Effectiveness of specific immunotherapy in the treatment of Hymenoptera venom hypersensitivity: A meta-analysis

Background: For most people, Hymenoptera stings produce a transient, local inflammatory reaction (pain, redness, swelling). However, for those who are allergic to components of this venom, the reactions can be severe, frighte ning, and sometimes fatal. Specific immunotherapy (SIT) has been the only m eans of desensitizing patients who have experienced a systemic reaction to this venom. Objective: This meta-analysis was conducted to compare the effects of SIT i n the treatment of Hymenoptera venom hypersensitivity. Methods: All studies of SIT in the treatment of Hymenoptera venom hypersens itivity published in English between the years 1966 and 1996 were identifie d through a MEDLINE(R) search. Because of the ethical difficulties involved in designing a double-blind, placebo-controlled study in this patient popu lation, most of the studies were open and not placebo-controlled. One autho r (R.N.R.) extracted data from the studies. Odds ratios (ORs) and 95% confi dence intervals (CIs) were calculated using a random-effects model. Results: Data were extracted from 8 studies involving 453 patients; 1 study was conducted in adults (n = 20), 2 in children (n = 188), and 5 in all ag es (n = 245). The symptoms of Hymenoptera venom hypersensitivity were preve nted in 80 (79%) of the 101 patients receiving SIT versus 49 (36%) of 136 c omparison patients. The symptoms were not prevented in 21 (21%) of the pati ents receiving SIT versus 87 (64%) of the comparison patients (OR 2.20, 95% CI 1.72 to 2.81). Conclusion: The findings of this mete-analysis support the conclusion that SIT is effective in the treatment of Hymenoptera venom hypersensitivity.