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Hymenoptera Venom Immunotherapy: Tolerance and Efficacy of an Ultrarush Protocol versus a Rush and a Slow Conventional Protocol.

Patella V, Florio G, Giuliano A, Oricchio C, Spadaro G, Marone G, Genovese A - J Allergy (Cairo) (2012)

Bottom Line: Reactions to accidental Hymenoptera stings did not differ among groups (1.1%, 1.2%, and 1.1%).Conclusion.Ultrarush was as effective as the rush and slow protocols and was associated with a low incidence of reactions to stings.

View Article: PubMed Central - PubMed

Affiliation: Division of Allergy and Clinical Immunology, Department of Medicine, Hospital of Agropoli, ASL, Salerno, 84043 Agropoli, Italy.

ABSTRACT
Background and Objective. Various venom immunotherapy (VIT) protocols are available for Hymenoptera allergy. Although adverse reactions (ADRs) to VIT are widely reported, controlled trials are still needed. We conducted a randomized prospective study to evaluate ADRs and the efficacy of three VIT regimens. Methods. 76 patients with Hymenoptera allergy, aged 16-76 years, were randomized to receive an ultrarush protocol (group A: 27 patients), a rush protocol (group B: 25), or a slow protocol (group C: 24). Aqueous venom extract was used in incremental phase and an adsorbed depot in maintenance phase. ADRs and accidental Hymenoptera stings during VIT were used to evaluate efficacy. Results. During incremental treatment, ADRs occurred in 1.99%, 3.7%, and 3.9% of patients in groups A, B, and C, and in 0.99%, 1.46%, and 2.7%, respectively, during maintenance. ADRs were significantly fewer in group A (incremental + maintenance phase) than in group C (1.29% versus 3.2%; P = 0.013). Reactions to accidental Hymenoptera stings did not differ among groups (1.1%, 1.2%, and 1.1%). Conclusion. Ultrarush was as effective as the rush and slow protocols and was associated with a low incidence of reactions to stings. This study indicates that ultrarush VIT is a valid therapeutic option for Hymenoptera allergy.

No MeSH data available.


Related in: MedlinePlus

Frequency of local side effects in three groups of patients treated according to different venom immunotherapy (VIT) protocols (see Methods for treatments). Results are shown per injections (□) and per patients (▪). Each bar represents the mean ± SEM. *P < 0.05 compared with the corresponding group A versus group B. **P < 0.001 compared with the corresponding group A versus group C.
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fig1: Frequency of local side effects in three groups of patients treated according to different venom immunotherapy (VIT) protocols (see Methods for treatments). Results are shown per injections (□) and per patients (▪). Each bar represents the mean ± SEM. *P < 0.05 compared with the corresponding group A versus group B. **P < 0.001 compared with the corresponding group A versus group C.

Mentions: During the incremental phase of venom immunotherapy, the numbers of LLR (defined as a swelling of more than 10 cm in diameter, lasting longer than 24 h) [9] were 7 out of 351 injections in group A (1.99%); 12/375 in group B (3.2%); 13/356 in group C (3.6%) (Figure 1). During the incremental phase, no SAR occurred in patients in group A (0/351 injections); two SARs occurred in group B (2/375; 0.9% of injections); one in group C (1/356; 0.56% of injections) (Figure 2). The rate of ADRs did not differ among the three groups: group A 7/351 (1.99%); group B 14/375 (3.7%); group C 14/356 (3.9%); (P = 0.27). During the incremental phase, two patients of group C withdrew from the study (at the fourth and seventh weeks). Adverse reactions were not the reasons for withdrawal. No patients in groups A and B withdrew from the trial.


Hymenoptera Venom Immunotherapy: Tolerance and Efficacy of an Ultrarush Protocol versus a Rush and a Slow Conventional Protocol.

Patella V, Florio G, Giuliano A, Oricchio C, Spadaro G, Marone G, Genovese A - J Allergy (Cairo) (2012)

Frequency of local side effects in three groups of patients treated according to different venom immunotherapy (VIT) protocols (see Methods for treatments). Results are shown per injections (□) and per patients (▪). Each bar represents the mean ± SEM. *P < 0.05 compared with the corresponding group A versus group B. **P < 0.001 compared with the corresponding group A versus group C.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3368199&req=5

fig1: Frequency of local side effects in three groups of patients treated according to different venom immunotherapy (VIT) protocols (see Methods for treatments). Results are shown per injections (□) and per patients (▪). Each bar represents the mean ± SEM. *P < 0.05 compared with the corresponding group A versus group B. **P < 0.001 compared with the corresponding group A versus group C.
Mentions: During the incremental phase of venom immunotherapy, the numbers of LLR (defined as a swelling of more than 10 cm in diameter, lasting longer than 24 h) [9] were 7 out of 351 injections in group A (1.99%); 12/375 in group B (3.2%); 13/356 in group C (3.6%) (Figure 1). During the incremental phase, no SAR occurred in patients in group A (0/351 injections); two SARs occurred in group B (2/375; 0.9% of injections); one in group C (1/356; 0.56% of injections) (Figure 2). The rate of ADRs did not differ among the three groups: group A 7/351 (1.99%); group B 14/375 (3.7%); group C 14/356 (3.9%); (P = 0.27). During the incremental phase, two patients of group C withdrew from the study (at the fourth and seventh weeks). Adverse reactions were not the reasons for withdrawal. No patients in groups A and B withdrew from the trial.

Bottom Line: Reactions to accidental Hymenoptera stings did not differ among groups (1.1%, 1.2%, and 1.1%).Conclusion.Ultrarush was as effective as the rush and slow protocols and was associated with a low incidence of reactions to stings.

View Article: PubMed Central - PubMed

Affiliation: Division of Allergy and Clinical Immunology, Department of Medicine, Hospital of Agropoli, ASL, Salerno, 84043 Agropoli, Italy.

ABSTRACT
Background and Objective. Various venom immunotherapy (VIT) protocols are available for Hymenoptera allergy. Although adverse reactions (ADRs) to VIT are widely reported, controlled trials are still needed. We conducted a randomized prospective study to evaluate ADRs and the efficacy of three VIT regimens. Methods. 76 patients with Hymenoptera allergy, aged 16-76 years, were randomized to receive an ultrarush protocol (group A: 27 patients), a rush protocol (group B: 25), or a slow protocol (group C: 24). Aqueous venom extract was used in incremental phase and an adsorbed depot in maintenance phase. ADRs and accidental Hymenoptera stings during VIT were used to evaluate efficacy. Results. During incremental treatment, ADRs occurred in 1.99%, 3.7%, and 3.9% of patients in groups A, B, and C, and in 0.99%, 1.46%, and 2.7%, respectively, during maintenance. ADRs were significantly fewer in group A (incremental + maintenance phase) than in group C (1.29% versus 3.2%; P = 0.013). Reactions to accidental Hymenoptera stings did not differ among groups (1.1%, 1.2%, and 1.1%). Conclusion. Ultrarush was as effective as the rush and slow protocols and was associated with a low incidence of reactions to stings. This study indicates that ultrarush VIT is a valid therapeutic option for Hymenoptera allergy.

No MeSH data available.


Related in: MedlinePlus