A safe and efficient 7‐week immunotherapy protocol with aluminum hydroxide adsorbed vespid venom

Healthcare provision for insect venom allergy patients during the COVID-19 pandemic

“…They have the advantage that the maximum dose is achieved after a short initiation treatment phase. Shortened outpatient up-titration protocols have also been investigated for vespid venom allergy patients and show good results in terms of safety [ 7 ]. However, they require a longer initiation phase (7 weeks), implying that such treatment protocols should be preferred out of the season.…”

“…During the out-of-season period and in case of shortages of inpatient resources, or in case of certain regional requirements, an up-titration can be performed in an outpatient setting. A shortened, 7‑week protocol for vespid venom allergy patients has been recently published [ 7 ]. Whenever possible, outpatient up-titration should be performed at a center experienced with this therapy and is able to provide emergency medical care.…”

Switch‐over from Pharmalgen to Alutard Bee and Wasp venom in the UK

“…Importantly, in contrast to the aqueous extracts, Alutard SQ cannot be used for "accelerated," "rush," or "ultra-rush" updosing but the Summary of with either product, 1mL constitutes the usual maintenance dose. 3 Treatment with bee and vespid VIT is effective in preventing systemic reactions to subsequent stings in 95%-100% of vespid venom and approximately 80% of bee venom anaphylaxis, and this benefit appears to be similar with both aqueous and depot products. 2 However, safety and efficacy of bee and vespid venom VIT (including long term) is not well established in the context of clonal mast cell disorders.…”

“…In contrast, both Pharmalgen and Alutard SQ Wasp Venom comprise the venom from six Vespula species using the same purified mixed allergen source. The manufacturer has provided assurance that the products are interchangeable in practice, and that although the venom concentration is given in different units (100 000 SQ‐U/mL of Alutard SQ = 100 µg/mL of Pharmalgen), the millilitre dosing is equivalent; with either product, 1mL constitutes the usual maintenance dose …”

Skin prick tests are not useful for the qualification for venom immunotherapy in children

“… 11 The validity of the shortening IDT procedure in children, by limiting it to concentrations of venom from 0.01 mcg/ml to 1.0 mcg/ml, to reduce pain and costs, was previously documented, 12 and applied by other authors. 13 In this study, we critically evaluated the utility of the standard SPT testing in the diagnosis of children with history of SR to insect sting. There are no studies critically assessing the usefulness of SPT in the diagnosis of venom allergy in children and its application to initiation of VIT.…”