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Factors Affecting the Safety and Effectiveness of Venom Immunotherapy
L. Arzt-Gradwohl, SA. Herzog, W. Aberer, T. Alfaya Arias, D. Antolín-Amérigo, P. Bonadonna, E. Boni, A. Bożek, M. Chełmińska, B. Ebner, N. Frelih, R. Gawlik, A. Gelincik, T. Hawranek, W. Hoetzenecker, A. Jiménez Blanco, K. Kita, R. Kendirlinan,...
Language English Country Spain
Document type Journal Article, Multicenter Study, Observational Study
PubMed
37937715
DOI
10.18176/jiaci.0967
Knihovny.cz E-resources
- MeSH
- Allergens immunology administration & dosage MeSH
- Histamine Antagonists therapeutic use MeSH
- Adrenergic beta-Antagonists therapeutic use MeSH
- Desensitization, Immunologic * methods adverse effects MeSH
- Child MeSH
- Adult MeSH
- Angiotensin-Converting Enzyme Inhibitors therapeutic use adverse effects MeSH
- Insect Bites and Stings immunology MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Prospective Studies MeSH
- Aged MeSH
- Treatment Outcome MeSH
- Venoms immunology adverse effects therapeutic use MeSH
- Animals MeSH
- Check Tag
- Child MeSH
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Observational Study MeSH
BACKGROUND: The safety profile of venom immunotherapy (VIT) is a relevant issue, and considerable differences have been reported in the safety and efficacy of this treatment modality. The primary aim of this study was to evaluate the safety of angiotensin-converting enzyme inhibitors and ß-blockers during VIT. In a second analysis, we evaluated data on premedication and venom preparations and their association with systemic adverse events (AEs) during the up-dosing phase and the first year of the maintenance phase, as well as the outcome of field stings and sting challenges. METHODS: Ours was an open, prospective, observational, multicenter study that recruited 1425 patients, of whom 1342 underwent VIT. RESULTS: Premedication with oral antihistamines was taken by 52.1% of patients during up-dosing and 19.7% of patients during the maintenance phase. Antihistamines had no effect on the frequency of systemic AEs (P=.11), although large local reactions (LLRs) were less frequent (OR, 0.74; 95%CI, 0.58-0.96; P=.02). Aqueous preparations were preferred for up-dosing (73.0%), and depot preparations were used for the maintenance phase (64.5%). The type of venom preparation had no influence on the frequency of systemic AEs or on the effectiveness of VIT (P=.26 and P=.80, respectively), while LLRs were less frequent with depot preparations (P<.001). CONCLUSIONS: Pretreatment with oral antihistamines during VIT significantly reduces the frequency of LLRs but not systemic AEs. All venom preparations were equally effective and did not differ in terms of the frequency of systemic AEs.
Allergology Department Medical University of Gdańsk Gdańsk Poland
Allergy Department Hospital Universitario Fundación Alcorcón Madrid Spain
Allergy Outpatient Clinic Reumannplatz Vienna Austria
Allergy Unit Sant ́Anna Hospital Como Italy
Allergy Unit Verona General Hospital Verona Italy
Clinical Allergology Department Pomeranian Medical University Szczecin Poland
Department of Dermatology and Allergology Paracelsus Medical University Salzburg Salzburg Austria
Department of Dermatology and Allergy University Hospital Würzburg Würzburg Germany
Department of Dermatology and Venereology Medical University of Graz Graz Austria
Department of Dermatology General Hospital Ordensklinikum Linz GmbH Elisabethinen Linz Austria
Department of Immunology and Allergology University Hospital Pilsen Czech Republic
High Specialization Unit of Allergology Hospital of Faenza AUSL of Romagna Romagna Italy
Laboratorio Unico Metropolitano Maggiore Hospital Bologna Italy
SD Allergologia Clinica Azienda Ospedaliero Universitaria Pisana Pisa Italy
Servicio de Alergia Hospital Universitario Ramón y Cajal Madrid Spain
University Clinic of Respiratory and Allergic Diseases Golnik and Medical Faculty Ljubljana Slovenia
University Clinic of Respiratory and Allergic Diseases Golnik Slovenia
References provided by Crossref.org
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