Immunotherapy in Bee Sting Hypersensitivity

Müller, Ulrich; U, Thurnheer; Patrizzi, R.; Spiess, Joachim; Hoigné, R

doi:10.1111/j.1398-9995.1979.tb02006.x

Cited by 104 publications

(53 citation statements)

References 18 publications

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“…Graft 1984, 73 Hunt 1978, 28 Müller 1979, 74 Schuberth 1983, 75 Thurneer 1983, 49 Tsicopoulos 1988, 76 Wyss 1993, 77 Yunginger 1979 78 a Brown 2003, 79 Hunt 1978, 28 Schuberth 1983, 75 Valentine 1990 Studies using standardised venom extract in any form of immunotherapy (subcutaneous or sublingual) were included. All appropriate allergens were included at all doses and all durations of treatment.…”

Section: Health-related Quality Of Lifementioning

confidence: 99%

A systematic review of the clinical effectiveness and cost-effectiveness of Pharmalgen® for the treatment of bee and wasp venom allergy.

Hockenhull

Elremeli²,

Cherry³

et al. 2012

Health Technol Assess

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An electronic version of this title, in Adobe Acrobat format, is available for downloading free of charge for personal use from the HTA website (www.hta.ac.uk). A fully searchable DVD is also available (see below).Printed copies of HTA journal series issues cost £20 each (post and packing free in the UK) to both public and private sector purchasers from our despatch agents.Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per issue and for the rest of the world £3 per issue. How to order:-fax (with credit card details) -post (with credit card details or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you to either print out your order or download a blank order form. Contact details are as follows:Synergie UK (HTA Department) Digital House, The Loddon Centre Wade Road Basingstoke Hants RG24 8QW Email: orders@hta.ac.uk Tel: 0845 812 4000 -ask for 'HTA Payment Services' (out-of-hours answer-phone service) Fax: 0845 812 4001 -put 'HTA Order' on the fax header Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to University of Southampton and drawn on a bank with a UK address.Paying by credit card You can order using your credit card by phone, fax or post. SubscriptionsNHS libraries can subscribe free of charge. Public libraries can subscribe at a reduced cost of £100 for each volume (normally comprising 40-50 titles). The commercial subscription rate is £400 per volume (addresses within the UK) and £600 per volume (addresses outside the UK). Please see our website for details. Subscriptions can be purchased only for the current or forthcoming volume.How do I get a copy of HTA on DVD?Please use the form on the HTA website (www.hta.ac.uk/htacd/index.shtml). HTA on DVD is currently free of charge worldwide.The website also provides information about the HTA programme and lists the membership of the various committees. NIHR Health Technology Assessment programmeThe Health Technology Assessment (HTA) programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care. The research findings from the HTA programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'National Knowledge Service' . The HTA programme is needs led in that it fills gaps in the evidence needed by the NHS. There are three routes to the start of projects. First is the commissioned route. Suggestions for research are ...

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Section: Health-related Quality Of Lifementioning

confidence: 99%

A systematic review of the clinical effectiveness and cost-effectiveness of Pharmalgen® for the treatment of bee and wasp venom allergy.

Hockenhull

Elremeli²,

Cherry³

et al. 2012

Health Technol Assess

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“…Some studies investigated the effective amounts of single venom allergens, which suggested 3 µg for Dol a 5 and Dol m 5 respectively from Dolichovespula arenaria and Dolichovespula maculata, 5 µg for Ves g 5 from Vespula germanica, and in 12 µg for Api m 1 from Apis mellifera [30,31].…”

