 1.6 million Australians are thought to be living with atopic dermatitis, with around one in five of these suffering from a moderate to severe form of the condition.

Atopic dermatitis has a significant impact on quality of life.  As there is no cure for atopic dermatitis, the main goals in managing the disease are to reduce itch, minimise rash, and limit the impact on quality of life. Access to targeted therapies such as RINVOQ® (upadacitinib) provides additional treatment options to help alleviate the burden of this chronic condition. 

More information: 

www.abbvie.com.au/media/rinvoq-eczema-atop-derm-pbs-listed.html

www.pbs.gov.au

www.allergy.org.au/patients/skin-allergy

www.allergy.org.au/about-ascia/info-updates/pbs-listing-of-dupixent-dupilumab-for-severe-atopic-dermatitis

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 1^st 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

This news item was issued on 13 January 2022 by ASCIA, the peak professional body for clinical immunology and allergy in Australia and New Zealand.

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 Februry 2022

ASCIA Guidelines - Adrenaline (Epinephrine) Injector Prescription Updated February 2022

ASCIA Guidelines Summary - Adrenaline (Epinephrine) Injector Prescription New February 2022 

The main updates include links to several publications (see below) that support ASCIA adrenaline injector dose recommendations for EpiPen^® and Anapen^® and the use of a 500 microgram device (Anapen^® 500), which:

• Provides doctors with  choice of dose for doctors, as some may prefer to prescribe a higher dose (500 microgram device) for people over 50kg.
• May potentially reduce the need for further doses of adrenaline in older adolescents and adults weighing over 50kg. 

The Guidelines and FAQ also include other reasons why it is important to have more than one brand of adrenaline injector available.

Publications 

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.

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

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 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.’

Other 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 and ‘Ensure 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.
• 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.

This news item was issued on 13 January 2022 and updated on 28 February 2022 by ASCIA, the peak professional body for clinical immunology and allergy in Australia and New Zealand.

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.

This news item was issued on 12 January 2022 by the Australasian Society of Clinical Immunology and Allergy (ASCIA), the peak professional body for clinical immunology and allergy in Australia and New Zealand.

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  

This news item was issued on 11 January 2022 by the Australasian Society of Clinical Immunology and Allergy (ASCIA), the peak professional body for clinical immunology and allergy in Australia and New Zealand.

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:

• Hosting of a highly successful ASCIA 2021 Virtual Conference with 694 delegates, the highest number of delegates on record for an ASCIA Annual Conference. In response to requests, access to on-demand ASCIA 2021 Virtual Conference recordings has been extended by two months, until 3 February 2022. This should allow registered delegates to catch up on missed sessions.
  allergy.org.au/conferences/ascia-annual-conference
• Increased membership, with over 700 ASCIA members as of December 2021. allergy.org.au/about-ascia#a4
• With more than 330 ASCIA online resources, the ASCIA website continues to attract a large number of visits. From 1st July 2020 to 30th June 2021 there were more than 3 million pageviews and 1.9 million visits and 1.5 million unique visitors, as well as 90,000 ASCIA e-training course registrations.  allergy.org.au/about-ascia/education-projects
• All ASCIA anaphylaxis online resources and e-training courses have been updated and new resources have been developed. allergy.org.au/anaphylaxis
• Several new ASCIA COVID-19 vaccination resources were developed, which have been widely accessed, contributing to the success of COVID-19 vaccine programs. allergy.org.au/members/covid-19
• Continued advocacy on behalf of ASCIA on allergy and immunology issues. allergy.org.au/ascia-reports
• More than $500,000 awarded in AIFA research grants since 2015. allergyimmunology.org.au/grants
• Several National Allergy Strategy project launches. allergy.org.au/about-ascia/info-updates/national-allergy-strategy-updates

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. 
• Launch of the ASCIA Immunodeficiency Strategy for Australia and New Zealand on Friday 29 April 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
• Further expansion of ASCIA 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 

This news item was issued on 20 December 2021 by the Australasian Society of Clinical Immunology and Allergy (ASCIA), the peak professional body for clinical immunology and allergy in Australia and New Zealand.

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 general version of the red ASCIA Action Plan for Anaphylaxis and the general 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  device specific plans for EpiPen^® and Anapen^® are still available.

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

• To enable translations, the general 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, the general red ASCIA Action Plan for Anaphylaxis was introduced in 2018.
• To provide a illustrative training tool, without being brand specific, a general 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 general 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.

This news item was issued on 7 December 2021 by the Australasian Society of Clinical Immunology and Allergy (ASCIA), the peak professional body for clinical immunology and allergy in Australia and New Zealand.