Safety of 100 µg venom immunotherapy rush protocols in children compared to adults
Please always quote using this URN: urn:nbn:de:bvb:20-opus-157830
- Background: There is a paucity of studies examining the safety of venom immunotherapy (VIT) in children. We aimed to assess the incidence of anaphylactic side effects during rush VIT in a cohort of pediatric patients and adult controls. Methods: 72 consecutive cycles of VIT-buildup in 71 children/adolescents aged 7–17 years were retrospectively evaluated and compared to an adult control group (n = 981) with regard to baseline parameters (sex, causative venom, severity of index sting reaction, results of allergy testing, comorbidities) andBackground: There is a paucity of studies examining the safety of venom immunotherapy (VIT) in children. We aimed to assess the incidence of anaphylactic side effects during rush VIT in a cohort of pediatric patients and adult controls. Methods: 72 consecutive cycles of VIT-buildup in 71 children/adolescents aged 7–17 years were retrospectively evaluated and compared to an adult control group (n = 981) with regard to baseline parameters (sex, causative venom, severity of index sting reaction, results of allergy testing, comorbidities) and the incidence of anaphylactic adverse reactions. Results: Compared to adults, severe index sting-induced anaphylaxis was significantly less common in children (P = .001). Children were more likely to suffer from bee venom allergy (P < .001) and showed higher levels of bee venom-specific IgE (P = .013), but lower serum tryptase concentrations (P = .014). The overall rate of VIT-induced anaphylactic reactions was higher in children than in adults (6.9% vs 2.5%, P = .046 by univariate analysis). In the final binary logistic regression model, however, only bee VIT (P = .039; odds ratio 2.25; confidence interval 1.04–4.87) and 5-day compared to 3-day buildup protocols (P = .011; odds ratio 2.64; confidence interval 1.25–5.57) were associated with an increased risk of treatment-induced anaphylaxis. All pediatric patients finally reached and tolerated the target maintenance dose of 100 µg. Conclusions: The higher anaphylactic reaction rate observed in pediatric patients may be attributed to a greater prevalence of bee venom allergy. VIT-induced anaphylaxis in children is usually mild and does not affect further updosing and maintenance of VIT.…
Author: | Johanna StoevesandtORCiD, Christine Hosp, Andreas Kerstan, Axel Trautmann |
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URN: | urn:nbn:de:bvb:20-opus-157830 |
Document Type: | Journal article |
Faculties: | Medizinische Fakultät / Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie |
Language: | English |
Parent Title (English): | Allergy, Asthma & Clinical Immunology |
Year of Completion: | 2017 |
Volume: | 13 |
Issue: | 32 |
Source: | Allergy, Asthma & Clinical Immunology (2017) 13:32. DOI: 10.1186/s13223-017-0204-y |
DOI: | https://doi.org/10.1186/s13223-017-0204-y |
Dewey Decimal Classification: | 5 Naturwissenschaften und Mathematik / 59 Tiere (Zoologie) / 595 Arthropoden (Gliederfüßer) |
Tag: | anaphylaxis; bee; buildup phase; hymenoptera; pediatric; risk factor; vespula |
Release Date: | 2018/02/23 |
Collections: | Open-Access-Publikationsfonds / Förderzeitraum 2017 |
Licence (German): | CC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International |