The VISYT trial: Venom Immunotherapy Safety and Tolerability with purified vs nonpurified extracts

Bilò, Maria Beatrice; Severino, Maurizio; Cilia, M.; Pio, Antonio; Casino, G; Ferrarini, E; Campodonico, Patrizia; Milani, Massimo

doi:10.1016/s1081-1206(10)60144-5

Cited by 38 publications

(23 citation statements)

References 10 publications

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“…52,145 Use of purified extracts potentially reduces large local reactions during venom immunotherapy. 146 Venom immunotherapy can be safely administered to all those at risk, including high-risk patients with mastocytosis or clonal mast cell disorders, although a slow rate of dose escalation is often necessary in such patients. 147,148 Anti-IgE antibody is reported to be useful in controlling reactions to venom immunotherapy in patients with mastocytosis.…”

Section: Long-term Risk Reduction: Prevention Of Anaphylaxismentioning

confidence: 99%

Anaphylaxis

Simons

2010

Journal of Allergy and Clinical Immunology

397

380

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Anaphylaxis occurs commonly in community settings. The rate of occurrence is increasing, especially in young people. Understanding potential triggers, mechanisms, and patient-specific risk factors for severity and fatality is the key to performing appropriate risk assessment in those who have previously experienced an acute anaphylactic episode. The diagnosis of anaphylaxis is based primarily on clinical criteria and is valid even if the results of laboratory tests, such as serum total tryptase levels, are within normal limits. Positive skin test results or increased serum specific IgE levels to potential triggering allergens confirm sensitization but do not confirm the diagnosis of anaphylaxis because asymptomatic sensitization is common in the general population. Important patient-related risk factors for severity and fatality include age, concomitant diseases, and concurrent medications, as well as other less well-defined factors, such as defects in mediator degradation pathways, fever, acute infection, menses, emotional stress, and disruption of routine. Prevention of anaphylaxis depends primarily on optimal management of patient-related risk factors, strict avoidance of confirmed relevant allergen or other triggers, and, where indicated, immunomodulation (eg, subcutaneous venom immunotherapy to prevent Hymenoptera sting-triggered anaphylaxis, an underused, potentially curative treatment). The benefits and risks of immunomodulation to prevent food-triggered anaphylaxis are still being defined. Epinephrine (adrenaline) is the medication of first choice in the treatment of anaphylaxis. All patients at risk for recurrence in the community should be equipped with 1 or more epinephrine autoinjectors; a written, personalized anaphylaxis emergency action plan; and up-to-date medical identification. Improvements in the design of epinephrine autoinjectors will help to optimize ease of use and safety. Randomized controlled trials of pharmacologic agents, such as antihistamines and glucocorticoids, are needed to strengthen the evidence base for treatment of acute anaphylactic episodes.

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Section: Long-term Risk Reduction: Prevention Of Anaphylaxismentioning

confidence: 99%

Anaphylaxis

Simons

2010

Journal of Allergy and Clinical Immunology

397

380

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“…In fact, antigen-specific IT is the only treatment that can afford long-lasting protection against allergic disease after therapy is finished (78) . However, IT has been shown to be very effective in the treatment of rhinitis and insect venom allergy but less beneficial in allergic asthma (78)(79)(80) .…”

Section: Resultsmentioning

confidence: 99%

Influence of polyphenols on allergic immune reactions: mechanisms of action

Magrone

Jirillo

2012

Proc. Nutr. Soc.

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The increased incidence of allergic disease seems to rely on many factors. Among them, the association between genetic variations of the immune response and environmental pressure by allergens, infectious agents and pollutants should be taken into consideration. In alternative to conventional treatments with corticosteroids and antihistaminics, nutraceuticals have been shown to act on allergic disease either during allergic sensitisation or on consolidated disease. In this review, special emphasis is placed on the effects of dietary polyphenols on three major allergic diseases, namely atopic eczema, food allergy and asthma. Interference of polyphenols with T-helper 2 activation seems to be the main mechanism of their inhibitory effects on allergy development. Moreover, deficits of T-regulatory cells seem to play a pathogenic role in allergic disease and, therefore, these cells may represent a major target of polyphenol activity

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“…60 Purified aqueous preparations cause smaller local reactions compared with nonpurified aqueous preparations. 61 A systematic literature review has documented a similar rate of systemic adverse events when depot and aqueous venom allergen preparations were used, but the difference between purified and nonpurified aqueous preparations was not taken into account. 62 A comparative study in honeybee venom-allergic patients indicates the superiority of the purified aqueous preparations over the corresponding nonpurified aqueous preparation under the same rush protocol in terms of systemic reactions during the build-up phase 63 ( Table 3).…”

Section: Preparation Of Venommentioning

confidence: 99%

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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The VISYT trial: Venom Immunotherapy Safety and Tolerability with purified vs nonpurified extracts

Cited by 38 publications

References 10 publications

Anaphylaxis

Anaphylaxis

Influence of polyphenols on allergic immune reactions: mechanisms of action

EAACI guidelines on allergen immunotherapy: Hymenoptera venom allergy

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