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The Sting Challenge Test: An EAACI Position Paper on Hymenoptera Venom Allergy
Arantza Vega Castro1,2, Christine Breynaert3,4, Teresa Alfaya5
1Allergy Department, University Hospital of Guadalajara, Guadalajara, Spain.
Allergy
|October 11, 2025
Summary
The Sting Challenge Test (SCT) is the sole reliable method to confirm venom immunotherapy (VIT) effectiveness in Hymenoptera venom allergy patients. This EAACI paper details SCT applications, risks, and outcomes for personalized allergy treatment.
Area of Science:
- Allergy and Immunology
- Clinical Practice Guidelines
- Hymenoptera Venom Allergy
Background:
- Hymenoptera venom allergy is a significant cause of anaphylaxis in adults.
- Venom immunotherapy (VIT) is the only curative treatment for severe Hymenoptera venom allergy.
- A reliable method is needed to verify VIT effectiveness.
Purpose of the Study:
- To provide an in-depth analysis of the Sting Challenge Test (SCT) in clinical practice.
- To focus on the SCT's role in monitoring VIT efficacy and patient quality of life.
- To offer practical considerations for performing the SCT safely.
Main Methods:
- Review of existing literature on SCT.
- Expert consensus from the Insect Venom Hypersensitivity Working Group of EAACI.
- Analysis of SCT applications, risks, and outcomes.
Main Results:
- SCT is the only reliable method to verify VIT effectiveness.
- SCT is used to assess VIT protection, adjust dosage, and confirm safety.
- SCT is not recommended for routine diagnosis due to systemic reaction risks.
Conclusions:
- SCT is a valuable tool for personalized allergy treatment and monitoring VIT.
- Careful insect handling and patient preparation are crucial for SCT safety.
- This position paper guides clinicians in the appropriate use of SCT.
