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Vol. 147, No. 3, 2008
Issue release date: October 2008
Section title: Original Paper
Int Arch Allergy Immunol 2008;147:241–245
(DOI:10.1159/000142048)

Analysis of Safety, Risk Factors and Pretreatment Methods during Rush Hymenoptera Venom Immunotherapy

Gorska L.a · Chelminska M.a · Kuziemski K.a · Skrzypski M.a · Niedoszytko M.a · Damps-Konstanska I.a · Szymanowska A.a · Siemińska A.a · Wajda B.a · Drozdowska A.a · Jutel M.b · Jassem E.a
aDepartment of Allergology, Medical University of Gdańsk, Gdańsk, and bDepartment of Internal Medicine, Medical University of Wroclaw, Wroclaw, Poland

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 4/2/2007
Accepted: 4/2/2008
Published online: 7/2/2008
Issue release date: October 2008

Number of Print Pages: 5
Number of Figures: 1
Number of Tables: 2

ISSN: 1018-2438 (Print)
eISSN: 1423-0097 (Online)

For additional information: http://www.karger.com/IAA

Abstract

Background: The safety profile of venom immunotherapy is a relevant issue. We evaluated the frequency of severe adverse events (SAE), associated risk factors, retrospective comparison of pretreatment protocols including solely H1 receptor blockers and a combination of H1 and H2 receptor blockers during rush Hymenoptera venom immunotherapy. Methods: The study group comprised 118 patients. The treatment was initiated according to a 5-day rush protocol with the use of standardized venom allergens of either wasp or honeybee. Results: During the rush induction, side effects occurred in 18 patients (15.2%), whereas SAE were present in 7 patients (5.9%). Twelve out of 18 (66.6%) developed anaphylactic reactions on the fourth day of the rush protocol, with the majority of cases at a dose of 40 or 60 µg of the venom extract (p = 0.001). The frequency of SAE was also significantly higher on the fourth day than thereafter (p = 0.0001) as well as in patients allergic to bee venom (p = 0.049). All systemic side effects were more frequent in women (p = 0.0065). However, this relation was not true when SAE were consider (p = 0.11). A higher percentage of SAE was observed in the subjects pretreated with both H1 and H2 receptor antagonists than in those pretreated with H1 blocker only (8.8 vs. 4.1%); however, the difference was not significant. Conclusions: Considerable severity of allergic adverse events requires particular attention to patients allergic to bee venom and during rush phase, especially when rapidly increasing doses are administered. Pretreatment with H2 blockers is debatable and warrants further investigation.


  

Author Contacts

Correspondence to: Dr. Ewa Jassem
Department of Allergology
Medical University of Gdańsk
Debinki Str. 7, PL–80-211 Gdańsk (Poland)
Tel./Fax +48 58 349 16 25, E-Mail ejassem@amg.gda.pl

  

Article Information

Received: April 2, 2007
Accepted after revision: April 2, 2008
Published online: July 2, 2008
Number of Print Pages : 5
Number of Figures : 1, Number of Tables : 2, Number of References : 28

  

Publication Details

International Archives of Allergy and Immunology

Vol. 147, No. 3, Year 2008 (Cover Date: October 2008)

Journal Editor: Valenta R. (Vienna)
ISSN: 1018–2438 (Print), eISSN: 1423–0097 (Online)

For additional information: http://www.karger.com/IAA


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 4/2/2007
Accepted: 4/2/2008
Published online: 7/2/2008
Issue release date: October 2008

Number of Print Pages: 5
Number of Figures: 1
Number of Tables: 2

ISSN: 1018-2438 (Print)
eISSN: 1423-0097 (Online)

For additional information: http://www.karger.com/IAA


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