VENOM IMMUNOTHERAPY - COMPARISON OF RUSH VS CONVENTIONAL SCHEDULES

Abstract

Patients (23) aged 5-52 yr with good clinical histories of severe systemic reactions to hymenoptera stings confirmed by skin tests and RAST [radioallergosorbent test] levels were treated with specific insect venoms. A more conventional, slow biweekly schedule was used to determine whether they could be as successfully treated as those in earlier studies employing the rush desensitization approach. It was also hoped these subjects would experience fewer untoward reactions. Comparisons of IgG (anti-hyaluronidase and phospholipase) levels pretreatment and after top dose (100 mcg) in all cases showed > 3-fold rise, indicating protection. RAST IgE rose in most cases and plateaued by 6 mo. Nineteen patients were restung to verify protection. Untoward reactions to injections were low (13%) and easily controlled. The use of specific freeze-dried insect venoms in a slow dose schedule is safe and effective in protecting severely sensitized individuals.