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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.


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Total IgE during the incremental and maintenance phases in group A (Vespidae 18; Apidae 9; n = 27), group B (Vespidae 16; Apidae 9; n = 25), and group C (Vespidae 16; Apidae 8; n = 24). Vertical bars indicate the mean ± SEM.
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fig3: Total IgE during the incremental and maintenance phases in group A (Vespidae 18; Apidae 9; n = 27), group B (Vespidae 16; Apidae 9; n = 25), and group C (Vespidae 16; Apidae 8; n = 24). Vertical bars indicate the mean ± SEM.

Mentions: Total and specific IgE was monitored before starting VIT, at the end of VIT, and during the study in the three groups (Figures 3 and 4). The serum s-IgE/total IgE ratio has been reported to predict the clinical response to allergen-specific immunotherapy [33]. We compared the serum s-IgE/total IgE ratio in our three groups of patients using the number of SARs before VIT and after hymenoptera sting during the maintenance phase. There was a similar highly significant direct correlation between the sIgE/tIgE post/preultrarush VIT delta and the SAR pre/postultrarush VIT delta in the three groups considered: group A (rho = 0.79; P = 0.034, Spearman rank correlation test), group B (rho = 0.83; P = 0.039, Spearman rank correlation test), and group C (rho = 0.77; P = 0.041, Spearman rank correlation test).


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)

Total IgE during the incremental and maintenance phases in group A (Vespidae 18; Apidae 9; n = 27), group B (Vespidae 16; Apidae 9; n = 25), and group C (Vespidae 16; Apidae 8; n = 24). Vertical bars indicate the mean ± SEM.
© Copyright Policy - open-access
Related In: Results  -  Collection

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fig3: Total IgE during the incremental and maintenance phases in group A (Vespidae 18; Apidae 9; n = 27), group B (Vespidae 16; Apidae 9; n = 25), and group C (Vespidae 16; Apidae 8; n = 24). Vertical bars indicate the mean ± SEM.
Mentions: Total and specific IgE was monitored before starting VIT, at the end of VIT, and during the study in the three groups (Figures 3 and 4). The serum s-IgE/total IgE ratio has been reported to predict the clinical response to allergen-specific immunotherapy [33]. We compared the serum s-IgE/total IgE ratio in our three groups of patients using the number of SARs before VIT and after hymenoptera sting during the maintenance phase. There was a similar highly significant direct correlation between the sIgE/tIgE post/preultrarush VIT delta and the SAR pre/postultrarush VIT delta in the three groups considered: group A (rho = 0.79; P = 0.034, Spearman rank correlation test), group B (rho = 0.83; P = 0.039, Spearman rank correlation test), and group C (rho = 0.77; P = 0.041, Spearman rank correlation test).

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