Safety and Efficacy of a Progressively Prolonged Maintenance Interval of Venom Immunotherapy.
Int Arch Allergy Immunol
; 176(1): 39-43, 2018.
Article
em En
| MEDLINE
| ID: mdl-29649812
ABSTRACT
BACKGROUND:
The long-term protection provided by venom immunotherapy (VIT) is related to the dose administered and to its long duration; the latter, however, becomes inconvenient for patients in countries like Greece, with many islanders or inhabitants of distant mountainous areas. Maintenance interval prolongation reduces the number of office visits - saving time and money - and as a consequence contributes to the patients' compliance. The aim of this prospective study was to evaluate the safety and efficacy of VIT on a progressively prolonged maintenance interval (PPMI).METHOD:
450 venom-allergic patients were reviewed for participation in our study; all of them were initially treated with a modified rush or an ultrarush protocol using freshly reconstituted, pure venoms. Upon reaching the maintenance dose, the VIT interval was scheduled to be gradually prolonged - by 1 week each time - aiming at a maximal interval of 26 weeks.RESULTS:
267/450 patients consented to participate in our VIT PPMI protocol 98 were treated with vespid(s) venom, 142 with honeybee venom, and 27 with both. The mean duration of patient follow-up was 9.1 ± 4.2 years. The majority of systemic reactions due to VIT injections occurred up to the 8-weeks PPMI; few additional reactions were documented in a small fraction (2.9%) of our patient population beyond 9 weeks and up to 16 weeks; all were caused by honeybee VIT. No reactions were observed during VIT administration at the 26-week interval. Ninety-six patients reported 204 field sting occurrences by the culprit insect. Ten systemic reactions (8 mild and 2 moderate in severity) were registered between the 9- and 18-week PPMI; the honeybee was the culprit insect in all cases. 108 field stings by the offending insect were sustained beyond the 20- and up to the 26-week PPMI; there were no reactions at all.CONCLUSIONS:
Progressively prolonging the VIT maintenance interval up to 26 weeks appears to be safe and efficacious.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Venenos de Vespas
/
Vespas
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Venenos de Abelha
/
Abelhas
/
Dessensibilização Imunológica
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Hipersensibilidade Imediata
/
Mordeduras e Picadas de Insetos
Tipo de estudo:
Etiology_studies
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Observational_studies
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Prognostic_studies
Limite:
Animals
/
Humans
País como assunto:
Europa
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article