A simple 3-day "rush" venom immunotherapy protocol: documentation of safety.
BACKGROUND
Venom immunotherapy (VIT) is the only effective treatment for hymenoptera hypersensitivity, but conventional protocols require a few weeks.


OBJECTIVE
We present the safety of a 3-day "rush" protocol that requires only 7 injections and 255 mgr cumulative dose before the 100 microg maintenance dose.


METHODS
Forty-nine patients (33 males, 16 females) of mean age 43.57+/-12.9 yrs received "rush" VIT. Only 7 injections were required until the maintenance dose of 100 mgr was reached on Day 5. On Day 1, four injections were administered with initial dose of 5 mgr and total dose of 75 microg. On Day 3 a cumulative dose of 180 mgr was administered in three injections (40 mgr, 60 mgr and 80 mgr). A dose of 100 mgr was administered on Day 5. Twenty-nine individuals were treated with Honey-Bee venom; 18 with Common wasp; 5 with Paper Wasp; while 13 patients received Mixed Vespid preparation. Inclusion criteria were documented IgE-mediated allergy with intradermal sensitivity to < or =0.1 mgr/ml venom concentration and concomitant detection of specific venom IgE > or =0.35 kU/l.


RESULTS
All patients reached the maintenance dose. Forty-nine patients received 65 immunotherapy courses, resulting in 1520 injections. Thirty-three systemic reactions: 7 during building phase (1.5%); and 26 in the maintenance dose (2.4%) were observed in 9 patients. The percentage of reactions/total injection number was 2.2%; all reactions were mild-to-moderate. Fourteen patients reported documented field stings at least two months after VIT onset with only one reported mild systemic reaction.


CONCLUSIONS
We propose a simple "rush" VIT protocol in an outpatient setting as an easy-to-perform alternative option for VIT induction phase.
Allergy Clinical Research Center, Allergy Unit, Attikon University Hospital, Medical School, University of Athens, Greece.
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D
Kalogeromitros
M
M
Makris
I
I
Koti
C
C
Chliva
A
A
Mellios
G
G
Avgerinou
T C
TC
Theoharides
D000328:Adult; D000818:Animals; D001180:Arthropod Venoms / Q000009:adverse effects / Q000627:therapeutic use*; D002985:Clinical Protocols; D003888:Desensitization, Immunologic / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D006927:Hymenoptera / Q000276:immunology*; D006967:Hypersensitivity / Q000628:therapy*; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D007299:Insect Bites and Stings / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
D001180:Arthropod Venoms; D007073:Immunoglobulin E