EAACI Guidelines on Allergen Immunotherapy: Hymenoptera venom allergy

Gunter J Sturm, Eva-Maria Varga, Graham Roberts, Holger Mosbech, M Beatrice Bilò, Cezmi A Akdis, Darío Antolín-Amérigo, Ewa Cichocka-Jarosz, Radoslaw Gawlik, Thilo Jakob, Mitja Kosnik, Joanna Lange, Ervin Mingomataj, Dimitris I Mitsias, Markus Ollert, Joanna N G Oude Elberink, Oliver Pfaar, Constantinos Pitsios, Valerio Pravettoni, Franziska RuëffBetül Ayşe Sin, Ioana Agache, Elizabeth Angier, Stefania Arasi, Moises A Calderón, Montserrat Fernandez-Rivas, Susanne Halken, Marek Jutel, Susanne Lau, Giovanni Battista Pajno, Ronald van Ree, Dermot Ryan, Otto Spranger, Roy Gerth van Wijk, Sangeeta Dhami, Hadar Zaman, Aziz Sheikh, Antonella Muraro

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Abstrakt

Hymenoptera venom allergy is a potentially life-threatening allergic reaction following a honeybee, vespid, or ant sting. Systemic-allergic sting reactions have been reported in up to 7.5% of adults and up to 3.4% of children. They can be mild and restricted to the skin or moderate to severe with a risk of life-threatening anaphylaxis. Patients should carry an emergency kit containing an adrenaline autoinjector, H 1-antihistamines, and corticosteroids depending on the severity of their previous sting reaction(s). The only treatment to prevent further systemic sting reactions is venom immunotherapy. This guideline has been prepared by the European Academy of Allergy and Clinical Immunology's (EAACI) Taskforce on Venom Immunotherapy as part of the EAACI Guidelines on Allergen Immunotherapy initiative. The guideline aims to provide evidence-based recommendations for the use of venom immunotherapy, has been informed by a formal systematic review and meta-analysis and produced using the Appraisal of Guidelines for Research and Evaluation (AGREE II) approach. The process included representation from a range of stakeholders. Venom immunotherapy is indicated in venom-allergic children and adults to prevent further moderate-to-severe systemic sting reactions. Venom immunotherapy is also recommended in adults with only generalized skin reactions as it results in significant improvements in quality of life compared to carrying an adrenaline autoinjector. This guideline aims to give practical advice on performing venom immunotherapy. Key sections cover general considerations before initiating venom immunotherapy, evidence-based clinical recommendations, risk factors for adverse events and for relapse of systemic sting reaction, and a summary of gaps in the evidence.

OriginalsprogEngelsk
TidsskriftAllergy: European Journal of Allergy and Clinical Immunology
Vol/bind73
Udgave nummer4
Sider (fra-til)744-764
ISSN0105-4538
DOI
StatusUdgivet - apr. 2018

Bibliografisk note

© 2017 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.

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