Allergen specific immunotherapy is safe and effective in patients with systemic mastocytosis and Hymenoptera allergy

Bonadonna, Patrizia; Zanotti, Roberta; Caruso, Beatrice; Castellani, Luca; Perbellini, Omar; Colarossi, Sabrina; Chilosi, Marco; Dama, Annarita; Schiappoli, Michele; Pizzolo, Giovanni; Senna, Gianenrico; Passalacqua, Giovanni

doi:10.1016/j.jaci.2007.10.014

Cited by 64 publications

(46 citation statements)

References 9 publications

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“…13,15,19,32 Moreover, sBT levels positively correlated with the severity of the systemic reaction because 31 (70.5%) of 44 subjects with increased sBT levels had a previous history of anaphylaxis. 13,15,33 An MC clonal disorder was diagnosed in 30 (8%) of 379 of the subjects with systemic reactions to Hymenoptera stings. This could underestimate the real prevalence because the subjects with normal sBT levels did not undergo BM analysis.…”

Section: Discussionmentioning

confidence: 99%

Clonal mast cell disorders in patients with systemic reactions to Hymenoptera stings and increased serum tryptase levels

Bonadonna

Perbellini

Passalacqua

et al. 2009

Journal of Allergy and Clinical Immunology

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256

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Section: Discussionmentioning

confidence: 99%

Clonal mast cell disorders in patients with systemic reactions to Hymenoptera stings and increased serum tryptase levels

Bonadonna

Perbellini

Passalacqua

et al. 2009

Journal of Allergy and Clinical Immunology

Self Cite

357

256

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“…Due to the high risk of relapse after early termination of VIT 41,42 and the low risk of VIT may be recommended in patients with underlying systemic mastocytosis as it is safe and effective IV C Weak based on two case series 45,47 In few patients, sideeffects can be more frequent and severe Bonadonna 2008, 45 2013 47 adverse events, 24,43 a well-tolerated ongoing VIT regime during pregnancy should be continued, using the tolerated VIT maintenance dose administered before pregnancy.…”

Section: Pregnancymentioning

confidence: 99%

“…44 VIT is usually well tolerated by the majority of patients with underlying systemic mastocytosis, 45 although adverse events can occur more frequently. 46 In a recent large study on patients with confirmed systemic mastocytosis and severe initial sting reactions (63% suffered from loss of consciousness), it could be shown that VIT was safe and effective.…”

Section: Mastocytosismentioning

confidence: 99%

“…85 A study performed in patients with mastocytosis concluded that VIT is safe and efficacious, 47 confirming previous data. 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%

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EAACI guidelines on allergen immunotherapy: Hymenoptera venom allergy

Sturm

Varga

Roberts

et al. 2017

Allergy

398

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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“…38 However, the buildup phase of VIT can also induce systemic reactions, particularly in patients with elevated baseline serum tryptase concentration. 38,39 Therefore, it should be done under close supervision and under the cover of premedication with antihistamines and, in some cases, omalizumab. 37,40 Finally, as patient fatalities have been reported following discontinuation of VIT after the usual 3-to 5-year duration, it is now recommended to give VIT for the patient's lifetime in those with an elevated baseline serum tryptase level.…”

Section: Emotions/stress Nsaidsmentioning

confidence: 99%

Expanding Spectrum of Mast Cell Activation Disorders: Monoclonal and Idiopathic Mast Cell Activation Syndromes

Picard

Giavina‐Bianchi

Mezzano

et al. 2013

Clinical Therapeutics

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Allergen specific immunotherapy is safe and effective in patients with systemic mastocytosis and Hymenoptera allergy

Cited by 64 publications

References 9 publications

Clonal mast cell disorders in patients with systemic reactions to Hymenoptera stings and increased serum tryptase levels

Clonal mast cell disorders in patients with systemic reactions to Hymenoptera stings and increased serum tryptase levels

EAACI guidelines on allergen immunotherapy: Hymenoptera venom allergy

Expanding Spectrum of Mast Cell Activation Disorders: Monoclonal and Idiopathic Mast Cell Activation Syndromes

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