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Venom immunotherapy in children

Published Online: December 1, 2016

Immunotherapy is a treatment protocol by which the allergen to which a person is allergic to is injected (allergy shots) in graduated incremental doses until reaching the maintenance dose. Venom immunotherapy (VIT) is the recommended treatment for systemic allergic reactions induced by bee or wasp stings. Achieving the full protective maintenance dose by weekly injections in conventional VIT (CVIT) usually requires 3–4 months. Accelerated protocols have been developed in an attempt to shorten the build-up phase of VIT (i.e. rush VIT). Although venom allergy in children is prevalent, data regarding the safety and efficacy of rush VIT in this age group is limited.

In a study recently published in The Journal of Allergy and Clinical Immunology: In Practice, Confino-Cohen and colleagues retrospectively evaluated the outcomes of VIT performed on a large number of venom allergic children in an attempt to better evaluate the safety and efficacy of rush VIT, lasting 3 days, in this specific age group.

Data on 127 children with allergy to venom was available. Eighty-four children chose to receive rush VIT and the rest chose CVIT. There was no difference between the children receiving rush or CVIT with regard to the incidence of systemic reactions induced by the treatment (19% and 23.2%, respectively, p=0.6), nor was there any difference with regard to the severity of these reactions. This finding was consistent in the subset of children with bee-venom allergy, which is a known risk factor, and in very young children (under the age of 6). More patients were able to reach full maintenance dose, demonstrating improved protection from future stings in rush VIT as compared to CVIT (83/84 patients, 98.8% and 39/43, 90.7%, respectively, P=0.04).

The authors concluded that rush VIT is safe and efficient for children in general and for bee allergic and very young children as well.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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