Effectiveness of specific immunotherapy in the treatment of hymenoptera venom hypersensitivity: a meta-analysis.
BACKGROUND
For most people, Hymenoptera stings produce a transient, local inflammatory reaction (pain, redness, swelling). However, for those who are allergic to components of this venom, the reactions can be severe, frightening, and sometimes fatal. Specific immunotherapy (SIT) has been the only means of desensitizing patients who have experienced a systemic reaction to this venom.


OBJECTIVE
This meta-analysis was conducted to compare the effects of SIT in the treatment of Hymenoptera venom hypersensitivity.


METHODS
All studies of SIT in the treatment of Hymenoptera venom hypersensitivity published in English between the years 1966 and 1996 were identified through a MEDLINE search. Because of the ethical difficulties involved in designing a double-blind, placebo-controlled study in this patient population, most of the studies were open and not placebo-controlled. One author (R.N.R.) extracted data from the studies. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a random-effects model.


RESULTS
Data were extracted from 8 studies involving 453 patients; 1 study was conducted in adults (n = 20), 2 in children (n = 188), and 5 in all ages (n = 245). The symptoms of Hymenoptera venom hypersensitivity were prevented in 80 (79%) of the 101 patients receiving SIT versus 49 (36%) of 136 comparison patients. The symptoms were not prevented in 21 (21%) of the patients receiving SIT versus 87 (64%) of the comparison patients (OR 2.20, 95% CI 1.72 to 2.81).


CONCLUSIONS
The findings of this meta-analysis support the conclusion that SIT is effective in the treatment of Hymenoptera venom hypersensitivity.
Ross
R N
RN
Medical/Science Analytics, Brookline, Massachusetts 02445, USA.
Nelson
H S
HS
Finegold
I
I
D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D001514:Bee Venoms / Q000008:administration & dosage* / Q000737:chemistry / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D006801:Humans; D006927:Hymenoptera / Q000737:chemistry*; D006967:Hypersensitivity / Q000628:therapy*; D007167:Immunotherapy / Q000009:adverse effects; D007299:Insect Bites and Stings / Q000628:therapy*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D016896:Treatment Outcome
D001514:Bee Venoms