American Academy of Asthma, Allergy & Immunology membership experience with venom immunotherapy in chronic medical conditions and pregnancy, and in young children.

Abstract

BACKGROUND:

Few data exist regarding the use of venom immunotherapy (VIT) in specific high-risk chronic medical conditions and pregnancy, and in young children.

METHODS:

A Web-based survey was sent to American Academy of Asthma Allergy & Immunology members to explore their VIT experience in potential high-risk medical conditions and pregnancy, and in young children. Major problems were defined as "activation of underlying disease and/or VIT not well tolerated (systemic adverse events) and/or VIT discontinued for medical reasons." Results were expressed descriptively.

RESULTS:

A total of 697 of 5123 surveys (14%) were completed: 87% of the respondents were based in the United States, and 28% worked in an academic setting. Most respondents (71%) believed that pregnancy was a contraindication for starting VIT. Most were comfortable continuing VIT (51%) if the woman became pregnant after starting therapy. Of the allergists who treated children, many would give VIT down to age 5 years (42%) or younger, ages 1-4 years (35%). The following list is of the specific medical condition, the number of allergists who used VIT in patients with this condition, and the percentage who reported major problems: severe asthma, 212 (4.2%); hypertension, 287 (1.1%); coronary artery disease, 222 (3.6%); arrhythmias, 136 (3.4%); cerebrovascular disease, 104 (5.1%); cancer in remission, 166 (0%); cancer stable but still under treatment, 44 (7.2%); a history of bone marrow transplantation, 15 (4.9%); a history of solid organ transplantation, 29 (3.6%); human immunodeficiency virus, 53 (1.4%); acquired immunodeficiency syndrome, 24 (6.2%); stable autoimmune disease, 164 (2.8%); mastocytosis, 66 (18.4%); elevated serum tryptase, 101 (10.8%); immunodeficiency 59 (2.5%).

CONCLUSION:

Many allergists were comfortable using VIT in young children and continuing but not starting pregnant women on VIT. VIT was commonly used in patients with hypertension, coronary artery disease, arrhythmias, cancer in remission, and stable autoimmune disease. Major problems were most frequently reported in use with mastocytosis, elevated tryptase, and cancer still under treatment.

• Authors: Christopher W Calabria, David W Hauswirth, Matthew Rank, Lawrence Sher, Desiree Larenas-Linnemann
• Journal: Allergy and asthma proceedings (Allergy Asthma Proc) Vol. 38 Issue 2 Pg. 121-129 (Mar 01 2017) ISSN: 1539-6304 [Electronic] United States
• PMID: 28234049 (Publication Type: Journal Article)

Chemical References

• Arthropod Venoms

Topics

• Acquired Immunodeficiency Syndrome (epidemiology)
• Adolescent
• Adult
• Age Factors
• Allergy and Immunology
• Anaphylaxis (prevention & control)
• Animals
• Arthropod Venoms (immunology, therapeutic use)
• Asthma (epidemiology)
• Attitude of Health Personnel
• Autoimmune Diseases (epidemiology)
• Bone Marrow Transplantation
• Cerebrovascular Disorders (epidemiology)
• Child
• Child, Preschool
• Chronic Disease
• Comorbidity
• Coronary Artery Disease (epidemiology)
• Desensitization, Immunologic (methods)
• Female
• HIV Infections (epidemiology)
• Humans
• Hymenoptera
• Hypersensitivity, Immediate (drug therapy, epidemiology)
• Hypertension (epidemiology)
• Infant
• Insect Bites and Stings (immunology)
• Male
• Mastocytosis (epidemiology)
• Neoplasms (epidemiology)
• Organ Transplantation
• Practice Patterns, Physicians'
• Pregnancy
• Pregnancy Complications (drug therapy, epidemiology)
• Premedication (statistics & numerical data)
• Societies, Medical
• Surveys and Questionnaires
• Young Adult