| Popis: |
Background The standard venom immunotherapy involves the administration of the maintenance dose every 4 to 6 weeks. This regimen may have compliance problem especially in the long term, thus extended intervals have been proposed. We prospectively compared the efficacy of 3- or 4-month extended maintenance dose and the conventional regimen. Methods Patients receiving immunotherapy of a single venom were offered the delayed maintenance dose, and were then followed-up for field re-stings. Only the re-stings by the insect for which the patients received immunotherapy were considered. A matched group of patients receiving the conventional maintenance were used for comparison, by univariate and multivariate analysis. Results Fifty-two patients (44 male, 8 female, mean age 52 years) were certainly re-stung on 113 occasions by the insect for which they were receiving immunotherapy. 90 re-stings occurred during the 3- month maintenance and 23 during the 4-month maintenance. The control group, on conventional protocol with one single venom, included 103 patients (79 male, 24 female, mean age 41 years) certainly re-stung on 160 occasions by the specific insect. The rate of re-sting without reaction was 97% in the delayed maintenance and 82% in the conventional group with a significant difference in favour of the former (P = 0.01). None of the variables considered resulted predictive for systemic reactions by logistic regression analysis Conclusions The delayed maintenance dose approach is al least as effective and safe as the conventional one. The 4-month maintenance seems to be the best option in term of convenience and economic save. |
Full text from SpringerLink