Modified rapid venom desensitization

The clinical and immunologic response to a modified rapid (r) regimen of venom immunotherapy was evaluated and compared to a traditional (t) therapeutic regimen. Nineteen patients in the r group received a starting dose of 0.01 microgram and reached a maintenance dose of 50 micrograms in 7 weeks. Twelve patients in the t group received an average of twenty-one injections on a weekly basis, reaching the same maintenance dose. The age and sex distribution and pre-treatment venom-specific IgE titres (RAST) of both groups were comparable. There were thirteen local reactions to venom therapy in both groups and no systemic reactions. Following therapy, most patients developed a rising titre of serum venom-specific IgG (V-IgG). Serum venom-specific IgE (V-IgE) changes were similar in the two groups; over half of the patients had a falling titre when on maintenance dose. Twelve patients were re-stung after reaching maintenance dose. Only one developed a mild systemic reaction, an individual who failed to show a V-IgG response with rapid therapy. Five of nine patients did not have an anamnestic V-IgE response. This rapid method of venom immunotherapy appears to be safe, clinically effective, and comparable to traditional dosing without additional adverse reaction.