Stinging insect allergy: current perspectives on venom immunotherapy
File(s)
Author(s)
Ludman, SW
Boyle, RJ
Type
Journal Article
Abstract
Systemic allergic reactions to insect stings affect up to 5% of the population during their lifetime, and up to 32% of beekeepers. Such reactions can be fatal, albeit very rarely, and fear of a further systemic reaction (SR) can lead to significant anxiety and quality of life impairment. A recent Cochrane systematic review confirmed that venom immunotherapy (VIT) is an effective treatment for people who have had a systemic allergic reaction to an insect sting. VIT reduces risk of a further SR (relative risk 0.10, 95% confidence interval 0.03-0.28), but VIT also reduces risk of a future large local reaction, and significantly improves disease-specific quality of life. However, health economic analysis showed that VIT is generally not cost effective for preventing future SRs; most people are stung infrequently, most SRs resolve without long-term consequences, and a fatal outcome is extremely rare. VIT only becomes cost effective if one is stung frequently (eg, beekeepers) or if quality of life improvement is considered. Thus, for most people with insect sting allergy, anxiety and quality of life impairment should be the overriding consideration when making treatment decisions, highlighting the importance of a patient-centered approach. Areas which need to be explored in future research include efforts to improve the safety and convenience of VIT such as the use of sublingual immunotherapy; quality of life effects of venom allergy in children and adolescents as well as their parents; and the optimal duration of treatment.
Date Issued
2015-07-23
Date Acceptance
2015-04-29
Citation
Journal of Asthma and Allergy, 2015, 8, pp.75-86
ISSN
1178-6965
Publisher
Dove Medical Press
Start Page
75
End Page
86
Journal / Book Title
Journal of Asthma and Allergy
Volume
8
Copyright Statement
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License.
License URL
Identifier
PII: jaa-8-075
Subjects
anaphylaxis
quality of life
1107 Immunology
Publication Status
Published