Lipid-lowering medications (LLMs) could increase the risk of severe anaphylactic reactions toward insect venom, which has significant implications for patients with conditions associated with anaphylaxis, such as systemic mastocytosis (SM), according to a recent abstract in the 2024 Annual Scientific Meeting American College of Allergy, Asthma & Immunology.
The authors assessed the association between LLMs and anaphylaxis towards insect venom in over 700 patients with a confirmed anaphylactic reaction to Hymenoptera venom found in bees, wasps, and ants.
Learn more about SM signs and symptoms
Researchers used the Brown Severity Score to grade anaphylaxis severity in each patient. The scale rates anaphylaxis as mild when it only involves skin symptoms. Moderate crises involve compromise of the gastrointestinal, cardiovascular, and respiratory symptoms with symptoms such as shortness of breath, dizziness, and abdominal pain. Severe reactions involve severe difficulty breathing with blue coloration of the skin (cyanosis), low blood oxygen saturation, low blood pressure (hypotension), and unconsciousness.
Of the 700 patients in the study, 200 suffered severe reactions, representing 28% of the sample. However, among the 86 patients taking LLMs, 44% suffered a severe reaction; statistical analysis revealed a correlation between LLM use and severe anaphylaxis.
“This is the first study to report this association in clinical practice,” the authors wrote. “ Its findings are important given the widespread use of LLM worldwide and their potential impact on patients with anaphylaxis,”
Understanding SM and anaphylaxis
Mast cells are critical mediators in allergic reactions; they release biologically active substances such as heparin and histamine, which bind to receptors in multiple organ systems, causing many of the signs and symptoms observed in anaphylaxis.
Patients with SM have a higher risk of anaphylaxis than the general population; according to some studies, up to 40% of patients with SM experience anaphylaxis during their lifetimes. Common triggers include insect stings, medications, and certain foods. Many patients with SM require prophylactic treatment for anaphylaxis and must carry sel-injectors for emergency situations.
