title: Three days rush venom immunotherapy in bee allergy: safe, inexpensive and instantaneously effective.
abstract: BACKGROUND
  Rush venom immunotherapy (VIT) is highly effective in vespid venom allergy, but comparable data regarding bee venom (BV) allergy are sparse. We evaluated its safety, efficacy and cost in BV-allergic patients.
  
  
  METHODS
  Conventional or rush VIT were offered to all patients with systemic reaction to insect sting. Rush VIT was also given to hyperreactive patients who failed to reach the maintenance dose with conventional VIT due to multiple systemic reactions. In BV-allergic patients, honeybee sting challenge was performed within 1 week after reaching the maintenance dose.
  
  
  RESULTS
  179 patients, some of them allergic to more than one venom, received 246 rush VIT courses. Bee VIT was administered to 132 patients (73.7%); 173 patients (96.6%) reached the maintenance dose. The incidence of systemic reactions was 29.6%. They were more common in VIT with BV than with vespid venoms (31.1 and 16.3%, respectively, p = 0.01). After excluding the hyperreactive subgroup (n = 20), this difference was not significant (23.7 and 16%, respectively, p = 0.19). Despite the high incidence of systemic reactions (15 of 20, 75%) among hyperreactive patients, 17 patients (85%) achieved the maintenance dose. Sting challenges resulted in systemic reaction in 4 of 8 (50%) hyperreactive patients and in 2 of 47 (4.3%) ordinary patients. The cost of rush VIT was 41% of that of conventional VIT.
  
  
  CONCLUSIONS
  Rush VIT with BV is safe, instantaneously effective, less expensive and enables most patients with previous failures of conventional VIT to reach the maintenance dose.
authors: The Allergy and Clinical Immunology Unit, Meir Medical Center, Kfar Saba, Israel. arnong @ clalit.org.il
authors: Arnon
authors: A
authors: Goldberg
authors: Ayala
authors: A
authors: Yogev
authors: Ronit
authors: R
authors: Confino-Cohen
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D001514:Bee Venoms / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D001516:Bees / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D003888:Desensitization, Immunologic / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D004306:Dose-Response Relationship, Immunologic; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000209:etiology / Q000276:immunology / Q000628:therapy*; D007299:Insect Bites and Stings / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome; D014862:Wasp Venoms / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D014863:Wasps / Q000276:immunology; D055815:Young Adult
chemical_list: D001514:Bee Venoms; D014862:Wasp Venoms