PLoS ONE (Jan 2013)

Clinical effectiveness of hymenoptera venom immunotherapy: a prospective observational multicenter study of the European academy of allergology and clinical immunology interest group on insect venom hypersensitivity.

  • Franziska Ruëff,
  • Bernhard Przybilla,
  • Maria Beatrice Biló,
  • Ulrich Müller,
  • Fabian Scheipl,
  • Michael J Seitz,
  • Werner Aberer,
  • Anna Bodzenta-Lukaszyk,
  • Floriano Bonifazi,
  • Paolo Campi,
  • Ulf Darsow,
  • Gabrielle Haeberli,
  • Thomas Hawranek,
  • Helmut Küchenhoff,
  • Roland Lang,
  • Oliviero Quercia,
  • Norbert Reider,
  • Peter Schmid-Grendelmeier,
  • Maurizio Severino,
  • Gunter Johannes Sturm,
  • Regina Treudler,
  • Brunello Wüthrich

DOI
https://doi.org/10.1371/journal.pone.0063233
Journal volume & issue
Vol. 8, no. 5
p. e63233

Abstract

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BackgroundTreatment failure during venom immunotherapy (VIT) may be associated with a variety of risk factors.ObjectiveOur aim was to evaluate the association of baseline serum tryptase concentration (BTC) and of other parameters with the frequency of VIT failure during the maintenance phase.MethodsIn this observational prospective multicenter study, we followed 357 patients with established honey bee or vespid venom allergy after the maintenance dose of VIT had been reached. In all patients, VIT effectiveness was either verified by sting challenge (n = 154) or patient self-reporting of the outcome of a field sting (n = 203). Data were collected on BTC, age, gender, preventive use of anti-allergic drugs (oral antihistamines and/or corticosteroids) right after a field sting, venom dose, antihypertensive medication, type of venom, side effects during VIT, severity of index sting reaction preceding VIT, and duration of VIT. Relative rates were calculated with generalized additive models.Results22 patients (6.2%) developed generalized symptoms during sting challenge or after a field sting. A strong association between the frequency of VIT failure and BTC could be excluded. Due to wide confidence bands, however, weaker effects (odds ratios InterpretationIt is unlikely that an elevated BTC has a strong negative effect on the rate of treatment failures. The magnitude of the latter, however, may depend on the method of effectiveness assessment. Failure rate is higher in patients suffering from bee venom allergy.