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Journal of Allergy
Volume 2012 (2012), Article ID 192192, 8 pages
http://dx.doi.org/10.1155/2012/192192
Clinical Study

Hymenoptera Venom Immunotherapy: Tolerance and Efficacy of an Ultrarush Protocol versus a Rush and a Slow Conventional Protocol

1Division of Allergy and Clinical Immunology, Department of Medicine, Hospital of Agropoli, ASL, Salerno, 84043 Agropoli, Italy
2Afferent Site to the School Network in Allergy and Clinical Immunology, University of Naples Federico II, Hospital of Agropoli, ASL, Salerno, 84043 Agropoli, Italy
3Laboratory of Enviromental Analysis, Department of Hygiene and Public Health, ASL, Salerno, 84078 Vallo della Lucania, Italy
4Unit of Transfusion Medicine and Immunohematology, Hospital of Agropoli, Salerno, 84043 Agropoli, Italy
5Division of Allergy and Clinical Immunology, Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, 80131 Naples, Italy

Received 28 December 2011; Revised 15 March 2012; Accepted 21 March 2012

Academic Editor: H. Renz

Copyright © 2012 Vincenzo Patella et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background and Objective. Various venom immunotherapy (VIT) protocols are available for Hymenoptera allergy. Although adverse reactions (ADRs) to VIT are widely reported, controlled trials are still needed. We conducted a randomized prospective study to evaluate ADRs and the efficacy of three VIT regimens. Methods. 76 patients with Hymenoptera allergy, aged 16–76 years, were randomized to receive an ultrarush protocol (group A: 27 patients), a rush protocol (group B: 25), or a slow protocol (group C: 24). Aqueous venom extract was used in incremental phase and an adsorbed depot in maintenance phase. ADRs and accidental Hymenoptera stings during VIT were used to evaluate efficacy. Results. During incremental treatment, ADRs occurred in 1.99%, 3.7%, and 3.9% of patients in groups A, B, and C, and in 0.99%, 1.46%, and 2.7%, respectively, during maintenance. ADRs were significantly fewer in group A (incremental + maintenance phase) than in group C (1.29% versus 3.2%; 𝑃 = 0 . 0 1 3 ). Reactions to accidental Hymenoptera stings did not differ among groups (1.1%, 1.2%, and 1.1%). Conclusion. Ultrarush was as effective as the rush and slow protocols and was associated with a low incidence of reactions to stings. This study indicates that ultrarush VIT is a valid therapeutic option for Hymenoptera allergy.