Treatable Traits of Hymenoptera Venom-Induced Anaphylaxis: A Real-Life-Based Study

"Treatable traits" (TT) have been proposed as a new paradigm for asthma but never applied to anaphylaxis. Hymenoptera venom-induced anaphylaxis (HVA) is one of the leading causes of anaphylaxis worldwide.

Our aim was to propose TT for HVA based on evidence-based data.

This is a historic-prospective study based on the Hymenoptera venom-induced allergy and hypersensitivity database fed regularly by allergists at the Montpellier University hospital. Patients were classified as having "mild anaphylaxis" (MA), "moderate-severe anaphylaxis" (MSA), or "nonanaphylaxis" (NA), following Ring and Messmer Severity Score, and characteristics have been evaluated for each group. The potential risk factors have been classified as modifiable/controllable (MCRF) and nonmodifiable (NRF), and TT have been proposed from a preventive perspective.

Of overall 602 patients, 54.2% were men, with a mean age of 42.3 years. A total of 218 patients (36.2%) developed MA, 159 (26.4%) MSA, and 213 (35.4%) NA. Age and atopic and cardiovascular diseases were identified as significant NRF. Symptoms appeared within 5 minutes (P < .01) and less than 1 hour in MSA. Skin tests and in vitro ves v5 (P < .0355) were significant and sensitive tools for the diagnosis. Occupational exposure (30%), along with the use of adrenaline, and venom immunotherapy were considered MCRF.

Our results brought the evidence to TT through HVA data and tailored adapted preventive strategies to all severity degrees of HVA. This article based on real-life data is a wake-up call for actions. Step forward implementation of actions among specialists and the general population should be put in place to reduce the morbimortality induced by HVA.