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Original Article


Maintenance Venom Immunotherapy Administered at a 3-Month Interval Preserves Safety and Efficacy and Improves Adherence


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

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

J Investig Allergol Clin Immunol 2010; Vol. 20(1): 63-68



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.