Reduction of side‐effects from ultrarush immunotherapy with honeybee venom by pretreatment with fexofenadine:a double‐blind, placebo‐controlled trial

Reimers, Andrea; Hari, Yvonne; Müller, Ulrich

doi:10.1034/j.1398-9995.2000.00520.x

Cited by 97 publications

(77 citation statements)

References 17 publications

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“…[65][66][67][68] In detail, it was reported that levocetirizine decreased the rate of SSR 68 and fexofenadine decreased the rate of LLR and cutaneous SSR 67 (Table 3). Importantly, effectiveness of VIT was not negatively influenced.…”

Section: Preventive Pretreatmentmentioning

confidence: 99%

EAACI guidelines on allergen immunotherapy: Hymenoptera venom allergy

Sturm

Varga

Roberts

et al. 2017

Allergy

382

528

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Hymenoptera venom allergy is a potentially life‐threatening allergic reaction following a honeybee, vespid, or ant sting. Systemic‐allergic sting reactions have been reported in up to 7.5% of adults and up to 3.4% of children. They can be mild and restricted to the skin or moderate to severe with a risk of life‐threatening anaphylaxis. Patients should carry an emergency kit containing an adrenaline autoinjector, H1‐antihistamines, and corticosteroids depending on the severity of their previous sting reaction(s). The only treatment to prevent further systemic sting reactions is venom immunotherapy. This guideline has been prepared by the European Academy of Allergy and Clinical Immunology's (EAACI) Taskforce on Venom Immunotherapy as part of the EAACI Guidelines on Allergen Immunotherapy initiative. The guideline aims to provide evidence‐based recommendations for the use of venom immunotherapy, has been informed by a formal systematic review and meta‐analysis and produced using the Appraisal of Guidelines for Research and Evaluation (AGREE II) approach. The process included representation from a range of stakeholders. Venom immunotherapy is indicated in venom‐allergic children and adults to prevent further moderate‐to‐severe systemic sting reactions. Venom immunotherapy is also recommended in adults with only generalized skin reactions as it results in significant improvements in quality of life compared to carrying an adrenaline autoinjector. This guideline aims to give practical advice on performing venom immunotherapy. Key sections cover general considerations before initiating venom immunotherapy, evidence‐based clinical recommendations, risk factors for adverse events and for relapse of systemic sting reaction, and a summary of gaps in the evidence.

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Section: Preventive Pretreatmentmentioning

confidence: 99%

EAACI guidelines on allergen immunotherapy: Hymenoptera venom allergy

Sturm

Varga

Roberts

et al. 2017

Allergy

382

528

View full text Add to dashboard Cite

show abstract

“…When local adverse effects occur, premedication with an H1-antihistamine can be used to reduce the frequency and severity of adverse reactions (Grade A recommendation), but this prophylactic treatment does not prevent the onset of SRs or anaphylaxis. 187,188 Also, studies indicate that modified allergen extracts are associated with less adverse effects. [189][190][191][192] For aluminum hydroxide containing SCIT products, granulomas have been described from a foreign body reaction mainly caused by incorrect intradermal administration as well as contact allergic reactions, new onset of protein contact dermatitis, or a vasculitis inflammatory reactions have been reported.…”

