The incidence and nature of adverse reactions to injection immunotherapy in bee and wasp venom allergy

Abstract

The incidence, time course and nature of systemic reactions to injections of bee and wasp venom during immunotherapy have been estimated in an open, prospective, single centre study. One hundred and nine survivors of moderate to severe systemic reactions to stings from hymenoptera, received courses of bee or wasp venom by monthly subcutaneous injection for up to 3 years. Systemic reactions were recorded after 7.5% of 946 weekly venom injections during the initial phase of treatment, and after 2.1% of 1789 monthly maintenance injections. In both phases of treatment, reactions were more frequent after bee (17% of initial phase, 7.8% of maintenance treatment) than after wasp (3% of initial phase, 0.3% of maintenance treatment) venom injections. The percentage of patients experiencing at least one reaction was also higher for bee (46%) than for wasp (14%) sensitive patients. Over 80% of reactions began within 30 min of injection, over 90% within 1 h and only two (2%), between 1 and 2 h, the remaining six (5.5%) starting more than 2 h after injection. Only 0.47% of venom injections produced a systemic reaction which was severe enough to require adrenaline treatment. The female patients experienced more reactions (21% of the wasp, 60% of the bee, sensitive) than the males (5.5% wasp, 20% bee). Age and atopy did not appear to be significant risk factors for systemic reactions. We conclude that wasp and bee venom immunotherapy in a conventional dosage regimen was generally well tolerated.(ABSTRACT TRUNCATED AT 250 WORDS)

Induction of Specific Immunotherapy with Hymenoptera Venoms Using Ultrarush Regimen in Children: Safety and Tolerance

“…The results presented in this paper compare favourably with the frequency of side effects reported in adults and with the incidence of severe adverse reactions in conventional and rush protocols [5, 7, 15–20]. The ultrarush induction protocol performed in a paediatric intensive or intermediate care unit allows for much better monitoring of the patients compared to the conventional desensitization protocol performed in an outpatient setting.…”

The nociceptive and anti-nociceptive effects of bee venom injection and therapy: A double-edged sword

“…Bee venom immunotherapy (VIT, also termed as allergen-specific immunotherapy) is a medical treatment of patients with hypersensitivity to bee venom by vaccination with increasingly larger doses of an allergen (substances to which they are allergic) to induce immunologic tolerance. VIT began to be in use in the 1970s and has been demonstrated to be an effective medical practice to treat bee sting allergic disorders (Busse et al, 1975; Muller et al, 1979; Bousquet et al, 1988; Kay and Lessof, 1992; Youlten et al, 1995; Blaauw et al, 1996; Muller, 2003; Winther et al, 2006; Bilo and Bonifazi, 2007). Allergen-specific immunotherapy is the only treatment strategy which treats the underlying cause of the allergic disorder.…”

Analysis of Safety, Risk Factors and Pretreatment Methods during Rush Hymenoptera Venom Immunotherapy

“…Conflicting data pointing to the conventional [24], rush [14, 16, 17, 25] or ultrarush [18, 19] method as safe result from comparing different populations, extracts, preparations (aqueous or depot) and a variety of comorbidities in different populations. Brehler et al [18] showed a decreased incidence of side effects during 2-day ultrarush VIT as compared with 3- to 6-day and 7- to 9-day protocols.…”