Prolonged interval maintenance venom immunotherapy.
Current guidelines recommend indefinite administration of venom immunotherapy at 4-week intervals. To simplify this therapy, we examined the clinical and immunologic response after extending the interval between maintenance venom injections to 6, 8, and 12 weeks. Twenty-six patients who had had sting anaphylaxis and positive skin tests received maintenance bee or yellow jacket venom immunotherapy at greater or equal to 6-week intervals. This extended interval was started after a prior average 4-week maintenance interval of 2.3 years. Injections were given at 6-week intervals to all 26 patients and extended to 8-week intervals in 10, and 12-week intervals in 3 patients. Following venom injections, there were 14 mild local reactions and no systemic reactions. No adjustment in dosing was necessary. While on prolonged interval maintenance venom immunotherapy, there were 17 re-stings in 12 patients with no systemic reactions. During prolonged interval maintenance venom immunotherapy, either the serum venom-specific IgG increased or the already elevated titers remained the same in 18 patients and decreased in 2. In the others, preexisting titers were low and unchanged. Serum venom-specific IgE tended to slowly decrease. These clinical and immunologic data suggest that a 4-week maintenance interval may be safely extended.
Goldberg
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Department of Medicine, State University of New York, Buffalo.
Reisman
R E
RE
D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D002648:Child; D000939:Epitopes; D006801:Humans; D006967:Hypersensitivity / Q000097:blood / Q000628:therapy; D007073:Immunoglobulin E / Q000032:analysis; D007167:Immunotherapy / Q000379:methods*; D007299:Insect Bites and Stings; D007313:Insecta; D008875:Middle Aged; D013997:Time Factors; D014688:Venoms / Q000276:immunology / Q000627:therapeutic use*
D000939:Epitopes; D014688:Venoms; D007073:Immunoglobulin E