Comparison of 2 maintenance doses (100 microg vs 200 microg) in Hymenoptera venom immunotherapy: influence of the maintenance dose on the immunologic response.
BACKGROUND
In Hymenoptera venom immunotherapy, the maintenance dose is usually 100 microg. However, persistent systemic reactions to sting challenges could be treated by an increase in the maintenance dose to 200 microg with success, suggesting greater efficiency.


OBJECTIVE
To compare the effects of 2 monthly maintenance doses (100 microg vs 200 microg) on skin test sensitivity and venom specific IgE antibody levels.


METHODS
Twenty-two patients receiving Vespula venom immunotherapy were enrolled in this retrospective study. After rush therapy, the 100-microg maintenance dose initially administered was maintained (group 1, n = 13) or was increased to 200 microg (group 2, n = 9).


RESULTS
Levels of venom specific IgE antibody and skin test results measured before the onset of immunotherapy were comparable in both groups. Unlike in group 1, a maintenance dose of 200 microg resulted in significant decreases in venom specific IgE antibody levels and skin test sensitivity.


CONCLUSIONS
Increasing the monthly maintenance dose to 200 microg results in a greater degree of change in venom specific IgE antibody levels and skin test sensitivity than when maintaining a 100-microg dose. Our data strengthen those of previous clinical studies showing the usefulness of a 200-microg maintenance dose in the case of clinical failure of a 100-microg dose.
Glérant
Jean-Charles
JC
Service de Pneumologie et Unité de Réanimation Respiratoire, Centre Hospitalier Universitaire Sud, Amiens, France.
Martinez
Philippe
P
Guillaume
Claude
C
Jounieaux
Vincent
V
D000328:Adult; D000368:Aged; D000818:Animals; D001514:Bee Venoms / Q000008:administration & dosage* / Q000276:immunology; D003888:Desensitization, Immunologic / Q000379:methods*; D004306:Dose-Response Relationship, Immunologic; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D007299:Insect Bites and Stings / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012882:Skin Tests; D018709:Statistics, Nonparametric; D014863:Wasps / Q000276:immunology*
D001514:Bee Venoms; D007073:Immunoglobulin E