Section: Scitmentioning

confidence: 99%

EAACI Guidelines on Allergen Immunotherapy: Allergic rhinoconjunctivitis

Roberts

Pfaar

Akdiş

et al. 2017

Allergy

561

705

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drawn on data from a systematic review of the literature, more recent published studies and multistakeholder expert clinical opinion. This Guideline is aimed at healthcare professionals who are encouraged to take the recommendations into account in the context of delivering clinical care. This Guideline is not a substitute for professional clinical judgment, which professionals need to exercise in the context of delivering personalised healthcare. AbstractAllergic rhinoconjunctivitis (AR) is an allergic disorder of the nose and eyes affecting about a fifth of the general population. Symptoms of AR can be controlled with allergen avoidance measures and pharmacotherapy. However, many patients continue to have ongoing symptoms and an impaired quality of life; pharmacotherapy may also induce some side-effects. Allergen immunotherapy (AIT) represents the only currently available treatment that targets the underlying pathophysiology, and it may have a disease-modifying effect. Either the subcutaneous (SCIT) or sublingual (SLIT) routes may be used. This Guideline has been prepared by the European Academy of Allergy and Clinical Immunology's (EAACI) Taskforce on AIT for AR and is part of the EAACI presidential project "EAACI Guidelines on Allergen Immunotherapy." It aims to provide evidence-based clinical recommendations and has been informed by a formal systematic review and meta-analysis. Its generation has followed the Appraisal of Guidelines for Research and Evaluation (AGREE II) approach.The process included involvement of the full range of stakeholders. In general, broad evidence for the clinical efficacy of AIT for AR exists but a product-specific evaluation of evidence is recommended. In general, SCIT and SLIT are recommended for both seasonal and perennial AR for its short-term benefit. The strongest evidence for long-term benefit is documented for grass AIT (especially for the grass 766 | ROBERTS, PFAAR ET AL. tablets) where long-term benefit is seen. To achieve long-term efficacy, it is recommended that a minimum of 3 years of therapy is used. Many gaps in the evidence base exist, particularly around long-term benefit and use in children. | ME TH ODOLOGYThis Guideline was produced using the Appraisal of Guidelines forResearch & Evaluation (AGREE II) approach, 17,18 a structured approach to guideline production (see Table S1). This is designed to ensure appropriate representation of the full range of stakeholders, a careful search for and critical appraisal of the relevant literature, a systematic approach to the formulation and presentation of recommendations and steps to ensure that the risk of bias is minimized at each step of the process. The process started on April 2015 beginning with detailed face-to-face discussions agreeing on the process and the key clinical areas to address, followed by face-to-face meetings, and regular web conferences in which professional and lay representatives participated. | Clarifying the scope and purpose of the guidelinesThe scope of this EAACI Guideline is multifaceted...

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“…The response to rApi m 2 was not significant. Phenotype B includes patients who might benefit from specific interventions from early on, such as premedication during bVIT (which has already been proposed as a means of achieving better tolerance [27][28][29]), different build-up phases, or use of higher venom doses [30].…”

Section: Clinical Changes Bvit Safetymentioning

confidence: 99%

IgE-Api m 4 Is Useful for Identifying a Particular Phenotype of Bee Venom Allergy

Ruiz¹,

Serrano²,

Moreno‐Aguilar³

2016

J Investig Allergol Clin Immunol

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Background and Objective: Different clinical behaviors have been identified in patients allergic to bee venom. Compound-resolved diagnosis could be an appropriate tool for investigating these differences. The aims of this study were to analyze whether specific IgE to Api m 4 (sIgE-Api m 4) can identify a particular kind of bee venom allergy and to describe response to bee venom immunotherapy (bVIT). Methods: Prospective study of 31 patients allergic to bee venom who were assigned to phenotype group A (sIgE-Api m 4 <0.98 kU/L), treated with native aqueous (NA) extract, or phenotype group B (sIgE-Api m 4 ≥0.98 kU/L), treated with purified aqueous (PA) extract. Sex, age, cardiovascular risk, severity of preceding sting reaction, exposure to beekeeping, and immunological data (intradermal test, sIgE/ sIgG4-Apis-nApi m 1, and sIgE-rApi m 2-Api m 4 were analyzed. Systemic reactions (SRs) during bVIT build-up were analyzed. Immunological and sting challenge outcomes were evaluated in each group after 1 and 2 years of bVIT. Results: Phenotype B patients had more severe reactions (P=.049) and higher skin sensitivity (P=.011), baseline sIgE-Apis (P=.0004), sIgE-nApi m 1 (P=.0004), and sIgG4-Apis (P=.027) than phenotype A patients. Furthermore, 41% of patients in group B experienced SRs during the build-up phase with NA; the sting challenge success rate in this group was 82%. There were no significant reductions in serial intradermal test results, but an intense reduction in sIgE-nApi m 1 (P=.013) and sIgE-Api m 4 (P=.004) was observed after the first year of bVIT. Conclusion: Use of IgE-Api m 4 as the only discrimination criterion demonstrated differences in bee venom allergy. Further investigation with larger populations is necessary.

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Reduction of side‐effects from ultrarush immunotherapy with honeybee venom by pretreatment with fexofenadine:a double‐blind, placebo‐controlled trial

Abstract: Pretreatment with fexofenadine during venom immunotherapy reduces local allergic reactions and generalized symptoms of the urticaria and angioedema type.

Cited by 97 publications

References 17 publications

EAACI guidelines on allergen immunotherapy: Hymenoptera venom allergy

EAACI guidelines on allergen immunotherapy: Hymenoptera venom allergy

EAACI Guidelines on Allergen Immunotherapy: Allergic rhinoconjunctivitis

IgE-Api m 4 Is Useful for Identifying a Particular Phenotype of Bee Venom Allergy

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