Comparison of the Safety Profiles of 3 Different Hymenoptera Venom Immunotherapy Protocols: A Retrospective 2-Center Study of 143 Patients.

Détails

ID Serval
serval:BIB_42358D9FBCC8
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Comparison of the Safety Profiles of 3 Different Hymenoptera Venom Immunotherapy Protocols: A Retrospective 2-Center Study of 143 Patients.
Périodique
International archives of allergy and immunology
Auteur⸱e⸱s
Pospischil I.M., Kagerer M., Cozzio A., Angelova-Fischer I., Guenova E., Ballmer-Weber B., Hoetzenecker W.
ISSN
1423-0097 (Electronic)
ISSN-L
1018-2438
Statut éditorial
Publié
Date de publication
2020
Peer-reviewed
Oui
Volume
181
Numéro
10
Pages
783-789
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
Venom immunotherapy (VIT) is highly effective and the treatment of choice for patients with a history of systemic anaphylactic reactions to a Hymenoptera sting. It has been assumed that VIT protocols with a rapid dose increase during the induction phase are associated with a higher frequency of systemic reactions (SR); however, study data addressing this issue are conflicting.
The aim of this study was to compare the safety of 3 different Hymenoptera VIT protocols (half-day ultra-rush, 3-day rush, 3-week cluster).
This retrospective 2-center study included 143 Hymenoptera venom-allergic patients, who underwent 147 VIT procedures during the years 2015-2018. Twenty cluster, 75 rush, and 52 ultra-rush VIT protocols were performed with honeybee (54 protocols) and wasp (93 protocols) venom. All documented side effects were classified into large local and SR (Ring and Messmer classification).
SR were observed during 11 (7.5%) VIT procedures and did not exceed severity grade II. SR occurred more frequently in cluster compared to accelerated protocols. This result was observed for both honeybee (cluster: 25%, rush: 8.7%, and ultra-rush: 15.8%) and wasp VIT (cluster: 12.5%, rush: 0%, and ultra-rush: 6.1%), though the differences were statistically significant only in the wasp VIT subgroup. Honeybee venom elicited more SR than wasp venom (14.8 and 3.2%, respectively, p = 0.01). The risk for SR did not depend on age, sex, concomitant antihypertensive medication, hypertryptasemia, or severity of the index sting reaction.
Accelerated VIT protocols, namely, rush and ultra-rush protocols are safe therapeutic options for Hymenoptera venom-allergic patients and displayed fewer SR than cluster VIT protocols in our study.
Mots-clé
Cluster protocol, Hymenoptera venom allergy, Rush protocol, Side effects, Ultra-rush protocol, Venom immunotherapy
Pubmed
Web of science
Création de la notice
17/08/2020 9:21
Dernière modification de la notice
04/11/2020 6:23
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