Adrenaline for the treatment of anaphylaxis: cochrane systematic review

A. Sheikh, Y.A. Shehata, Simon Brown, F.E.R. Simons

    Research output: Contribution to journalArticle

    123 Citations (Scopus)

    Abstract

    Background: Anaphylaxis is a serious allergic reaction that is rapid in onset and may cause death. Adrenaline is recommended as the initial treatment of choice for anaphylaxis. Objectives: To assess the benefits and harms of adrenaline in the treatment of anaphylaxis. Methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) ( The Cochrane Library 2007, Issue 1), MEDLINE (1966 to March 2007), EMBASE (1966 to March 2007), CINAHL (1982 to March 2007), BIOSIS (to March 2007), ISI Web of Knowledge (to March 2007) and LILACS (to March 2007). We also searched websites listing ongoing trials: , and and contacted pharmaceutical companies and international experts in anaphylaxis in an attempt to locate unpublished material. Randomized and quasi-randomized controlled trials comparing adrenaline with no intervention, placebo or other adrenergic agonists were eligible for inclusion. Two authors independently assessed articles for inclusion. Results: We found no studies that satisfied the inclusion criteria. Conclusions: On the basis of this review, we are unable to make any new recommendations on the use of adrenaline for the treatment of anaphylaxis. In the absence of appropriate trials, we recommend, albeit on the basis of less than optimal evidence, that adrenaline administration by intramuscular injection should still be regarded as first-line treatment for the management of anaphylaxis.
    Original languageEnglish
    Pages (from-to)204-212
    JournalAllergy
    Volume64
    Issue number2
    DOIs
    Publication statusPublished - 2009

    Fingerprint

    Anaphylaxis
    Epinephrine
    Therapeutics
    Adrenergic Agonists
    Intramuscular Injections
    MEDLINE
    Libraries
    Cause of Death
    Hypersensitivity
    Randomized Controlled Trials
    Placebos
    Pharmaceutical Preparations

    Cite this

    Sheikh, A. ; Shehata, Y.A. ; Brown, Simon ; Simons, F.E.R. / Adrenaline for the treatment of anaphylaxis: cochrane systematic review. In: Allergy. 2009 ; Vol. 64, No. 2. pp. 204-212.
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    abstract = "Background: Anaphylaxis is a serious allergic reaction that is rapid in onset and may cause death. Adrenaline is recommended as the initial treatment of choice for anaphylaxis. Objectives: To assess the benefits and harms of adrenaline in the treatment of anaphylaxis. Methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) ( The Cochrane Library 2007, Issue 1), MEDLINE (1966 to March 2007), EMBASE (1966 to March 2007), CINAHL (1982 to March 2007), BIOSIS (to March 2007), ISI Web of Knowledge (to March 2007) and LILACS (to March 2007). We also searched websites listing ongoing trials: , and and contacted pharmaceutical companies and international experts in anaphylaxis in an attempt to locate unpublished material. Randomized and quasi-randomized controlled trials comparing adrenaline with no intervention, placebo or other adrenergic agonists were eligible for inclusion. Two authors independently assessed articles for inclusion. Results: We found no studies that satisfied the inclusion criteria. Conclusions: On the basis of this review, we are unable to make any new recommendations on the use of adrenaline for the treatment of anaphylaxis. In the absence of appropriate trials, we recommend, albeit on the basis of less than optimal evidence, that adrenaline administration by intramuscular injection should still be regarded as first-line treatment for the management of anaphylaxis.",
    author = "A. Sheikh and Y.A. Shehata and Simon Brown and F.E.R. Simons",
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    Adrenaline for the treatment of anaphylaxis: cochrane systematic review. / Sheikh, A.; Shehata, Y.A.; Brown, Simon; Simons, F.E.R.

    In: Allergy, Vol. 64, No. 2, 2009, p. 204-212.

    Research output: Contribution to journalArticle

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    AU - Shehata, Y.A.

    AU - Brown, Simon

    AU - Simons, F.E.R.

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    N2 - Background: Anaphylaxis is a serious allergic reaction that is rapid in onset and may cause death. Adrenaline is recommended as the initial treatment of choice for anaphylaxis. Objectives: To assess the benefits and harms of adrenaline in the treatment of anaphylaxis. Methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) ( The Cochrane Library 2007, Issue 1), MEDLINE (1966 to March 2007), EMBASE (1966 to March 2007), CINAHL (1982 to March 2007), BIOSIS (to March 2007), ISI Web of Knowledge (to March 2007) and LILACS (to March 2007). We also searched websites listing ongoing trials: , and and contacted pharmaceutical companies and international experts in anaphylaxis in an attempt to locate unpublished material. Randomized and quasi-randomized controlled trials comparing adrenaline with no intervention, placebo or other adrenergic agonists were eligible for inclusion. Two authors independently assessed articles for inclusion. Results: We found no studies that satisfied the inclusion criteria. Conclusions: On the basis of this review, we are unable to make any new recommendations on the use of adrenaline for the treatment of anaphylaxis. In the absence of appropriate trials, we recommend, albeit on the basis of less than optimal evidence, that adrenaline administration by intramuscular injection should still be regarded as first-line treatment for the management of anaphylaxis.

    AB - Background: Anaphylaxis is a serious allergic reaction that is rapid in onset and may cause death. Adrenaline is recommended as the initial treatment of choice for anaphylaxis. Objectives: To assess the benefits and harms of adrenaline in the treatment of anaphylaxis. Methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) ( The Cochrane Library 2007, Issue 1), MEDLINE (1966 to March 2007), EMBASE (1966 to March 2007), CINAHL (1982 to March 2007), BIOSIS (to March 2007), ISI Web of Knowledge (to March 2007) and LILACS (to March 2007). We also searched websites listing ongoing trials: , and and contacted pharmaceutical companies and international experts in anaphylaxis in an attempt to locate unpublished material. Randomized and quasi-randomized controlled trials comparing adrenaline with no intervention, placebo or other adrenergic agonists were eligible for inclusion. Two authors independently assessed articles for inclusion. Results: We found no studies that satisfied the inclusion criteria. Conclusions: On the basis of this review, we are unable to make any new recommendations on the use of adrenaline for the treatment of anaphylaxis. In the absence of appropriate trials, we recommend, albeit on the basis of less than optimal evidence, that adrenaline administration by intramuscular injection should still be regarded as first-line treatment for the management of anaphylaxis.

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