Maintenance venom immunotherapy administered at a 3-month interval preserves safety and efficacy and improves adherence.
BACKGROUND
Hymenoptera venom immunotherapy (VIT) is a safe and effective approach to insect sting allergy. However, after discontinuation, relapses can occur in some patients, especially those with a high occupational risk, and they may need to prolong VIT indefinitely. In order to improve adherence, we propose extending the interval between injections of maintenance VIT (MVIT).


OBJECTIVE
To evaluate the safety, efficacy, and patient acceptance of a 3-month interval between MVIT injections in a group of Hymenoptera-allergic patients who are occupationally exposed to insect stings.


METHODS
We included 72 patients with severe systemic reactions to Hymenoptera stings. MVIT was administered for 4 years at intervals increasing up to 3 months and then continued for a further 2 years. Patients were informed of the risk of relapse after discontinuation and of the need for indefinite treatment at 3-month intervals.


RESULTS
During the 3-month interval maintenance phase, only 235 local reactions (17.8%) were observed in 17 patients. Sixty patients experienced 125 field re-stings and only 1 experienced a systemic reaction with generalized urticaria.


CONCLUSIONS
The study confirms that the conventional MVIT interval of 4 to 6 weeks can be extended to 3 months in most patients with no adverse events, while maintaining safety and efficacy, improving adherence, and guaranteeing safe continuation of professional activity.
Cavallucci
E
E
Allergy Related Disease Unit, G d'Annunzio University Foundation, Chieti, Italy.
Ramondo
S
S
Renzetti
A
A
Turi
M C
MC
Di Claudio
F
F
Braga
M
M
Incorvaia
C
C
Schiavone
C
C
Ballone
E
E
Di Gioacchino
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D001514:Bee Venoms / Q000008:administration & dosage* / Q000276:immunology; D003888:Desensitization, Immunologic / Q000009:adverse effects / Q000379:methods*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000628:therapy*; D007299:Insect Bites and Stings / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D014862:Wasp Venoms / Q000008:administration & dosage* / Q000276:immunology
D001514:Bee Venoms; D014862:Wasp Venoms