Lipid-lowering medications associated with increased anaphylaxis severity

Key takeaways:

• 44% of patients using LLM had severe anaphylaxis.
• This was the first study to show an association between LLM and severe anaphylaxis.

BOSTON — Patients using lipid-lowering medications experienced increased anaphylaxis severity, according to an abstract presented at the American College of Allergy, Asthma & Immunology Annual Scientific Meeting.

Lipid-lowering medications (LLM) decrease low-density lipoprotein and platelet-activating factor acetylhydrolase activity, Kaylee Sohng, a medical student at the University of Toronto, and colleagues wrote. This increases platelet-activating factor bioactivity and half-life, which led to a hypothesis that using LLM increases the risk for having severe anaphylaxis.

The retrospective chart review study spanned 2010 to 2023 and included 730 U.S. and Canadian patients (median age, 42 years; age range, 2-90 years; 414 females) with multi-system reactions to insect stings. Anaphylaxis severity was graded using the Brown Severity Score.

Among the included patients, 12% (n = 86) were on LLM. A confirmed Hymenoptera venom anaphylaxis by skin test or standard IgE was found in 65% (n = 471) of patients. Reaction severity was severe in 27% (n = 200) of patients and mild to moderate in 73% (n = 530) of patients.

Among patients using LLM, 44% (n = 38) had severe reactions compared with 56% (n = 48) who had mild to moderate reactions. The use of LLM was significantly associated with increased anaphylaxis severity with an adjusted odds ratio of 1.9 (95% CI; 1.1-3.1).

The authors highlighted that this was the first study to show this association in clinical practice. They emphasized the importance of the results, as LLM use is very common and can have significant impacts on patients with anaphylaxis.