title: Premedication with antihistamines may enhance efficacy of specific-allergen immunotherapy.
abstract: BACKGROUND
  Antihistamine premedication has been used to increase safety of specific-allergen immunotherapy. Its influence on the efficacy of this treatment has not been studied so far.
  
  
  OBJECTIVE
  The goal was to analyze the influence of antihistamine premedication on long-term efficacy of specific-allergen immunotherapy.
  
  
  METHODS
  Patients included in a double-blind, placebo controlled trial who received premedication with terfenadine or placebo during initial rush immunotherapy with honeybee venom in 1988/1989 were assessed in a retrospective analysis for the long-term protective effect, as indicated by the tolerance of a bee sting challenge or field sting during immunotherapy.
  
  
  RESULTS
  Of the 52 patients who had participated in the 1988/1989 trial, 47 could be reassessed after an average of 3 years. Of these, 45 were still receiving bee venom immunotherapy. A total of 41 patients were stung by bees while receiving immunotherapy (20 of the terfenadine-premedicated group and 21 of the placebo-premedicated group), 17 with in-field stings and 24 with in-hospital sting challenge. Six (29%) of the patients receiving placebo had a mild-to-moderate systemic allergic reaction, whereas none of the patients receiving terfenadine reacted to the bee sting (P =.012).
  
  
  CONCLUSIONS
  These results indicate that antihistamine premedication during the initial phase of specific-allergen immunotherapy may enhance the efficacy of this treatment.
authors.affiliation: Medical Division, Zieglerspital, Bern, Switzerland.
authors.forename: U
authors.initials: U
authors.lastname: Müller
authors.forename: Y
authors.initials: Y
authors.lastname: Hari
authors.forename: E
authors.initials: E
authors.lastname: Berchtold
mesh_terms: D000293:Adolescent; D000328:Adult; D000485:Allergens / Q000276:immunology*; D004311:Double-Blind Method; D000939:Epitopes; D005260:Female; D006634:Histamine H1 Antagonists / Q000627:therapeutic use*; D006801:Humans; D007167:Immunotherapy; D007299:Insect Bites and Stings / Q000175:diagnosis / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011292:Premedication; D012882:Skin Tests
chemical_list: D000485:Allergens; D000939:Epitopes; D006634:Histamine H1 Antagonists