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TOPLINE
Venom immunotherapy demonstrated a favorable safety profile, with low rates of adverse reactions, and provided sustained protection against severe systemic reactions in children and adolescents with Hymenoptera venom allergy.
METHODOLOGY
- To assess the safety and efficacy of venom immunotherapy, researchers conducted an observational study of 40 children and adolescents (87.5% male) with Hymenoptera venom allergy; all were advised to start venom immunotherapy at a tertiary allergy center in Italy between 1999 and 2023, following a systemic allergic reaction to Hymenoptera sting.
- Venom immunotherapy was given subcutaneously using commercially available extracts, starting at 0.01 µg and reaching a maintenance dose of 100 µg. During maintenance, injections were given every 4 weeks during the first year and progressively extended up to every 8 weeks by the fifth year.
- Patients were stratified by immunotherapy duration; 67.5% completed at least 5 years of treatment, 20.0% received immunotherapy for 3-4 years, and 12.5% discontinued immunotherapy before 3 years.
- Outcomes included adverse reactions to immunotherapy, re-stings during and after immunotherapy, and venom-specific immunoglobulin E (IgE) levels measured before and after completion of immunotherapy.
TAKEAWAY
- Adverse reactions occurred in 37.5% of those treated for 3-4 years and in 29.6% of those completing at least 5 years of immunotherapy, with local reactions being most common among those completing 5 years or more. No severe systemic reactions were reported, and adrenaline was never required to treat a reaction.
- During therapy, re-stings occurred in 75.0% of those treated for at least 3 years and in 66.7% of those completing at least 5 years. Among those re-stung, 33.3% and 5.6%, respectively, had Mueller grade 1 reactions, with no moderate-to-severe systemic reactions reported.
- After the discontinuation of therapy, 33.3% of those completing at least 5 years were re-stung; no one experienced a systemic reaction or required adrenaline, suggesting sustained protection.
- Venom-specific IgE levels significantly decreased after completion of immunotherapy (P = .004).
IN PRACTICE
"VIT [Venom immunotherapy] is confirmed as the only treatment able to modify the natural history of HVA [Hymenoptera venom allergy], protecting patients with IgE-mediated allergies from systemic reactions after subsequent stings and improving patients' quality of life," the authors wrote.
SOURCE
Valentina Gueli, with the University of Verona in Verona, Italy, was the corresponding author of the study, which was published online on August 17 in Pediatric Allergy and Immunology.
LIMITATIONS
The study's retrospective design, inclusion of parent-reported events, potential recall bias, and relatively small sample size may have limited the interpretation of its findings. Changes in product availability, diagnostic platforms, and clinical practice over the 24-year study period may have influenced findings.
DISCLOSURES
The authors reported no specific funding and no relevant conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
