When can immunotherapy for insect sting allergy be stopped?

Abstract

BACKGROUND:

Stings by Hymenoptera (honey bees, vespids, ants) can cause systemic allergic reactions (SARs). Venom immunotherapy (VIT) is highly effective and reduces an allergic patient's risk of a recurrent SAR to less than 5-20%. The risk of a recurrent SAR to a re-sting decreases the longer VIT is continued. The recommended duration of VIT is at least 3 to 5 years.

RISK FACTORS:

Risk factors for recurrent SARs to a sting after stopping VIT have been identified and discussed: Recommendations concerning stopping VIT: For patients without any of the identified risk factors, VIT should be continued for 5 rather than 3 years. In patients with definite risk factors, a longer duration of VIT has to be discussed before stopping it. In mast cell disorders, VIT for life is recommended. Because of the residual risk of SARs after VIT, all patients are advised to carry an epinephrine autoinjector indefinitely and to continue to take measures to avoid Hymenoptera stings.

• Authors: Ulrich R Müller, Johannes Ring
• Journal: The journal of allergy and clinical immunology. In practice (J Allergy Clin Immunol Pract) 2015 May-Jun Vol. 3 Issue 3 Pg. 324-8; quiz 329-30 ISSN: 2213-2201 [Electronic] United States
• PMID: 25956311 (Publication Type: Journal Article, Review)
• Copyright: Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Chemical References

• Arthropod Venoms

Topics

• Anaphylaxis (immunology, therapy)
• Animals
• Arthropod Venoms (adverse effects, immunology, therapeutic use)
• Desensitization, Immunologic (adverse effects, methods)
• Humans
• Hymenoptera (classification, immunology)
• Hypersensitivity (diagnosis, epidemiology, immunology, therapy)
• Insect Bites and Stings (diagnosis, epidemiology, immunology, therapy)
• Predictive Value of Tests
• Risk Factors
• Skin Tests
• Time Factors
• Treatment Outcome