Real-World Safety and Efficacy Clinical Data of an Improved Allergen-Specific Immunotherapy Product for the Treatment of Bee Venom Allergy.

The aim of this study is to explore the safety and efficacy of bee venom immunotherapy without HSA, in real-life patients. Methods: This is an observational retrospective study developed in seven hospitals in Spain, where patients treated with this immunotherapy were included. They gathered the protocol used to initiate the immunotherapy, adverse reactions, field re-stings, and the patient clinical data (clinical history, biomarkers, and skin prick test). Results: A total of 108 patients were included. In total, 4 protocols were used (5 weeks reaching 200 µg, and 4, 3, and 2 weeks reaching 100 µg). An incidence of systemic adverse reactions for each 100 injections of 1.5, 1.7, 0, and 0.58, respectively, was found. The demographic data showed not to directly affect the appearance of adverse reactions, except for those having a grade 2 systemic reaction with immunotherapy previously had a grade 4 systemic reaction; the IgE to Apis mellifera was 3 times higher in patients with systemic reactions of grade 1 than in the general group, and other specific IgEs were lower in those with systemic reactions. Most of the patients recognized Api m 1 followed by Api m 10. In the sample, 32% experienced spontaneous re-stings, without presenting systemic reactions, after a year of treatment.

Relación entre presencia de comorbilidad y control del asma / Relationship Between Comorbidity and Asthma Control

Introducción. La coexistencia de procesos potencialmente agravantes es frecuente en asmáticos, especialmente en individuos con control difícil. Es objetivo primario conocer si la comorbilidad es más frecuente en los pacientes no controlados. Como objetivo secundario nos propusimos evaluar el grado de correlación entre test de control del asma (ACT) y la fracción exhalada de óxido nítrico (FENO). Pacientes y métodos. Estudio prospectivo, observacional, que comparó funcional y clínicamente dos grupos de asmáticos: controlados (ACT≥20) y no controlados (ACT<20). En todos se investigó la presencia de tabaquismo, rinosinusitis, obesidad, ansiedad, depresión, disfunción de cuerdas vocales, reflujo gastroesofágico (RGE), aspergilosis broncopulmonar alérgica (ABPA), EPOC y poliposis nasal. Resultados. Se incluyeron 56 pacientes con asma controlada y 102 con un control subóptimo. Los pacientes con un ACT≥20 tenían mejor función pulmonar, menor variabilidad del PEF, menos hiperreactividad bronquial y menores valores de FENO. Se hallaron comorbilidades en el 95% de los asmáticos controlados y en el 97% de los no controlados. Sólo la presencia de poliposis nasal, RGE y ABPA fue más frecuente en el grupo no controlado. Sin embargo, la presencia simultánea de 3 o más factores de comorbilidad fue significativamente más frecuente en los pacientes con un control subóptimo (p=0,01). No hubo correlación significativa entre los valores del FENO y los del ACT (rho=−0,08; p=0,32). Conclusiones. La suma de comorbilidades agravantes es más frecuente en pacientes con control subóptimo. No existe correlación entre los valores de ACT y de FENO (AU)

Introduction. The coexistence of potentially aggravating processes is common in asthmatics, particularly in patients with difficult control. The primary aim of this study is to ascertain whether comorbidity id more common in uncontrolled patients. As a secondary aim, we propose to evaluate the correlation between the asthma control test (ACT) and the fraction of exhaled nitric oxide (FENO). Patient and methods. A prospective, observational study comparing the function and clinical picture of two groups of asthmatics: controlled (ACT≥20) and uncontrolled (ACT<20). They were all assessed for, smoking, rhinosinusitis, obesity, anxiety, depression, vocal cord dysfunction, gastro-oesophageal reflux (GORD), allergic bronchopulmonary aspergillosis (ABPA), COPD and nasal polyps. Results. A total of 50 patients with controlled asthma and 102 with suboptimal control were included. The patients with an ACT≥20 had better lung function, less variation in PEF, less bronchial hyper-reactivity and lower FENO values. Comorbidities were found in 95% of the controlled asthmatics and in 97% of the uncontrolled. Only the presence of nasal polyps, GORD and ABPA was more frequent in the uncontrolled group. However, the simultaneous presence of 3 or more comorbidity factors was significantly more frequent in patients with sub-optimal control (P=0.01). There was no significant correlation between the FENO and the ACT values (rho=−0.08; P=0.32). Conclusions. Aggravating comorbidities are more common in patients with sub-optimal control. There was no correlation between the FENO and the ACT values (AU)

Hymenoptera venom allergy: characteristics, tolerance and efficacy of immunotherapy in the paediatric population

Hymenoptera venom allergy is a growing problem in Spain. This problem has a special relevance in areas where population is frequently exposed to hymenoptera stings, being paediatric patients a high risk population. Immunotherapy with hymenoptera venom is an effective and safe treatment for these patients. However, there is a lack of data on the role of this treatmenton paediatric population. For this reason, from the data base of the Allergy Unit from Hospital Xeral (Lugo, Spain) which includes 560 patients, have been analyzed the 21 paediatric patients, all of them treated with venom immunotherapy.Eighteen patients completed the treatment. The maintenance dose administered was 100 mg. Two systemic reactions (both with an Apis extract) were registered. Cutaneous test and specific IgE shown a statistical significant reduction at the end of treatment (p = .0004 and p < .0001respectively). Seven patients (33 %) suffered a spontaneous re-stung during maintenance phase or after immunotherapy was completed. In 4 patients there was no allergic reaction and the other 3 children suffered a mild local reaction.In conclusion, venom immunotherapy is a safe and effective treatment in paediatric patients with hymenoptera venom allergy, being necessary to increase the experience on this specific segment of the allergic population (AU)

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