Rush venom immunotherapy in patients experiencing recurrent systemic reactions to conventional venom immunotherapy

Ann Allergy Asthma Immunol. 2003 Oct;91(4):405-10. doi: 10.1016/S1081-1206(10)61689-4.

Abstract

Background: An unknown number of venom-allergic patients fail to reach the maintenance dose (MD) during the build-up period of conventional venom immunotherapy (VIT) due to recurrent systemic reactions (SRs).

Objective: To establish an alternative VIT protocol that will enable these patients to reach a full protective MD.

Methods: Venom-allergic patients who had experienced recurrent SRs during the build-up period of conventional VIT underwent rush VIT.

Results: Of the 9 patients who participated in this study, the 6 who underwent 8 treatment courses tolerated the rush VIT well and reached the MD within 3 days. In 3 of these patients, mild cutaneous SRs were overcome with loratadine. In 2 patients who experienced recurrent and more severe SRs, the original 3-day rush VIT had to be modified and extended to 5 days until the MD was reached. In a single patient who experienced an anaphylactic reaction, VIT was discontinued.

Conclusions: Rush VIT is an appropriate therapeutic alternative that enables most patients with recurrent SRs throughout the build-up period of conventional VIT to reach a full protective MD.

MeSH terms

  • Anaphylaxis / etiology
  • Animals
  • Bee Venoms / administration & dosage
  • Bee Venoms / adverse effects*
  • Desensitization, Immunologic / adverse effects*
  • Dose-Response Relationship, Immunologic
  • Drug Administration Schedule
  • Humans
  • Insect Bites and Stings
  • Time Factors
  • Wasp Venoms / administration & dosage
  • Wasp Venoms / adverse effects*

Substances

  • Bee Venoms
  • Wasp Venoms