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Original Article |
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Maintenance Venom Immunotherapy
Administered at a 3-Month Interval Preserves Safety and
Efficacy and Improves Adherence |
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E Cavallucci,1,2 S
Ramondo,2 A Renzetti,2 MC Turi,1-2
F Di Claudio,2 M Braga,3 C
Incorvaia,4 C Schiavone,2 E
Ballone,5 M Di Gioacchino1,2 |
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1Allergy Related Disease Unit, G
d’Annunzio University Foundation, Chieti, Italy
2Department of Medicine and Science of Ageing, Section
of Allergy, Clinical Immunology and Occupational
Medicine, G d’Annunzio University, Chieti, Italy
3Allergy Unit, Spedali Civili, Brescia, Italy
4Allergy/Pulmonary Rehabilitation Unit, ICP Hospital,
Milan, Italy
5Biostatistical Laboratory, Department of Biomedical
Sciences, G d’Annunzio University Chieti, Italy |
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J Investig Allergol Clin Immunol
2010; Vol. 20(1): 63-68 |
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Abstract |
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Background:
Hymenoptera venom
immunotherapy (VIT)
is a safe and
effective approach
to insect sting
allergy. However,
after
discontinuation,
relapses can occur
in some patients,
especially those
with a high
occupational risk,
and they may need to
prolong VIT
indefinitely. In
order to improve
adherence, we
propose extending
the interval between
injections of
maintenance VIT (MVIT).
Objective: To
evaluate the safety,
effi cacy, and
patient acceptance
of a 3-month
interval between
MVIT injections in a
group of
Hymenopteraallergic
patients who are
occupationally
exposed to insect
stings.
Patients and Methods:
We included 72
patients with severe
systemic reactions
to Hymenoptera
stings. MVIT was
administered for 4
years at intervals
increasing up to 3
months and then
continued for a
further 2 years.
Patients were
informed of the risk
of relapse after
discontinuation and
of the need for
indefinite treatment
at 3-month
intervals.
Results: During the
3-month interval
maintenance phase,
only 235 local
reactions (17.8%)
were observed in 17
patients. Sixty
patients experienced
125 field re-stings
and only 1
experienced a
systemic reaction
with generalized
urticaria.
Conclusions: The
study confirms that
the conventional
MVIT interval of 4
to 6 weeks can be
extended to 3 months
in most patients
with no adverse
events, while
maintaining safety
and efficacy,
improving adherence,
and guaranteeing
safe continuation of
professional
activity.
Key words: Venom
immunotherapy.
Patient acceptance.
Safety. Efficacy.
3-month interval.
Maintenance.
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