TOPLINE:

A novel 4‑day outpatient Hymenoptera venom immunotherapy showed a favorable safety profile, with only 4.4% of systemic reactions requiring emergency intervention compared with 9.3% and 12.9% for traditional rush and ultra‑rush inpatient regimens, respectively.

METHODOLOGY:

• Researchers conducted a retrospective analysis at Heidelberg University Hospital, including 560 patients who underwent 566 venom immunotherapy treatments between January 2010 and December 2024.
• They compared three protocols for honeybee or vespid venom allergy: a novel 4-day outpatient venom immunotherapy (n = 363; mean age, 53 years; 54.5% female), a 3-day inpatient rush regimen (n = 118; mean age, 54 years; 51.7% female), and a 2-day inpatient ultra-rush regimen (n = 85; mean age, 52 years; 57.6% female).
• The primary outcome was the incidence of systemic allergic reactions requiring emergency intervention during the buildup phase.

TAKEAWAY:

• The novel outpatient venom immunotherapy showed a lower rate of systemic reactions requiring emergency intervention (4.4%) than the rush (9.3%) and ultra-rush (12.9%) therapies.
• The novel therapy was independently associated with a reduced risk for systemic reactions (odds ratio, 0.33; 95% CI, 0.17-0.66; P = .002).
• None of the patients required epinephrine for the treatment of systemic reactions.

IN PRACTICE:

“Our novel protocol effectively combines the benefits of both conventional outpatient schedules and accelerated inpatient regimens. It provides protection as quickly as inpatient protocols with a low rate of adverse events comparable to that of cost-effective outpatient approaches,” the authors of the study wrote. “Additionally, the use of minimal premedication, a lower total venom dose, and only two daily injections further enhance the practicality of our protocol,” they added.

SOURCE:

Knut Schäkel, MD, Heidelberg University Hospital, Heidelberg, Germany, was the corresponding author of the study, which was published online on November 23, 2025, in Annals of Allergy, Asthma & Immunology.

LIMITATIONS:

The retrospective, single-center design of the study and the lack of randomization may have limited its generalizability. Treatment groups were nonconcurrent — protocols ran at different times, including during the COVID pandemic. Buildup phase safety appeared favorable; however, long‑term outcome data for venom immunotherapy were limited.

DISCLOSURES:

Two authors reported receiving grants from the Deutsche Forschungsgemeinschaft.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.