RAPID VENOM IMMUNOTHERAPY IS SAFE FOR ROUTINE USE IN THE TREATMENT OFPATIENTS WITH HYMENOPTERA-ANAPHYLAXIS

Background: Rapid venom immunotherapy regimens have been developed to provide safe protection to individuals who have experienced Hymenopter a anaphylaxis by administering greater than 50 mu g of venom over two to three hours on treatment day 1.(1-3) A rapid venom immunotherapy pr otocol which consisted of administration of a cumulative dose of 58.55 mu g of each venom on treatment day 1 followed by an accelerated buil d-up over 3 weeks to a final maintenance dose of 100 mu g per venom wa s developed by our group in 1984. Objective: We report our 10-year cum ulative experience with this rapid venom immunotherapy regimen. Method s: Seventy-seven venom-allergic patients received a cumulative dose of 58.55 mu g per venom on treatment day 1 in an ambulatory care setting . Rapid venom immunotherapy was assessed for safety. A cost analysis w as performed to compare rapid venom immunotherapy to a modified rush i mmunotherapy regimen. Results: Four patients (5.2%), experienced mild systemic reactions consisting of diffuse urticaria on day 1. Treatment was otherwise well tolerated. Resting events occurred in 21 patients, a mean number of 12 months (range: 3 days to 48 months) after treatme nt, without systemic reactions. Conclusions: This experience confirms that rapid venom immunotherapy is safe to administer in an ambulatory setting and should be considered especially for patients during the st inging insect season when rapid protection is required.