February 23, 2017
Joint Message Announcing Venom Extract Shortage Task Force Report
The AAAAI and ACAAI previously announced a venom extract shortage due to ALK - Abello A/S experiencing a manufacturing delay in regards to its venom products. In response, we formed a task force of experts to generate guidance outlining recommendations for our members which could lead to a reduction in the consumption of the product. The task force report is now complete so we want to share some highlights as well as where you can read the full version.
The venom extract shortage has created two kinds of problems: the need to change suppliers and/or the need to manage the reduced availability because demand now exceeds supply.
Prescribers will need to assess whether substitute products are interchangeable or whether dose adjustments are appropriate. There are slight differences between HollisterStier and ALK venoms. The task force report describes such differences and also details two patient examples illustrating the range of possible scenarios that clinicians should consider when changing the supplier of venom treatment extracts, but they are not meant as specific treatment recommendations.
To be able to adequately treat those with the greatest need, all allergists should consider the following measures to conserve venom:
• extending the maintenance interval
• decreasing the maintenance dose
• suspending or restricting treatment in patients with the lowest risk of severe reaction to stings
• developing strategies to minimize waste.
The task force report provides further detail on each of these. An over-riding theme in the application of these recommendations is the need to stratify patients according to the known risk factors for severe reactions to stings. The recommended measures for which there is the best evidence are: discontinuation of VIT in patients for whom it is optional (“not required” according to the Practice Parameters); extension of the maintenance interval within the standard guidelines (see Table 1 in the report); and reduction of dose to 50 mcg in children.
Read the Full Report
The task force report has been simultaneously published online by The Journal of Allergy and Clinical Immunology: In Practice and the Annals of Allergy, Asthma and Immunology.
Click here to view it.
Thank You to the Task Force Members
We would like to acknowledge David B.K. Golden, MD, FAAAAI, FACAAI, David I. Bernstein, MD, FAAAAI, FACAAI, Theodore M. Freeman, MD, FAAAAI, FACAAI, James M. Tracy, DO, FAAAAI, FACAAI, David M. Lang, MD, FAAAAI, FACAAI, and Richard A. Nicklas, MD, FAAAAI, FACAAI, for serving on the task force. We appreciate the time and effort they devoted to writing this report to assist our members in making decisions about the appropriate care of their patients during the venom extract shortage. It is another example of our two organizations working together to address an issue that is important to many of our members and our patients.