Incidence Rate of Hypersensitivity Reactions to Bee-Venom Acupuncture

Abstract

Introduction: Bee-venom acupuncture (BVA) has been widely applied to various disorders including pain-related diseases; however, patients are often warned of adverse reactions such as anaphylaxis. This study aimed to estimate the risk of hypersensitivity reactions to BVA and to determine their clinical features. Methods: We retrospectively surveyed the medical records of patients treated by BVA between January 2010 and April 2019 in Dunsan Hospital of Daejeon University, and all cases of allergic reactions and their clinical symptoms were analyzed. Results: A total of 8,580 patients (males 4,081 and females 4,499) were treated with BVA which amounts to a total of 60,654 treatments (average 7.1 ± 14.8 times). A total of fifteen patients (7 males and 8 females) reported an allergic reaction (0.175%, 95% CI, 0.086-0.263) of type 1 hypersensitivity, indicating a rate of allergic reaction in 0.025% (95% CI, 0.012-0.037) of the total BVA treatments. The average number of BVA treatments in those patients was 6.9 ± 6.5 (males: 4.1 ± 3.4 and females: 9.3 ± 7.9). Among the cases of hypersensitivity reactions, 4 involved anaphylactic shock; therefore, the incidence rate of anaphylaxis was 0.047% (95% CI, 0.001-0.092) for the 8,580 subjects and 0.007% (95% CI, 0.000-0.013) for the 60,654 treatments. All grade 1 cases were recovered within 1 day, whereas others took up to 30 days for complete recovery. Conclusion: Our results may emphasize paying attention to unforeseeable risks of anaphylaxis after bee-venom acupuncture. This study could be essential reference data for the guidelines of appropriate use of bee-venom acupuncture and bee-venom-derived interventions in clinical applications.

Investigation of the Adverse Events Associated with Bee Venom Pharmacopuncture in Patients Hospitalized in a Korean Hospital: A Retrospective Chart Review 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 ]). This difference is assumed to result from the proportion of women (≥60%), a higher mean number of procedures in the present study compared to other studies and differences between investigators in determining causality between the drug and AEs due to the limitation of the retrospective study design.…”

“…In traditional East Asian medicine, BVP is used for the treatment of various diseases. Studies on the incidence of AEs and relevant factors are continuously published to prevent and identify AEs that can occur when performing BVP [ 6 , 7 , 8 , 10 ].…”

“…A single-center, large-scale retrospective study and systematic review of the incidence of AEs related to BVP as well as AE conditions has been conducted. However, since most previous studies included patients with musculoskeletal disorders, neoplasms or autoimmune diseases, there is a lack of studies on patients with internal diseases such as cardiovascular and respiratory disorders, who are relatively vulnerable to bee stings and patients with various disorders [ 6 , 7 , 8 ].…”

Sweet Bee Venom Triggers Multiple Cell Death Pathways or Spurs Acute Cell Rupture According to Its Concentration in THP-1 Monocytic Leukemia Cells

“…Therapeutic approaches using BV have been tried in various forms, including direct administration of live bee stings and BV acupuncture [ 20 , 21 ]. Despite the successful clinical outcome of BV as a pharmacological drug, it has also been shown to have unexpected side effects such as anaphylaxis [ 22 ]. Anaphylaxis by BV has been reported by several papers, but actual cases might be far more numerous [ 16 , 23 ].…”

Bee Venom and Its Biological Effects

“…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). The incidence of anaphylactic shock seen during treatment with penicillin, an antibiotic that has been used for a long time in the treatment of many infections, has been reported to be between 0.02-0.04% (Patterson & Stankewicz, 2021).…”