Safety and tolerability of venom immunotherapy: Evaluation of 581 rush- and ultra-rush induction protocols (safety of rush and ultra-rush venom immunotherapy).

BTC, basal tryptase concentration BV, bee venom Bee venom allergy Hymenoptera venom immunotherapy IgE, Immunoglobulin E R, rush Rush protocol UR, ultra-rush Ultra-rush protocol VIT, venom immunotherapy VV, vespid venom Vespid venom allergy f, female m, male ml, millilitres n, number of patients y, years μL, microlitres

Journal

The World Allergy Organization journal
ISSN: 1939-4551
Titre abrégé: World Allergy Organ J
Pays: United States
ID NLM: 101481283

Informations de publication

Date de publication:
Jan 2021
Historique:
received: 02 06 2020
revised: 05 11 2020
accepted: 20 11 2020
entrez: 30 12 2020
pubmed: 31 12 2020
medline: 31 12 2020
Statut: epublish

Résumé

Current literature is inconsistent regarding the risk of severe side effects using accelerated induction protocols in Hymenoptera venom immunotherapy (VIT). In addition, several data indicate the influence of purity grade of venom preparation on tolerability. We evaluated the safety and tolerability of ultra-rush and rush build-up protocols using purified and non-purified venom preparations. Retrospective single-center study of 581 VIT inductions (325 ultra-rush and 256 rush protocols) from 2005 to 2018 in 559 patients with bee and vespid venom allergy using aqueous purified (ALK SQ®) for ultra-rush protocol and aqueous non-purified (ALK Reless®) venom preparations for rush protocol. Urticaria (8% vs. 3.1%, p = 0,013) and dose reductions (4.3% vs. 1.2%, p = 0,026) were significantly more frequent in the ultra-rush group. Overall rate of moderate-to-severe side effects (anaphylaxis Rush and ultra-rush protocols show an excellent safety profile with only infrequent and mild anaphylactic reactions in bee and vespid venom allergy. Ultra-rush immunotherapy reduces the duration of the inpatient build-up phase setting and thus is viewed by the authors as preferred treatment in Hymenoptera venom allergic patients.

Sections du résumé

BACKGROUND BACKGROUND
Current literature is inconsistent regarding the risk of severe side effects using accelerated induction protocols in Hymenoptera venom immunotherapy (VIT). In addition, several data indicate the influence of purity grade of venom preparation on tolerability. We evaluated the safety and tolerability of ultra-rush and rush build-up protocols using purified and non-purified venom preparations.
METHODS METHODS
Retrospective single-center study of 581 VIT inductions (325 ultra-rush and 256 rush protocols) from 2005 to 2018 in 559 patients with bee and vespid venom allergy using aqueous purified (ALK SQ®) for ultra-rush protocol and aqueous non-purified (ALK Reless®) venom preparations for rush protocol.
RESULTS RESULTS
Urticaria (8% vs. 3.1%, p = 0,013) and dose reductions (4.3% vs. 1.2%, p = 0,026) were significantly more frequent in the ultra-rush group. Overall rate of moderate-to-severe side effects (anaphylaxis
CONCLUSION CONCLUSIONS
Rush and ultra-rush protocols show an excellent safety profile with only infrequent and mild anaphylactic reactions in bee and vespid venom allergy. Ultra-rush immunotherapy reduces the duration of the inpatient build-up phase setting and thus is viewed by the authors as preferred treatment in Hymenoptera venom allergic patients.

Identifiants

DOI: 10.1016/j.waojou.2020.100496 PMID: 33376576 PMC: PMC7750415
pubmed: 33376576
doi: 10.1016/j.waojou.2020.100496
pii: S1939-4551(20)30399-9
pmc: PMC7750415
doi:

Types de publication

Journal Article

Langues

eng

Pagination

100496

Informations de copyright

© 2020 The Authors.

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Auteurs

Richard Stock (R)

Department of Dermatology, Venereology and Allergology, University Hospital, Goethe University of Frankfurt, Theodor Stern Kai 7, D-60590, Frankfurt am Main, Germany.

Tatjana Fischer (T)

Department of Dermatology, Venereology and Allergology, University Hospital, Goethe University of Frankfurt, Theodor Stern Kai 7, D-60590, Frankfurt am Main, Germany.

Katharina Aẞmus (K)

Department of Dermatology, Venereology and Allergology, University Hospital, Goethe University of Frankfurt, Theodor Stern Kai 7, D-60590, Frankfurt am Main, Germany.

Nadja Zoeller (N)

Department of Dermatology, Venereology and Allergology, University Hospital, Goethe University of Frankfurt, Theodor Stern Kai 7, D-60590, Frankfurt am Main, Germany.

Hanns Ackermann (H)

Institute for Biostatistics, University Hospital, Goethe University of Frankfurt, Theodor Stern Kai 7, D-60590, Frankfurt, Germany.

Roland Kaufmann (R)

Department of Dermatology, Venereology and Allergology, University Hospital, Goethe University of Frankfurt, Theodor Stern Kai 7, D-60590, Frankfurt am Main, Germany.

Markus Meissner (M)

Department of Dermatology, Venereology and Allergology, University Hospital, Goethe University of Frankfurt, Theodor Stern Kai 7, D-60590, Frankfurt am Main, Germany.

Eva Valesky (E)

Department of Dermatology, Venereology and Allergology, University Hospital, Goethe University of Frankfurt, Theodor Stern Kai 7, D-60590, Frankfurt am Main, Germany.

Classifications MeSH