Low uptake of treatment options for insect venom allergies

Patients need better information

Vienna, June 12, 2006. An insect venom allergy can be fatal. The good news is that that this condition responds well to therapeutic management. Patients who receive causal treatment in the form of specific immunotherapy (SIT) have an almost 100 percent chance of a cure. "Despite its proven tolerability and efficacy, SIT uptake rates are much too low. It's probably because patients are not well enough informed," concluded Franziska Ruëff, an insect venom allergy expert with the Dermatology Department of Munich University Hospital, in her presentation at the 25th Congress of the European Academy of Allergology and Clinical Immunology (EAACI) in Vienna.

Insect venom allergies are caused by an excessive immune response, usually to a wasp or bee sting. The possible consequences include itching and rash on the palms of the hand and soles of the feet, difficulty breathing, vertigo and nausea. Some allergy sufferers develop life-threatening anaphylactic shock. Assay of specific IgE antibodies and prick tests would detect sensitization to insect venom in an estimated 25% of the European population. Five percent of the population develop serious or indeed life-threatening symptoms. Reported prevalences of insect venom allergies range from 0.34 to 7.5 percent in different parts of Europe.(1) In spite of the potentially life-threatening consequences, only one in five allergy sufferers undergoes specific immunotherapy (SIT) to treat their condition.

Ruëff presented data from an international multicenter observational study investigating diagnostic and therapeutic approaches in a number of European countries. This study disclosed regional differences in the distribution of wasp and bee venom allergies and differences with respect to the tolerability of the allergen products used. Wasp venom allergies are more common in Germany, while the incidence of positive prick test responses to bee venom is higher in Austria and Switzerland. The study also showed that the products used for anti-bee venom allergy SIT are less well tolerated and less effective than products for wasp venom allergy. "The statistics on efficacy and tolerability of SIT differ in various European countries. There are also major differences in the therapeutic approaches employed. This might explain the more reserved attitude toward SIT in some countries, such as Switzerland, Austria, and indeed southern Germany," Ruëff stated. One of the surprising outcomes of the study was the very marked reluctance of sufferers to seek treatment, including people with major risk factors. "Only 80 percent of people with insect venom allergies in our studies were prepared to undergo this potentially life-saving treatment. Better and more extensive information on the hazards and the treatment options from primary care physicians would help to address this problem," allergologist Franziska Ruëff from Munich University noted.

(1) Biló BM, Ruëff F, et al. Diagnosis of Hymenoptera venom allergy. Allergy 2005: 60: 1339-1349

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