β-blockers and ACE inhibitors are not a risk factor for severe systemic sting reactions and adverse events during venom immunotherapy.
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Sturm Gunter Johannes, Herzog Sereina Annik, Aberer Werner, Alfaya Arias Teresa, Antolín-Amérigo Darío, Bonadonna Patrizia, Boni Elisa, Bożek Andrzej, Chełmińska Marta, Ernst Barbara, Frelih Nina, Gawlik Radoslaw, Gelincik Asli, Hawranek Thomas, Hoetzenecker Wolfram, Jiménez Blanco Aránzazu, Kita Karolina, Kendirlinan Reşat, Košnik Mitja, Laipold Karin, Lang Roland, Marchi Francesco, Mauro Marina, Nittner-Marszalska Marita, Poziomkowska-Gęsicka Iwona, Pravettoni Valerio, Preziosi Donatella, Quercia Oliviero, Reider Norbert, Rosiek-Biegus Marta, Ruiz-Leon Berta, Schrautzer Christoph, Serrano Pilar, Sin Aytül, Sin Betül Ayşe, Stoevesandt Johanna, Trautmann Axel, Vachová Martina, Arzt-Gradwohl Lisa
Аннотация
METHODS: In this open, prospective, observational, multicenter trial, we recruited patients with a history of a SSR and indication for VIT. The primary objective of this study was to evaluate whether patients taking β-blockers or ACEI show more systemic AE during VIT compared to patients without such treatment.
RESULTS: In total, 1,425 patients were enrolled and VIT was performed in 1,342 patients. Of all patients included, 388 (27.2%) took antihypertensive (AHT) drugs (10.4% took β-blockers, 11.9% ACEI, 5.0% β-blockers and ACEI). Only 5.6% of patients under AHT treatment experienced systemic AE during VIT as compared with 7.4% of patients without these drugs (OR: 0.74, 95% CI: 0.43-1.22, p = 0.25). The severity of the initial sting reaction was not affected by the intake of β-blockers or ACEI (OR: 1.14, 95% CI: 0.89-1.46, p = 0.29). In total, 210 (17.7%) patients were re-stung during VIT and 191 (91.0%) tolerated the sting without systemic symptoms. Of the 19 patients with VIT treatment failure, 4 took β-blockers, none an ACEI.
CONCLUSIONS: This trial provides robust evidence that taking β-blockers or ACEI does neither increase the frequency of systemic AE during VIT nor aggravate SSR. Moreover, results suggest that these drugs do not impair effectiveness of VIT. (Funded by Medical University of Graz, Austria; Clinicaltrials.gov number, NCT04269629).