Safety and Efficacy of a Progressively Prolonged Maintenance Interval of Venom Immunotherapy.

Autor:	Kontou-Fili K; Allergology Department, Laikon General Hospital, Athens, Greece.; Department of Allergology, Euroclinic Hospital of Athens, Athens, Greece., Pitsios C; Allergology Department, Laikon General Hospital, Athens, Greece.; Medical School, University of Cyprus, Nicosia, Cyprus., Kompoti E; Allergology Department, Laikon General Hospital, Athens, Greece., Giannakopoulos D; Allergology Department, Laikon General Hospital, Athens, Greece.; Allergy Outpatient Clinic, Metropolitan Hospital, Piraeus, Greece., Kouridakis S; Allergology Department, Laikon General Hospital, Athens, Greece.; Spata Health Center, Spata, Greece.
Jazyk:	angličtina
Zdroj:	International archives of allergy and immunology [Int Arch Allergy Immunol] 2018; Vol. 176 (1), pp. 39-43. Date of Electronic Publication: 2018 Apr 12.
DOI:	10.1159/000488143
Abstrakt:	Background: The long-term protection provided by venom immunotherapy (VIT) is related to the dose administered and to its long duration; the latter, however, becomes inconvenient for patients in countries like Greece, with many islanders or inhabitants of distant mountainous areas. Maintenance interval prolongation reduces the number of office visits - saving time and money - and as a consequence contributes to the patients' compliance. The aim of this prospective study was to evaluate the safety and efficacy of VIT on a progressively prolonged maintenance interval (PPMI). Method: 450 venom-allergic patients were reviewed for participation in our study; all of them were initially treated with a modified rush or an ultrarush protocol using freshly reconstituted, pure venoms. Upon reaching the maintenance dose, the VIT interval was scheduled to be gradually prolonged - by 1 week each time - aiming at a maximal interval of 26 weeks. Results: 267/450 patients consented to participate in our VIT PPMI protocol: 98 were treated with vespid(s) venom, 142 with honeybee venom, and 27 with both. The mean duration of patient follow-up was 9.1 ± 4.2 years. The majority of systemic reactions due to VIT injections occurred up to the 8-weeks PPMI; few additional reactions were documented in a small fraction (2.9%) of our patient population beyond 9 weeks and up to 16 weeks; all were caused by honeybee VIT. No reactions were observed during VIT administration at the 26-week interval. Ninety-six patients reported 204 field sting occurrences by the culprit insect. Ten systemic reactions (8 mild and 2 moderate in severity) were registered between the 9- and 18-week PPMI; the honeybee was the culprit insect in all cases. 108 field stings by the offending insect were sustained beyond the 20- and up to the 26-week PPMI; there were no reactions at all. Conclusions: Progressively prolonging the VIT maintenance interval up to 26 weeks appears to be safe and efficacious. (© 2018 S. Karger AG, Basel.)
Databáze:	MEDLINE
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