Sublingual immunotherapy for large local reactions caused by honeybee sting: A double-blind, placebo-controlled trial - 15/08/11
Reprint requests: Giovanni Passalacqua, MD, Allergy and Respiratory Diseases, Department of Internal Medicine, Padiglione Maragliano, L.go R. Benzi 10, 16132 Genoa, Italy.Abstract |
Background |
Sublingual immunotherapy (SLIT) proved effective and safe in respiratory allergy, and thus its use in hymenoptera allergy can be hypothesized.
Objective |
We sought to assess, in a proof-of-concept study, whether SLIT might potentially be beneficial in hymenoptera allergy. The sting challenge in large local reactions (LLRs) was used to test this hypothesis.
Methods |
We performed a randomized, double-blind, placebo-controlled study involving patients with LLRs who were monosensitized to honeybee. After the baseline sting challenge, they were randomized to either SLIT or placebo for 6 months. The treatment (Anallergo, Florence, Italy) involved a 6-week build-up period, followed by maintenance with 525 μg of venom monthly. The sting challenge was repeated after 6 months.
Results |
Thirty patients (18 male patients; mean age, 44.5 years) were enrolled, and 26 completed the study, with 1 dropout in the active group and 3 dropouts in the placebo group. In the active group the median of the peak maximal diameter of the LLRs decreased from 20.5 to 8.5 cm (P = .014), whereas no change was seen in the placebo group (23.0 vs 20.5 cm, P = not significant). The diameter was reduced more than 50% in 57% of patients. One case of generalized urticaria occurred in a placebo-treated patient at sting challenge. No adverse event caused by SLIT was reported.
Conclusion |
Honeybee SLIT significantly reduced the extent of LLRs, and its safety profile was good. Although LLRs are not an indication for immunotherapy, this proof-of-concept study suggests that SLIT in hymenoptera allergy deserves further investigation. Trials involving systemic reactions and dose-ranging studies are needed.
Le texte complet de cet article est disponible en PDF.Key words : Hymenoptera venom allergy, sublingual immunotherapy, large local reaction, sting challenge
Abbreviations used : HVA, LLR, SLIT, VIT
Plan
| The sublingual immunotherapy and matched placebo were kindly provided by Anallergo S.p.A, Florence, Italy. |
|
| Disclosure of potential conflict of interest: E. Francescato is employed by Entomon SAS. I. Spadolini owns stock in and is employed by Anallergo. The rest of the authors have declared that they have no conflict of interest. |
Vol 122 - N° 1
P. 44-48 - juillet 2008 Retour au numéro
Article précédent
- The Editors’ Choice
- Donald Y.M. Leung, Stanley J. Szefler, Associate Editors of the JACI
- Prospective study of breast-feeding in relation to wheeze, atopy, and bronchial hyperresponsiveness in the Avon Longitudinal Study of Parents and Children (ALSPAC)
- Leslie Elliott, John Henderson, Kate Northstone, Grace Y. Chiu, David Dunson, Stephanie J. London
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?