Citation

Kayikci H, Bostan OC, Tuncay G, Cihanbeylerden M, Damadoglu E, Karakaya G, Kalyoncu AF. Allergy Asthma Proc. 2024; 45(4): 268-275.

Copyright

(Copyright © 2024, OceanSide Publications)

DOI

10.2500/aap.2024.45.240035

PMID

38982604

Abstract

BACKGROUND: Being stung by Hymenoptera species can cause life-threatening anaphylaxis. Although venom immunotherapy (VIT) seems to be the most effective treatment, its long-term efficacy, and risk factors for adverse events remain unclear.

OBJECTIVE: The objective was to investigate the long-term efficacy of VIT and evaluate adverse events and risk factors related to this.

METHOD: Patients who received VIT in a tertiary-care adult allergy clinic between January 2005 and July 2022 were included. Patients' data were compared with those of individuals who had been diagnosed with bee and/or wasp venom allergy during the same period but had not received VIT and experienced field re-stings.

RESULTS: The study included 105 patients with venom allergy, of whom 68 received VIT and 37 did not receive VIT. Twenty-three patients (34%) completed 5 years of VIT, and the overall mean ± standard deviation VIT duration was 46.9 ± 20.9 months. Re-stings occurred in 5 of 23 patients who completed 5 years of VIT, and none of them developed a systemic reaction. Eighteen patients (40%) experienced re-stings after prematurely discontinuing VIT, of whom eight (44%) developed a systemic reaction. In the control group of patients who did not receive VIT, 26 patients (70.3%) experienced re-stings, and all had systemic reactions (100%), with no change in their median Mueller scores. There was a significant difference in the median Mueller score change between the patients who received VIT and the controls who did not (p = 0.016). A total of 13 patients (19%) experienced adverse events while receiving VIT, which were systemic reactions in nine honeybee VIT. The use of β-blockers was determined as the most important risk factor (odds ratio 15.9 [95% confidence interval, 1.2-208.8]; p = 0.035).

CONCLUSION: It was confirmed that VIT was effective in both reducing the incidence and the severity of re-sting reactions. These effects were more pronounced in the patients who completed 5 years of VIT.

Language: en

Keywords

Humans; Risk Factors; Adult; Aged; Female; Male; Middle Aged; Animals; Young Adult; Treatment Outcome; *Anaphylaxis/prevention & control/etiology; *Bee Venoms/immunology/therapeutic use/adverse effects; *Desensitization, Immunologic/methods/adverse effects; *Hymenoptera/immunology; *Insect Bites and Stings/immunology/therapy; Allergens/immunology/administration & dosage; Arthropod Venoms/immunology/adverse effects/therapeutic use; Hypersensitivity/therapy; Wasp Venoms/immunology/adverse effects/therapeutic use