膜翅目昆虫毒液免疫疗法:超急速方案与急速和慢速常规方案的耐受性和疗效对比。

Journal of allergy Pub Date : 2012-01-01 Epub Date: 2012-05-24 DOI:10.1155/2012/192192
Vincenzo Patella, Giovanni Florio, Ada Giuliano, Carmine Oricchio, Giuseppe Spadaro, Gianni Marone, Arturo Genovese
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摘要

背景和目的。目前有多种毒液免疫疗法(VIT)方案可用于膜翅目昆虫过敏症。尽管 VIT 的不良反应(ADRs)被广泛报道,但仍需要进行对照试验。我们进行了一项随机前瞻性研究,以评估三种 VIT 方案的不良反应和疗效。研究方法76 名年龄在 16-76 岁之间的膜翅目昆虫过敏症患者被随机分配接受超冲洗方案(A 组:27 名患者)、冲洗方案(B 组:25 名患者)或慢速方案(C 组:24 名患者)。在增量阶段使用水性毒液提取物,在维持阶段使用吸附剂。在 VIT 期间发生的不良反应和意外蛰伤用于评估疗效。结果显示在增量治疗期间,A、B 和 C 组分别有 1.99%、3.7% 和 3.9% 的患者发生 ADR,在维持治疗期间分别有 0.99%、1.46% 和 2.7% 的患者发生 ADR。A组(递增+维持阶段)的ADR明显少于C组(1.29%对3.2%;P = 0.013)。意外被膜翅目昆虫蜇伤的反应在各组之间没有差异(1.1%、1.2% 和 1.1%)。结论Ultrarush 与急速和慢速方案一样有效,而且蜇伤反应发生率低。这项研究表明,超绒毛 VIT 是治疗膜翅目昆虫过敏的有效方法。
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Hymenoptera Venom Immunotherapy: Tolerance and Efficacy of an Ultrarush Protocol versus a Rush and a Slow Conventional Protocol.

Background and Objective. Various venom immunotherapy (VIT) protocols are available for Hymenoptera allergy. Although adverse reactions (ADRs) to VIT are widely reported, controlled trials are still needed. We conducted a randomized prospective study to evaluate ADRs and the efficacy of three VIT regimens. Methods. 76 patients with Hymenoptera allergy, aged 16-76 years, were randomized to receive an ultrarush protocol (group A: 27 patients), a rush protocol (group B: 25), or a slow protocol (group C: 24). Aqueous venom extract was used in incremental phase and an adsorbed depot in maintenance phase. ADRs and accidental Hymenoptera stings during VIT were used to evaluate efficacy. Results. During incremental treatment, ADRs occurred in 1.99%, 3.7%, and 3.9% of patients in groups A, B, and C, and in 0.99%, 1.46%, and 2.7%, respectively, during maintenance. ADRs were significantly fewer in group A (incremental + maintenance phase) than in group C (1.29% versus 3.2%; P = 0.013). Reactions to accidental Hymenoptera stings did not differ among groups (1.1%, 1.2%, and 1.1%). Conclusion. Ultrarush was as effective as the rush and slow protocols and was associated with a low incidence of reactions to stings. This study indicates that ultrarush VIT is a valid therapeutic option for Hymenoptera allergy.

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