title: Risk associated with bee venom therapy: a systematic review and meta-analysis.
abstract: OBJECTIVE
  The safety of bee venom as a therapeutic compound has been extensively studied, resulting in the identification of potential adverse events, which range from trivial skin reactions that usually resolve over several days to life-threating severe immunological responses such as anaphylaxis. In this systematic review, we provide a summary of the types and prevalence of adverse events associated with bee venom therapy.
  
  
  METHODS
  We searched the literature using 12 databases from their inception to June 2014, without language restrictions. We included all types of clinical studies in which bee venom was used as a key intervention and adverse events that may have been causally related to bee venom therapy were reported.
  
  
  RESULTS
  A total of 145 studies, including 20 randomized controlled trials, 79 audits and cohort studies, 33 single-case studies, and 13 case series, were evaluated in this review. The median frequency of patients who experienced adverse events related to venom immunotherapy was 28.87% (interquartile range, 14.57-39.74) in the audit studies. Compared with normal saline injection, bee venom acupuncture showed a 261% increased relative risk for the occurrence of adverse events (relative risk, 3.61; 95% confidence interval, 2.10 to 6.20) in the randomized controlled trials, which might be overestimated or underestimated owing to the poor reporting quality of the included studies.
  
  
  CONCLUSIONS
  Adverse events related to bee venom therapy are frequent; therefore, practitioners of bee venom therapy should be cautious when applying it in daily clinical practice, and the practitioner's education and qualifications regarding the use of bee venom therapy should be ensured.
authors.affiliation: Acupuncture, Moxibustion and Meridian Research Group, Korean Institute of Oriental Medicine, Daejeon, South Korea.
authors.forename: Jeong Hwan
authors.initials: JH
authors.lastname: Park
authors.affiliation: Division of Cardiovascular and Rare Diseases, Center for Biomedical Science, National Institute of Health, Cheongju, Chungcheongbuk-do, South Korea.
authors.forename: Bo Kyung
authors.initials: BK
authors.lastname: Yim
authors.affiliation: Acupuncture, Moxibustion and Meridian Research Group, Korean Institute of Oriental Medicine, Daejeon, South Korea.
authors.forename: Jun-Hwan
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Acupuncture, Moxibustion and Meridian Research Group, Korean Institute of Oriental Medicine, Daejeon, South Korea.
authors.forename: Sanghun
authors.initials: S
authors.lastname: Lee
authors.affiliation: Korean Medicine Clinical Trial Center, Korean Medicine Hospital, Kyung Hee University, Seoul, South Korea.
authors.forename: Tae-Hun
authors.initials: TH
authors.lastname: Kim
mesh_terms: D000707:Anaphylaxis / Q000453:epidemiology* / Q000209:etiology*; D001514:Bee Venoms / Q000009:adverse effects* / Q000627:therapeutic use; D004342:Drug Hypersensitivity / Q000453:epidemiology*; D006801:Humans; D012306:Risk
chemical_list: D001514:Bee Venoms