Safety and efficacy of an imported fire ant rush immunotherapy protocol with and without prophylactic treatment

Abstract

RIT with IFA WBE for IFA hypersensitivity is both safe and efficacious; the rate of mild systemic reactions is low. Premedication is not necessary, inasmuch as prophylactic pretreatment with antihistamines and steroids did not reduce the systemic reaction rate associated with RIT.

Stinging insect hypersensitivity: A practice parameter update 2011

“…4,13,15,[56][57][58] Fire ant whole-body extract has been shown to contain relevant venom allergens, and evidence continues to accumulate, despite the absence of a placebocontrolled study, to support its efficacy for use as a diagnostic and therapeutic agent. 12,13,15,16,18,44,57,59,68 The current criteria for immunotherapy for fire ant allergy are similar to those for other Hymenoptera (ie, a history of a systemic reaction and demonstration of fire ant antigen-specific IgE antibodies by means of skin or in vitro testing). Controversy exists regarding the management of children who have systemic reactions that are confined to the skin.…”

“…4,13,15,[56][57][58] Fire ant wholebody extract has been shown to contain relevant venom allergens, and evidence continues to accumulate, despite the lack of any placebo-controlled study, to support the effectiveness of immunotherapy with fire ant whole-body extract. 12,[15][16][17][18]44,59 Recommendations for immunotherapy with fire ant whole-body extract are generally the same as those for VIT. 14 Patients who have experienced a systemic reaction to an insect sting should be given a prescription for an injectable epinephrine device and be advised to carry it with them at all times.…”

“…Prompt recognition and treatment of systemic reactions and appropriate allergy management, as described in this practice parameter, can reduce the occurrence of future systemic reactions and fatalities. 14,15,31,32,56,59,67,68 This parameter addresses the management of allergic reactions from yellow jacket, hornet, wasp, honeybee, and imported fire ant stings. Much less is known about allergic reactions to stings of other insects, and they are not the subject of this parameter.…”

Ketotifen use in a patient with fire ant hypersensitivity and mast cell activation syndrome

“…Therefore, they used a modified version of the Wilford-Hall IFA-WBE 2-day rush protocol. 8 Given her high risk of mortality from IFA venom, history of IFA-WBE immunotherapy-induced anaphylaxis, and MCAS, the authors administered the immunotherapy protocol in an intensive care setting and monitored her respiratory status with frequent bedside spirometry. The protocol is presented in Table 1.…”

Specific immunotherapy using Hymenoptera venom: systematic review

“…There are only observational studies that have validated immunotherapy with whole-body extract to treat hypersensitivity to the venom from this type of ant. [19][20][21] other relevant information Even though the evidence is based only on one trial 7 and on observational studies, 11,22-25 the efficacy of specific-venom immunother-apy for avoiding anaphylaxis to bee stings or venom is well accepted. This recommendation can be found in an important manual 26 published conjointly by three major allergy and immunology societies: the American College and the American Academy of Allergy, Asthma and Immunology (ACAAI and AAAAI); and the Joint Council of Allergy, Asthma and Immunology.…”