Safety and efficacy of venom immunotherapy: a real life study

Abstract

IntroductionVenom immunotherapy (VIT) is recommended as the first-line treatment for patients allergic to Hymenoptera venom.AimTo analyze the safety and efficacy of VIT in a real life setting.Material and methodsOne hundred and eighty patients undergoing VIT were studied to evaluate the safety, efficacy, incidence and nature of symptoms after field stings and adverse reactions to VIT.ResultsSignificantly more patients were allergic to wasp than bee venom (146 vs. 34, p < 0.0001). Early and late side effects were more common during the maintenance (48 patients, 26.7%) than during the induction of VIT (32 patients, 17.8%), were more frequent in patients allergic to bees, and were not associated with angiotensin convertase inhibitors (ACEi) or β-adrenergic antagonists use. Systemic reactions were observed in 4 individuals on wasp VIT (2.7%) and in 6 patients allergic to bees (17.65%). The VIT was efficacious as most patients reported no reactions (50%) or reported only mild local reactions (43.75%) to field stings. The decrease in sIgE at completion of VIT correlated with the dose of vaccine received (r = 0.53, p = 0.004). Beekeeping (RR = 29.54, p < 0.0001) and female sex (RR = 1.27, p = 0.033) were associated with a higher risk of venom allergy.ConclusionsVenom immunotherapy is highly efficacious and safe as most of the adverse events during the induction and maintenance phase are mild and local. Side effects of VIT are more common in subjects on bee VIT. Beekeeping and female sex are associated with a higher risk of allergy to Hymenoptera venom.

Safety of specific immunotherapy using an ultra-rush induction regimen in bee and wasp allergy

“…This finding is consistent with previous studies. 8,9,10 The rapid protocols were safer than the conventional therapy, but these differences were frequently on the boundary of statistical significance. The safety of the rapid protocol has been compared many times since 1980.…”

“…However, there were also opposing findings, for example, men are more susceptible to allergic adverse reactions during bee venom VIT. 10 Our observational study focused on one type of vaccine -Venomenhal (Hal Allergy, Leiden, Netherlands). This homogeneity resulted in greater reliability for comparing adverse reactions in patients.…”

Apitherapy for Osteoarthritis: Perspectives from Basic Research

“…The application of BV generally leads to frequent adverse reactions such as pruritus and edema at the site of application [85]. Although allergy to BV has been described, it is not frequent and the use of an allergy test allows its identification in a timely manner [86,87]. The allergy to propolis, honey, royal jelly, and pollen, although they have been described, are much less frequent [88][89][90].…”

Simultaneous up‐dosing of bee and vespid venom immunotherapy is safe

“…In recent studies, objective systemic adverse events (AE) were reported in 2.7 to 17.8% of patients. [1][2][3] It is well known that systemic AEs occur more frequently during the up-dosing phase of bee VIT compared with vespid VIT. 1,4,5 However, the rate of AEs was usually analyzed in mono-venom immunotherapy or in stepwise dual immunotherapy Ninety-two patients were treated with bee venom, 435 with vespid venom, and 123 simultaneously with bee and vespid venom; the rate of systemic AEs was 10.9%, 6.4%, and 10.6%, respectively.…”