TABLE 12Local reactions

Study IDaName of interventionDefinitionTimingn (%)p-value
RCTs
Golden 198041,44Slow therapyLLRDuring VIT9/22 (40.9) patients, 37/450 (8.2) doses
Step therapy12/20 (60.0) patients, 31/260 (11.9) doses
Rush therapy11/22 (50.0) patients, 22/233 (9.4) doses
Mosbech 198645PharmalgenLLRDuring maintenance1/10 (10.0) patientsNR
Alutard0/12 (0.0) patients
Aquagen0/10 (0.0) patients
Non-RCTs
Cadario 200440Aqueous induction and aqueous maintenanceDuring induction local reactionb

Clinician reported using criteria of Lockey et al.53 and Mueller50
Early = reactions within 60 minutes

Late = reactions after 60 minutes
All: 7/18 (38.9) patients, 13/216 (6.0) doses; early: 1/18 (5.6) patients, 1/216 (0.5) doses; late: 6/18 (33.3) patients, 12/216 (5.6) dosesAll: 0.0328 (patients), 0.0004 (doses)
Depot induction and depot maintenanceAll: 4/27 (14.8) patients, 5/405 (1.2) doses; early: 1/27 (3.7) patients, 1/405 (0.2) doses; late: 3/27 (11.1) patients, 4/405 (1.0) doses
Golden 1981424-weekly maintenance aLLR



During maintenance

6 per 100 injections



> 0.05
6-weekly maintenanceLLR2 per 100 injections
4-weekly maintenance bLLRNRNR
Patriarca 200832Ultra-rush SCITLLRDuring VIT3/20 (15) patientsNR
Ultra-rush SLIT0/21 (0.0)
Quercia 200148Pharmalgen: clusterLLR (erythema >10cm)During VIT4/20 (20.0) patientsUnclear
Pharmalgen: rush4/20 (20.0) patients
Depot cluster1/15 (6.7) patients
Thurnheer 198349ConventionalLLRDuring 3-year treatment5/21 (23.8) patientsNR
Rush3/21 (14.3) patients

NR, not reported; SCIT, subcutaneous immunotherapy; SLIT, sublingual immunotherapy.

a

Golden et al.43 did not report on ARs.

b

Müller et al.46,47 did not report on LLR as ARs.

From: 3, Assessment of clinical effectiveness

Cover of A Systematic Review of the Clinical Effectiveness and Cost-Effectiveness of Pharmalgen® for the Treatment of Bee and Wasp Venom Allergy
A Systematic Review of the Clinical Effectiveness and Cost-Effectiveness of Pharmalgen® for the Treatment of Bee and Wasp Venom Allergy.
Health Technology Assessment, No. 16.12.
Hockenhull J, Elremeli M, Cherry MG, et al.
Southampton (UK): NIHR Journals Library; 2012 Mar.
© 2012, Crown Copyright.

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