|Key message:Venom immunotherapy is effective in preventing serious allergic reactions and large local reactions to insect stings, but it carries a A way of expressing the chance of an event taking place, expressed as the number of events divided by the total number of observations or people. It can be stated as ‘the chance of falling were one in four’ (1/4 = 25%). This measure is good no matter the incidence of events i.e. common or infrequent. More of systemic allergic reaction.|
If you’re someone who’s suffered a severe allergic reaction to a sting, or if you’re a clinician with patients who have, you’ll be interested to hear about a new review, from the Cochrane Skin Group, on the use of venom immunotherapy (VIT) for preventing future reactions to stings. As with any Something done with the aim of improving health or relieving suffering. For example, medicines, surgery, psychological and physical therapies, diet and exercise changes. More, the potential benefits have to be weighed against the risks of harm, and this is a significant issue for this treatment.
VIT, which involves giving the person extracted insect venom, usually through a series of injections, hasn’t previously been evaluated in a high-quality systematic review. The reviewers found seven Clinical trials are research studies involving people who use healthcare services. They often compare a new or different treatment with the best treatment currently available. This is to test whether the new or different treatment is safe, effective and any better than what is currently used. No matter how promising a new treatment may appear during tests in a laboratory, it must go through clinical trials before its benefits and risks can really be known. More with 392 people to include in the review. The interventions included bee, wasp and ant immunotherapy, given by injection in six trials and under the tongue in one. Results relate to stings given during the trials or occurring accidentally up to four years later.
What did they find?
- 3/113 (2.7%) participants treated with VIT had a subsequent systemic (whole body) allergic reaction to a sting, compared with 37/93 (39.8%) untreated participants
- VIT also reduced the risk of large local reactions to stings (20 people reacted out of 60 in the VIT group and 46 out of 51 in the control group)
- VIT was associated with a significant risk of systemic allergic reaction to treatment, occurring in 9.3% of treated people who had previously had a systemic allergic reaction (reported in one trial as 1 per 25 injections)
- The two trials assessing quality of life showed a significant improvement in the A group of people in a study receiving a particular health care intervention (for example a drug, surgery, or exercise). More after a year compared with the control group, with reduced anxiety and limitation of activities due to fear of insects
- The ability of an intervention (for example a drug, surgery, or exercise) to produce a desired effect, such as reduce symptoms. More of VIT for preventing fatal systemic reactions to stings remains unknown (none reported)
- No evidence that Refers to serious adverse effects, such as those that threaten life, require or prolong hospitalization, result in permanent disability, or cause birth defects. More or effectiveness differed according to age, route of administration, length of treatment, insect species or dosing schedule
How good is the evidence?
An investigation of a healthcare problem. There are different types of studies used to answer research questions, for example randomised controlled trials or observational studies. More quality was mixed and the results come from a small number of studies and participants but evidence for the effectiveness of VIT was consistent across studies. In five studies the people assessing the Outcomes are measures of health (for example quality of life, pain, blood sugar levels) that can be used to assess the effectiveness and safety of a treatment or other intervention (for example a drug, surgery, or exercise). In research, the outcomes considered most important are ‘primary outcomes’ and those considered less important are ‘secondary outcomes’. More were aware of the group to which people had been allocated, which could have influenced their assessment. The follow-up period was short in most studies.
Boyle RJ, Elremeli M, Hockenhull J, Cherry MG, Bulsara MK, Daniels M, Oude Elberink J. Venom immunotherapy for preventing allergic reactions to insect stings. Cochrane Database of In systematic reviews we search for and summarize studies that answer a specific research question (e.g. is paracetamol effective and safe for treating back pain?). The studies are identified, assessed, and summarized by using a systematic and predefined approach. They inform recommendations for healthcare and research. More 2012, Issue 10. Art. No.: CD008838. DOI: 10.1002/14651858.CD008838.pub2.