Safety and tolerability during build-up phase of a rush venom immunotherapy

Bernkopf, Kathleen; Rönsch, Henriette; Spornraft‐Ragaller, Petra; Neumeister, Volker; Bauer, Andrea

doi:10.1016/j.anai.2016.02.014

Cited by 14 publications

(8 citation statements)

References 56 publications

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“…A recent meta‐analysis of venom allergen immunotherapy (VIT) indicated a substantial improvement of the quality of life in VIT‐treated patients . In VIT, a 3‐day rush protocol is possible, although associated with a risk of local (42%) and systemic adverse reactions (10%) . The efficacy of subcutaneous immunotherapy for allergic rhinitis and asthma was recently confirmed by systematic reviews .…”

Section: Subcutaneous Allergen Immunotherapy (Scit)mentioning

confidence: 99%

Allergen immunotherapy in people, dogs, cats and horses – differences, similarities and research needs

Mueller¹,

Jensen‐Jarolim

Roth‐Walter

et al. 2018

Allergy

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In human patients with seasonal allergic rhinoconjunctivitis sensitized to grass pollen, the first successful allergen immunotherapy (AIT) was reported in 1911. Today, immunotherapy is an accepted treatment for allergic asthma, allergic rhinitis and hypersensitivities to insect venom. AIT is also used for atopic dermatitis and recently for food allergy. Subcutaneous, epicutaneous, intralymphatic, oral and sublingual protocols of AIT exist. In animals, most data are available in dogs where subcutaneous AIT is an accepted treatment for atopic dermatitis. Initiating a regulatory response and a production of "blocking" IgG antibodies with AIT are similar mechanisms in human beings and dogs with allergic diseases. Although subcutaneous immunotherapy is used for atopic dermatitis in cats, data for its efficacy are sparse. There is some evidence for successful treatment of feline asthma with AIT. In horses, most studies evaluate the effect of AIT on insect hypersensitivity with conflicting results although promising pilot studies have demonstrated the prophylaxis of insect hypersensitivity with recombinant antigens of biting midges (Culicoides spp.). Optimizing AIT using allergoids, peptide immunotherapy, recombinant allergens and new adjuvants with the different administration types of allergen extracts will further improve compliance and efficacy of this proven treatment modality.

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Section: Subcutaneous Allergen Immunotherapy (Scit)mentioning

confidence: 99%

Allergen immunotherapy in people, dogs, cats and horses – differences, similarities and research needs

Mueller¹,

Jensen‐Jarolim

Roth‐Walter

et al. 2018

Allergy

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“…Ruëff et al [6] found that bee VIT, high levels of baseline tryptase, CVD, antihypertension medication, and older age were risk factors for SR. Data regarding the risk of concurrent BB or ACE-i treatment are based mostly on expert opinions and on a few case reports from the 1980s [10,11,12]. Bernkopf et al [13] found that concurrent ACE-i treatment, but not BB treatment, was a risk factor for VIT-ISR in a cohort of wasp-allergic patients undergoing RVIT. Müller and Haeberli [14] failed to demonstrate an increased risk of systemic adverse effects in patients receiving concurrent BB treatment during VIT, but their cohort consisted of only 4 patients during the build-up phase.…”

Section: Discussionmentioning

confidence: 99%

Venom Immunotherapy in High-Risk Patients: The Advantage of the Rush Build-Up Protocol

Rosman

Confino‐Cohen²,

Goldberg³

2017

Int Arch Allergy Immunol

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Background: Venom immunotherapy (VIT) is considered to be the gold standard treatment for patients with hymenoptera venom allergy. This treatment induces systemic reactions (SR) in a significant number of patients. Objective: To evaluate the outcome of VIT in patients with known risk factors for VIT-induced SR and to compare rush VIT (RVIT) and conventional VIT (CVIT). Methods: All of the patients who received VIT and had at least one of the following risk factors were included: current cardiovascular disease, uncontrolled asthma, high basal serum tryptase, current treatment with β-blockers or angiotensin-converting enzyme inhibitors, and age >70 or <5 years. Results: Sixty-four patients were included, and most of them (52; 81.5%) were allergic exclusively to bee venom. Thirty-five (54.7%) patients underwent RVIT and 29 CVIT. The incidence of patients who developed SR during the build-up phase was similar for RVIT and CVIT (25.7 and 27.5%, respectively; p = 1). However, the incidence of SR per injection was significantly higher in CVIT than in RVIT (5.6 and 2.75%, respectively; p = 0.01). Most reactions (79.1%) were mild, limited to the skin. Most of the patients (92.1%) reached the full maintenance dose of 100 μg. This dose was reached by a significantly larger number of patients receiving RVIT compared to CVIT (100 and 82.7%, respectively; p = 0.01). None of the patients experienced exacerbation of their concurrent chronic disease during VIT. Conclusion: VIT can be performed safely and efficiently in patients with risk factors for immunotherapy. In these patients RVIT appears to be safer and more efficient than CVIT.

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“…Nie stwierdzono w trakcie AIT zwiększonego ryzyka wystąpienia reakcji anafilaktycznych u pacjentów stosujących IEK [4]. W jednym z badań wykazano, że u chorych uczulonych na jad owadów błonkoskrzydłych przyjmowanie IEK było niezależnym czynnikiem ryzyka wystąpienia systemowej reakcji w trakcie zwiększania dawki metodą rush [5]. Inne badania nie potwierdziły jednak tej obserwacji.…”

Section: Ryzyko Wystąpienia Reakcji Anafilaktycznejunclassified

Treatment strategies of co-existing non-allergic diseases in relation to allergen immunotherapy

Kowal¹

2018

pja

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StreSzczenie Choroby alergiczne często współwystępują z innymi chorobami, takimi jak choroby sercowo-naczyniowe, metaboliczne i nowotworowe. Powoduje to ryzyko wystąpienia interakcji pomiędzy immunoterapią alergenową (AIT) a lekami stosowanymi w terapii chorób współistniejących. Ryzyko polega na wpływie leczenia chorób współistniejących na skuteczność i/lub bezpieczeństwo AIT, jak również na wpływie AIT na leczenie chorób współistniejących. Podejmowanie decyzji dotyczących stosowania AIT u osób ze współistniejącymi chorobami powinno opierać się na dogłębnej analizie ryzyka i korzyści z zaplanowanego leczenia przeprowadzonej przez doświadczonego alergologa. Słowa kluczowe immunoterapia alergenowa, choroby współistniejące.

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Safety and tolerability during build-up phase of a rush venom immunotherapy

Cited by 14 publications

References 56 publications

Allergen immunotherapy in people, dogs, cats and horses – differences, similarities and research needs

Allergen immunotherapy in people, dogs, cats and horses – differences, similarities and research needs

Venom Immunotherapy in High-Risk Patients: The Advantage of the Rush Build-Up Protocol

Treatment strategies of co-existing non-allergic diseases in relation to allergen immunotherapy

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