Published Online: November 8, 2015
Hymenoptera venom immunotherapy (VIT) is a highly effective treatment that has significantly improved the quality of life of patients with hymenoptera venom allergies. In order to obtain long-standing protection, even years after the completion of VIT, a treatment cycle of at least 5 years of duration is needed. The lack of adherence to therapy is a matter of concern for physicians, especially in chronic conditions that require long-term treatment. As for allergen immunotherapy (AIT), low adherence due to early discontinuation is commonly seen in inhalant AIT, owing to various reasons, such as lack of compliance, inconvenience, and cost of treatment. Patients’ adherence to VIT and reasons for early treatment discontinuation are not well known.
In a recent article published in The Journal of Allergy & Clinical Immunology: In Practice (JACI: In Practice), Bilò et al. investigated the adherence to VIT prescription and the major reasons for early treatment discontinuation in a sample of 508 Italian patients in a real-life setting. A thorough counseling on VIT efficacy and safety was performed, followed by patient-to-patient interaction performed simultaneously in small groups early during the VIT build-up phase. Adherence was assessed during VIT maintenance over a 5-year follow-up.
Unlike inhalant AIT, adherence to treatment was constantly high at one (98.6%), three (94.7%) and five years (83.7%) from VIT initiation. Reasons for discontinuation reported were low compliance to treatment (i.e., loss to follow-up and spontaneous interruption of treatment) and inconvenience (i.e., work incompatibilities, travel issues). The combination of patients’ perception of a life-threatening risk, a thorough counseling before initiation and peer-to-peer interactions during the early phases of treatment, may have been responsible for the sustained adherence seen. Further studies are needed to assess treatment adherence in broader realities.
The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.