title: Safety and tolerability during build-up phase of a rush venom immunotherapy.
abstract: BACKGROUND
  Safety and tolerability of venom immunotherapy (VIT) in patients with concomitant disease and comedications, especially β-blockers (BBs) and angiotensin-converting enzyme inhibitors (ACEIs), are under discussion.
  
  
  OBJECTIVE
  To identify risk factors for the occurrence of systemic reactions (SRs) during the build-up phase of a 3-day rush VIT with focus on comorbidities and related comedications.
  
  
  METHODS
  Data of 175 three-day rush VIT courses (Vespula venom, n = 161; honeybee venom, n = 14) were analyzed. Starting with 0.02 μg of venom, the maintenance dose of 100 μg was reached in 15-dose increments within 3 days. Local reactions (LRs) and SRs were documented during the build-up phase. Comorbidities and related comedications were registered. Univariate, bivariate, and multivariate data analysis was performed.
  
  
  RESULTS
  During the 3-day rush VIT, an LR was seen in 74 (42.3%) of 175, a large LR (>10-cm diameter) in 82 (46.9%) of 175, and SRs in 19 (10.9%) of 175 VIT courses. Multivariate logistic regression revealed that female sex (P = .01), immunotherapy with honeybee venom (P = .003), and accompanying ACEI medication (P = .03) were independent predictors of the development of SRs during the build-up phase of VIT.
  
  
  CONCLUSIONS
  This study revealed that female sex, honeybee VIT, and ACEI use independent predictors for SRs.
authors.affiliation: Department of Dermatology, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Bernkopf
authors.affiliation: Department of Dermatology, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany.
authors.forename: Henriette
authors.initials: H
authors.lastname: Rönsch
authors.affiliation: Department of Dermatology, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany.
authors.forename: Petra
authors.initials: P
authors.lastname: Spornraft-Ragaller
authors.affiliation: Departments of Clinical Chemistry and Laboratory Medicine, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany.
authors.forename: Volker
authors.initials: V
authors.lastname: Neumeister
authors.affiliation: Department of Dermatology, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany. Electronic address: andrea.bauer@uniklinikum-dresden.de.
authors.forename: Andrea
authors.initials: A
authors.lastname: Bauer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000485:Allergens / Q000009:adverse effects / Q000276:immunology*; D000818:Animals; D001516:Bees / Q000276:immunology / Q000378:metabolism; D003888:Desensitization, Immunologic / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000276:immunology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012306:Risk; D012737:Sex Factors; D014688:Venoms / Q000009:adverse effects / Q000276:immunology*; D014863:Wasps / Q000276:immunology; D055815:Young Adult
chemical_list: D000485:Allergens; D014688:Venoms