title: Reduction of side-effects from ultrarush immunotherapy with honeybee venom by pretreatment with fexofenadine: a double-blind, placebo-controlled trial.
abstract: BACKGROUND
  Immunotherapy with Hymenoptera venoms is highly effective but causes allergic side-effects frequently, especially when honeybee venom is used. Therefore, our objective was to investigate the effect of pretreatment with the antihistamine fexofenadine on the incidence of allergic side-effects during ultrarush immunotherapy with bee venom.
  
  
  METHODS
  In a double-blind, placebo-controlled trial, 57 patients with a history of systemic allergic reactions to honeybee stings and positive diagnostic tests (skin tests, serum specific IgE to honeybee venom) were investigated. Bee venom immunotherapy was started with an ultrarush protocol and patients were randomized to pretreatment with either fexofenadine 180 mg or placebo on days 1, 8, 22, and 50 of the protocol. Local and systemic allergic side-effects were registered.
  
  
  RESULTS
  Fifty-four patients completed the study, 28 on fexofenadine and 26 on placebo pretreatment. On day 1, large local reactions were significantly reduced in both extension and duration by fexofenadine pretreatment (P<0.025). Systemic allergic side-effects on the whole were not reduced. However, the symptoms pruritus, urticaria, and angioedema occurred less frequently with fexofenadine (P<0.05).
  
  
  CONCLUSIONS
  Pretreatment with fexofenadine during venom immunotherapy reduces local allergic reactions and generalized symptoms of the urticaria and angioedema type.
authors.affiliation: Medical Division Zieglerspital, Bern, Switzerland.
authors.forename: A
authors.initials: A
authors.lastname: Reimers
authors.forename: Y
authors.initials: Y
authors.lastname: Hari
authors.forename: U
authors.initials: U
authors.lastname: Müller
mesh_terms: D000293:Adolescent; D000328:Adult; D000799:Angioedema / Q000628:therapy; D018926:Anti-Allergic Agents / Q000627:therapeutic use*; D001514:Bee Venoms / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D011537:Pruritus / Q000628:therapy; D012882:Skin Tests; D016593:Terfenadine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D014581:Urticaria / Q000628:therapy
chemical_list: D018926:Anti-Allergic Agents; D001514:Bee Venoms; D016593:Terfenadine; C093230:fexofenadine