Incidence Rate of Bee Venom Acupuncture Related Anaphylaxis: A Systematic Review

Abstract

Background: Bee venom acupuncture (BVA) is an effective treatment method for various diseases. Bee venom, however, can cause adverse effects, even rarely including life-threatening anaphylaxis, so safety-related evidence is required. In this study, we systematically estimated the incidence rate of anaphylaxis in response to BVA. Methods: We searched eight databases (MEDLINE (Pubmed), EMBASE, Cochrane Central Register of Controlled, KISS, KMBASE, Koreamed, OASIS, and NDSL) and systematically reviewed the articles that met the inclusion/exclusion criteria. Results: Among 225 potentially relevant articles, 49 were selected for this study. The overall incidence rate of anaphylaxis in response to BVA was 0.045% (95% CI 0.028–0.062). Women (0.083%, 95% CI 0.010–0.157) showed a higher incidence rate than men (0.019%, 95% CI −0.018 to 0.055), while the incidence for patients who had a skin test conducted (0.041%, 95% CI 0.011–0.072) was not significantly different compared to that obtained for patients for which there was no information about a skin test (0.047%, 95% CI 0.026–0.067). The publication year affected the incidence rate: it was highest before 1999 (1.099%, 95% CI −1.043 to 3.241), lower between 2000 and 2009 (0.049%, 95% CI 0.025–0.073), and lowest between 2010 and 2021 (0.037% 95% CI 0.014–0.060). Conclusions: In this study, we provide reference data about risk size and factors of BVA-related anaphylaxis, which is essentially required for BVA application in clinics.

Investigation of the Adverse Events Associated with Bee Venom Pharmacopuncture in Patients Hospitalized in a Korean Hospital: A Retrospective Chart Review Study

“…There was no occurrence of anaphylaxis in this study, which is lower than the result of previous study. Ko et al, reported that incidence rate of anaphylaxis was 0.045% in a systematic review [ 5 ]. However, the incidence of overall AEs in this study was higher than that reported by other retrospective studies investigating post–BVP AEs (0.025% by Lee et al [ 8 ] and 0.23% by Kim et al [ 7 ]).…”

“…The method involves the injection of venom extracted and processed from the venom sac of honeybees into an acupoint or intramuscular pressure point associated with disease for therapeutic purposes [ 1 , 2 , 3 ]. Although BVP is used for the treatment of musculoskeletal disorders as well as various other diseases, some components in the body act as antigens and can cause life-threatening adverse events (AEs), such as anaphylaxis [ 4 , 5 ].…”

Africanized Bee Venom (Apis mellifera Linnaeus): Neuroprotective Effects in a Parkinson’s Disease Mouse Model Induced by 6-hydroxydopamine

“…It would be interesting to investigate the actions of the isolated melittin on the 6-OHDA lesion model (to date, in vivo studies were conducted on MPTP-induced PD [ 59 ]). Moreover, although bee venom therapy (acupuncture mainly) has been studied in human PD and other diseases with promising outcomes, it can cause adverse effects, even rarely, including anaphylaxis [ 60 ]. Thus, studies using nanotechnology (controlled drug delivery systems, increased bioavailability and target selectivity, lower dosage) targeting the delivery of BV to the nervous system would bring a great improvement in this field.…”

Bee Venom and Its Biological Effects

“…As a result, it is advised that an allergy test and controlled application be performed prior to treatment with BV (W. R. Zhang et al, 1995). When BV is applied to the human body, mild side effects such as fatigue, localized edema, pruritus, skin rash nausea, and vomiting may occur, as can severe side effects such as limb paralysis, dyspnea, and loss of consciousness (Cheng & Ren, 2004;Ko et al, 2022;Zhang et al, 1995). According to a retrospective study conducted at the hospital between January 2010 and April 2019, only 0.175% of 8580 patients admitted to the hospital reported type 1 hypersensitivity and 0.047% anaphylactic shock (Lee et al, 2020).…”