Discontinuation of bee venom immunotherapy in children and adolescents

Urbanek, R.; Förster, Johannes; Kühn, W; Ziupa, J.

doi:10.1016/s0022-3476(85)80508-4

Cited by 69 publications

(35 citation statements)

References 19 publications

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“…Bislang gibt es wenige Daten über wiederholte Stichprovokationen bei Patienten während fortgesetzter HG-SIT. Wiederholte Stichprovokationen wurden vorwiegend bei Kindern und Jugendlichen durchgeführt und zeigten eine hundertprozentige Reproduzierbarkeit vertragener Stichprovokationen [4,10,12,24]. In einer eigenen Untersuchung an erwachsenen Patienten nach vertragener Stichprovokation wurde der Ausgang von Feldstichen wäh-rend weiter fortgesetzter HG-SIT untersucht.…”

Section: Zuverlässigkeit Der Stichprovokationunclassified

Stichprovokation

Ruëff

Przybilla²

2014

Hautarzt

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For the majority of patients quality of life will significantly improve after tolerated sting challenge. A sting challenge test is particularly important in those patients who are at increased risk due their increased risk of treatment failure. If in patients with risk factors for treatment failure, VIT is done with elevated dose or if no risk factors are present, a sting challenge may not be needed. VIT with an elevated dose may prevent or correct treatment failure.

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Section: Zuverlässigkeit Der Stichprovokationunclassified

Stichprovokation

Ruëff

Przybilla²

2014

Hautarzt

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“…Obwohl Kinder häufiger gestochen werden als Erwachsene, treten systemisch-allergische Reaktionen bei lediglich 0,2-0,8 % der Kinder auf [161]. Die SCIT ist bei Hymenopterengiftallergien eine hocheffektive Behandlungsform und zeigt im Vergleich zur SIT bei Inhalationsallergien eine bessere Wirksamkeit, von 77-84 % bei Bienengiftund von 91-96 % bei Wespengiftallergikern [162][163][164][165][166]. Bei Kindern wurde auch nach Beendigung der SIT ein lang andauernder Schutz nachgewiesen, der mit einer "Relapse"-Rate von 5 % bis zu 20 Jahre nach der ersten systemischallergischen Reaktion, deutlich unter jener von Erwachsenen mit Insektengiftallergie, liegt (10-15 %).…”

Section: Spezifische Immuntherapie Mit Insektengiftallergenenunclassified

Allergenspezifische Immuntherapie bei IgE-vermittelten Erkrankungen im Kindes- und Jugendalter

Szépfalusi

Horák

Eiwegger

et al. 2018

Monatsschr Kinderheilkd

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“…The length of treatment required for long-term protection has been addressed in a number of studies which observed patients for their reactions to a sting provocation test 1–3 years after stopping venom immunotherapy [43, 44, 45, 46, 47, 48]. These studies indicate that after treatment for at least 3 years, 83–100% of the patients were still completely protected 1–3 years after stopping the treatment.…”

Section: New Developments In Treatmentmentioning

confidence: 99%

New Developments in the Diagnosis and Treatment of Hymenoptera Venom Allergy

Müller¹

2001

Int Arch Allergy Immunol

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According to most textbooks, diagnostic tests with Hymenoptera venoms are reliable, and immunotherapy with these venoms in Hymenoptera-venom-allergic patients leads in near to 100% to full protection. Careful analysis of the literature shows however that the specificity of diagnostic tests is far from perfect and that both efficacy and tolerance, especially in patients receiving honeybee venom immunotherapy, are still suboptimal. The major allergens of honeybee and vespid venoms are now available in recombinant form. Preliminary trials analyzing diagnostic tests with recombinant allergens in honeybee venom allergy are promising: the specificity is clearly increased in both skin testing and in determining venom-specific IgE antibodies when compared to natural venom allergens. An important recent finding is the frequent association of severe Hymenoptera venom allergy and elevated basal serum levels of the mast-cell-specific enzyme tryptase. Elevated levels are found in up to 30% of the patients with a history of severe shock reactions following Hymenoptera stings. The current findings indicate that basal tryptase levels indicating an increased mast cell load are much more frequent than previously thought and are a risk factor for severe or even fatal sting reactions. Premedication with antihistamines in the initial phase of venom immunotherapy reduced both local and systemic allergic side effects in several controlled studies. In a retrospective analysis of one of these trials it was found that reexposure during immunotherapy resulted in significantly more systemic allergic reactions in patients on placebo than on antihistamine premedication, suggesting that initial antihistamine premedication might increase the efficacy of venom immunotherapy. Different ways of allergen modification for venom immunotherapy have been proposed. While the results with chemical modifications were not convincing, recent studies with T-cell epitope peptides from the major bee venom allergen phospholipase A₂ look promising. Patient-tailored cocktails of recombinant venom allergens or isoforms thereof may be another possibility in the future. A number of prospective studies analyzing the duration of venom immunotherapy required for long-term protection have been published in the last decade. While most patients are still fully protected 1 year after discontinuation of therapy, relapses may occur in up to 20% of patients reexposed many years after treatment. Various risk factors for such relapses have been identified.

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Discontinuation of bee venom immunotherapy in children and adolescents

Cited by 69 publications

References 19 publications

Stichprovokation

Stichprovokation

Allergenspezifische Immuntherapie bei IgE-vermittelten Erkrankungen im Kindes- und Jugendalter

New Developments in the Diagnosis and Treatment of Hymenoptera Venom Allergy

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