The Hymenoptera venom study III: Safety of venom immunotherapy2

Lockey, Richard F.; Turkeltaub, Paul C.; Olive, Emory S.; Hubbard, James; Baird-Warren, Irene A.; Bukantz, Samuel C.

doi:10.1016/s0091-6749(05)80182-4

Cited by 164 publications

(144 citation statements)

References 6 publications

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“…Many studies have shown that bee venom is an independent risk factor for adverse reactions during immunotherapy [12,14,18,[23][24][25], whereas others showed no significant difference in the number of systemic reactions when comparing patients receiving wasp or bee venom extract [26]. However, our findings could well be the result of the small sample size.…”

Section: Discussioncontrasting

confidence: 66%

Insect Venom Immunotherapy: Analysis of the Safety and Tolerance of 3 Buildup Protocols Frequently Used in Spain

Fernández

Moreno-Ancillo

Melendez³

et al. 2016

J Investig Allergol Clin Immunol

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Introduction: Hymenoptera venom immunotherapy (VIT) is an effective treatment but not one devoid of risk, as both local and systemic adverse reactions may occur, especially in the initial phases. We compared the tolerance to 3 VIT buildup protocols and analyzed risk factors associated with adverse reactions during this phase. Materials and Methods: We enrolled 165 patients divided into 3 groups based on the buildup protocol used (3, 4, and 9 weeks). The severity of systemic reactions was evaluated according to the World Allergy Organization model. Results were analyzed using exploratory descriptive statistics, and variables were compared using analysis of variance. Results: Adverse reactions were recorded in 53 patients (32%) (43 local and 10 systemic). Local reactions were immediate in 27 patients (63%) and delayed in 16 (37%). The severity of the local reaction was slight/moderate in 15 patients and severe in 13. Systemic reactions were grade 1-2. No significant association was found between the treatment modality and the onset of local or systemic adverse reactions or the type of local reaction. We only found a statistically significant association between severity of the local reaction and female gender. As for the risk factors associated with systemic reactions during the buildup phase, we found no significant differences in values depending on the protocol used or the insect responsible. Conclusions: The buildup protocols compared proved to be safe and did not differ significantly from one another. In the population studied, patients undergoing the 9-week schedule presented no systemic reactions. Therefore, this protocol can be considered the safest approach.

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Section: Discussioncontrasting

confidence: 66%

Insect Venom Immunotherapy: Analysis of the Safety and Tolerance of 3 Buildup Protocols Frequently Used in Spain

Fernández

Moreno-Ancillo

Melendez³

et al. 2016

J Investig Allergol Clin Immunol

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“…venom-specific IgE levels, or skin test reactivity at low venom concentrations. 84,85 Conventional regimes appear to be best tolerated, while rush and ultra-rush protocols are more frequently associated with adverse events. 24 …”

Section: Preventive Pretreatmentmentioning

confidence: 99%

“…45 Although still a debated issue, ACE inhibitors and beta-blockers are not considered to be independent risk factors for adverse events. [23][24][25] Importantly, severe initial sting reactions, 24,25,84 positive skin tests at low test concentrations and high specific IgE levels 25,84,85 are not regarded as risk factors for adverse events ( …”

Section: Effectiveness During/after Maintenance Vitmentioning

confidence: 99%

EAACI guidelines on allergen immunotherapy: Hymenoptera venom allergy

Sturm

Varga

Roberts

et al. 2017

Allergy

385

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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“…Although this classical form of immunotherapy is beneficial for the treatment of rhinitis and insect venom allergy, it is less effective in allergic asthma (3)(4)(5). Moreover, immunotherapy can induce severe systemic reactions, such as asthma exacerbations and anaphylactic shock, due to cross-linking of allergen-specific IgE on mast cells (6).…”

Section: The Efficacy Of Immunotherapy In An Experimentalmentioning

confidence: 99%

The Efficacy of Immunotherapy in an Experimental Murine Model of Allergic Asthma Is Related to the Strength and Site of T Cell Activation During Immunotherapy

Janssen

Oosterhout

Nijkamp

et al. 2000

The Journal of Immunology

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In the present study, the relation between the efficacy of immunotherapy, and the strength and site of T cell activation during immunotherapy was evaluated. We used a model of allergic asthma in which OVA-sensitized and OVA-challenged mice display increased airway hyperresponsiveness, airway inflammation, and Th2 cytokine production by OVA-specific T cells. In this model, different immunotherapy strategies, including different routes of administration, or treatment with entire OVA or the immunodominant T cell epitope OVA323–339, or treatment with a peptide analogue of OVA323–339 with altered T cell activation capacity were studied. To gain more insight in how immunotherapy affects allergen-specific T cells, the site of Ag-specific T cell activation and the magnitude of the T cell response induced during different immunotherapy strategies were determined using an adoptive transfer model. Our data suggest that amelioration of airway hyperresponsiveness and inflammation is associated with the induction of a strong, synchronized, and systemic T cell response, resulting in a decreased OVA-specific Th2 response. In contrast, deterioration of the disease after immunotherapy is associated with the induction of a weak nonsynchronized T cell response, resulting in the enhancement of the OVA-specific Th2 response after challenge.

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The Hymenoptera venom study III: Safety of venom immunotherapy2

Cited by 164 publications

References 6 publications

Insect Venom Immunotherapy: Analysis of the Safety and Tolerance of 3 Buildup Protocols Frequently Used in Spain

Insect Venom Immunotherapy: Analysis of the Safety and Tolerance of 3 Buildup Protocols Frequently Used in Spain

EAACI guidelines on allergen immunotherapy: Hymenoptera venom allergy

The Efficacy of Immunotherapy in an Experimental Murine Model of Allergic Asthma Is Related to the Strength and Site of T Cell Activation During Immunotherapy

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