Section: Hymenoptera Venommentioning

confidence: 99%

Dose dependence of efficacy and safety of subcutaneous immunotherapy

Incorvaia

Frati

Panina-Bordignon

et al. 2016

Monaldi Arch Chest Dis

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A number of experimental and clinical evidence has shown that exposure to high amounts of allergen molecules favours the development of tolerance. This is true also for subcutaneous immunotherapy (SCIT), for which a dose dependence of clinical efficacy was clearly demonstrated. The effective doses, measured as μg of major allergens, to be administered during maintenance treatment were established for the main allergens. Regarding pollens, the range of effectiveness corresponds to 25-41 and 13-20 μg of major allergens Phl p 5 and Phl p 6 for grasses, to 10-47 μg of Amb a 1 for ragweed, to 12 μg of Bet v 1 for birch, and to 6.2 μg of Par j 1 for Parietaria. With house dust mites, a maintenance dose of 5-11.5 μg of the major allergen from Dermatophagoides pteronyssinus Der p 1 is associated to clinically relevant effects, and with cat epithelium the clinical success is observed using a dose of 13-15 μg of Fel d 1. Nevertheless, there are adverse reactions facing SCIT, which are related to the amount of injected allergen. In fact, the safety decreases when the administered doses increase. This has led to “optimal doses” being defined which show a good balance between efficacy and safety (corresponding for example to a dose of 7 μg for Der p 1 and of 13 μg for Fel d 1). The dose dependency with respect to both efficacy and safety makes essential to accurately consider the risk/benefit ratio in each patient eligible for SCIT.

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“…Complete protection following VIT has been described in 75 to over 90% of patients (37, 57, 65). However, treatment failures have been reported in most studies (25,341,46,57,65,69). In the "Insect Venom Group of the Arbeitsgemeinschaft Dermatologische Forschung", 41 treatment failures were observed, 36 patients were allergic to bee venom and five to vespid venoms (Rzany, personal communication).…”

Section: Efficacy Of Venom Immunotherapymentioning

confidence: 99%

“…All endeavour to obtain satisfactory protection in the majority, minimize side effects, and optimize convenience for the patients. Rush protocols (11,57,59,82,86,88,90) usually achieve rapid protection but give a higher frequency of untoward systemic reactions. Slow schedules are better tolerated but protective doses are only reached after several months (66).…”

Section: Schedules For Venom Immunotherapymentioning

confidence: 99%

Immunotherapy with Hymenoptera venoms

Bousquet¹,

Müller

Dreborg

et al. 1987

Allergy

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Immunotherapy with Hymenoptera venoms is widely used throughout the world and is accepted as an effective treatment for most patients with Hymenoptera venom allergy. There are, however, still some unresolved problems with this form of treatment. At present there is no definite test which makes it possible to identify patients at risk ‐ and thus candidates for immunotherapy ‐ unequivocally. On the basis of prospective studies on the natural history of Hymenoptera allergy, venom immunotherapy is indicated in adults with severe systemic anaphylaxis. It is usually not necessary in patients with large local reactions only. Children with mild systemic reactions, e.g. urticaria, will need immunotherapy only in case of repeated reactions and/or a high risk of re‐exposure. The selection of venoms for immunotherapy may lead to some confusion owing to common antigenic determinants shared by venoms of various Hymenoptera species. Many different regimens for immunotherapy have been proposed. At present, the three main are: rush, stepwise or clustered and classical. The maintenance dose of 100 μg usually protects from life‐threatening reactions. However, in some patients 200 μg are necessary for complete protection. The usual interval between maintenance injections is 4 to 6 weeks. In many patients a strong increase of venom specific serum IgG‐antibodies usually parallels clinical protection induced by venom immunotherapy, although many exceptions have been reported. Allergic side effects of venom immunotherapy are not rare, especially with honey bee venom and during the initial phase of dose increase. The question of the duration of venom immunotherapy is handled differently: although some authors recommend treatment for life, most suggest treating patients until skin tests and RAST become negative.

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Immunotherapy in Bee Sting Hypersensitivity

Cited by 104 publications

References 18 publications

A systematic review of the clinical effectiveness and cost-effectiveness of Pharmalgen® for the treatment of bee and wasp venom allergy.

A systematic review of the clinical effectiveness and cost-effectiveness of Pharmalgen® for the treatment of bee and wasp venom allergy.

Dose dependence of efficacy and safety of subcutaneous immunotherapy

Immunotherapy with Hymenoptera venoms

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