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Regimens of Hymenoptera Venom Immunotherapy

[+] Article and Author Information

Grant support: by grant AI 08270 from the National Institute of Allergy and Infectious Diseases.

This paper is Publication #379 of the O'Neill Research Laboratories, The Good Samaritan Hospital, Baltimore, Maryland.

▸Requests for reprints should be addressed to David B. K. Golden, M.D.; The Johns Hopkins University School of Medicine at The Good Samaritan Hospital, 5601 Loch Raven Boulevard; Baltimore, MD 21239.

Baltimore, Maryland

Ann Intern Med. 1980;92(5):620-624. doi:10.7326/0003-4819-92-5-620
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We studied 64 sting-allergic patients treated with one of three regimens of insect-venom immunotherapy: slow, rush, or a step-function regimen. All regimens had a top dose of 100 g and a similar cumulative dose. Efficacy was 100% in all regimens. Fifty percent of the patients had at least one large local reaction at a rate of 9.6 reactions/100 injections. Sixteen percent had systemic symptoms at 1.6 reactions/100 injections. Reaction rates did not differ among the groups, but the slow regimen involved twice as many injections as the rush regimen, and thus caused twice the number of reactions. The rush regimen caused a greater and more rapid rise in antivenom IgG than did the slow regimen, with no difference in IgE levels. We conclude that although equally effective, the rush regimen of venom immunotherapy is associated with a greater immune response and fewer adverse reactions that the slow regimen.





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