EAACI guidelines on allergen immunotherapy: Hymenoptera venom allergy

Area of Science:

• Allergy and Immunology
• Clinical Medicine

Background:

• Hymenoptera venom allergy, from bee, wasp, or ant stings, can cause severe, life-threatening anaphylaxis.
• Systemic sting reactions affect up to 7.5% of adults and 3.4% of children, ranging from mild skin reactions to severe anaphylaxis.

Purpose of the Study:

• To provide evidence-based recommendations for the use of venom immunotherapy (VIT) in managing Hymenoptera venom allergy.
• To offer practical guidance on performing VIT, including indications, risk factors, and adverse event management.

Main Methods:

• Developed by the European Academy of Allergy and Clinical Immunology (EAACI) Taskforce on Venom Immunotherapy.
• Informed by a systematic review, meta-analysis, and the Appraisal of Guidelines for Research and Evaluation (AGREE II) approach.
• Involved a diverse range of stakeholders to ensure comprehensive recommendations.

Main Results:

• Venom immunotherapy is indicated for children and adults with venom allergy to prevent moderate-to-severe systemic sting reactions.
• VIT is also recommended for adults experiencing generalized skin reactions, significantly improving their quality of life compared to emergency kits alone.

Conclusions:

• Venom immunotherapy is the only definitive treatment to prevent recurrent systemic sting reactions in Hymenoptera venom-allergic individuals.
• The guideline provides practical advice on initiating and managing VIT, addressing risk factors and evidence gaps.