Impact of specific immunotherapy and sting challenge on the quality of life in patients with hymenoptera venom allergy

Tamara Eitel; Kim Nikola Zeiner; Katharina Assmus; Hanns Ackermann; Nadja Zoeller; Markus Meissner; Roland Kaufmann; Stefan Kippenberger; Eva Maria Valesky

doi:10.1016/j.waojou.2021.100536

Impact of specific immunotherapy and sting challenge on the quality of life in patients with hymenoptera venom allergy

World Allergy Organ J. 2021 Apr 21;14(5):100536. doi: 10.1016/j.waojou.2021.100536. eCollection 2021 May.

Authors

Tamara Eitel¹, Kim Nikola Zeiner¹, Katharina Assmus¹, Hanns Ackermann², Nadja Zoeller¹, Markus Meissner¹, Roland Kaufmann¹, Stefan Kippenberger¹, Eva Maria Valesky¹

Affiliations

¹ Department of Dermatology, Venereology and Allergology, Goethe University Frankfurt, Frankfurt/Main, Germany.
² Department of Biostatistics and Mathematical Models, Goethe University Frankfurt, Frankfurt/Main, Germany.

Abstract

Background: An experienced life-threating anaphylactic reaction to hymenoptera venom can sustainably impair patients' quality of life (QoL). Besides carrying emergency medication, venom-specific immunotherapy (VIT) exists as a causal treatment of allergy.

Objective: This study aimed to examine QoL, anxiety, depression, and physical and mental health in patients allergic to hymenoptera venom before and during VIT and the impact of a tolerated sting challenge (SC).

Methods: Between July 2017 and August 2017, 142 patients with venom allergy were analyzed using validated questionnaires as the: Vespid Allergy Quality for Life Questionnaire" (VQLQ-d), the "Hospital Anxiety and Depression Scale" (HADS-D) and the "Short Form 36" (SF-36). To evaluate the impact of VIT and SC on the QoL, patients were divided into 3 groups: (A) VIT and tolerated SC (n = 45), (B) VIT before carrying out SC (n = 73), and (C) therapy-naïve before VIT (n = 20). Further parameters like gender, age, insect species, and severity of the anaphylactic reaction were assessed.

Results: A significant correlation between the health-related QoL and the parameters of gender and state of treatment was seen. Especially male patients, as well as patients allergic to yellow jacket venom, benefit from a SC in terms of a significant increase in their QoL. In the total study cohort, a clear trend was observed towards a higher QoL in patients under VIT who tolerated a SC. Overall, neither the patients' age nor the insect species exerted a relevant influence on QoL, depression or anxiety. However, women showed a lower QoL combined with higher anxiety and depression scores than men.

Conclusion: Immunotherapy leads to an improved QoL, which can be further increased by a SC. A tolerated SC conceivably reassures the patients by objectifying the treatment success. Female patients appear to have a stronger impaired QoL per se. Taken together, a SC can be performed during VIT to strengthen the patients' QoL.

Keywords: Hymenoptera venom allergy; Immunotherapy; Quality of life; Sting challenge.