Immunothérapie allergénique aux venins d’hyménoptères : doses et espacement des rappels – quelle conduite à tenir à long terme ?

Abstract

Allergenic immunotherapy for hymenoptera venom follows clearly defined recommendations based for the most part on the opinions of experts. While the booster dose of venom usually recommended is 100μg, several studies have shown that effective protection may be achieved with lower doses. The dose should be increased to 200μg in situations involving high risk such as beekeepers, mastocyte-line abnormalities, tests that continue to be highly positive, and systemic reactions on subsequent stings. For hornets of the species Vespa crabro and Vespa velutina, a maintenance dose of 100μg of Vespula wasp venom appears effective. Treatment durations of less than 5 years provide insufficient guarantees of avoidance of anaphylactic reactions to further stings following discontinuation. Prolonged treatment, in some cases lifelong, is indicated in patients at risk. Beyond 5 years, a booster interval of 3 or 4 months appears safe and effective.