EAACI-Leitlinien zur allergen-spezifischen Immuntherapie: Insektengiftallergie
2020
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,
H1-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.
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