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β-blockers and ACE inhibitors are not a risk factor for severe systemic sting reactions and adverse events during venom immunotherapy.
Identificadores del recurso
http://hdl.handle.net/10668/17198
33605465
10.1111/all.14785
1398-9995
PMC8359427
https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/all.14785
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8359427/pdf
Origin
(RISalud-ANDALUCÍA)

File

Title:
β-blockers and ACE inhibitors are not a risk factor for severe systemic sting reactions and adverse events during venom immunotherapy.
Tema:
ACE inhibitor
adverse event
beta-blocker
systemic insect sting reaction
venom immunotherapy
Anaphylaxis
Angiotensin-Converting Enzyme Inhibitors
Bee Venoms
Desensitization, Immunologic
Humans
Insect Bites and Stings
Prospective Studies
Risk Factors
Description:
There is controversy whether taking β-blockers or ACE inhibitors (ACEI) is a risk factor for more severe systemic insect sting reactions (SSR) and whether it increases the number or severity of adverse events (AE) during venom immunotherapy (VIT). 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. 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. 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).
Idioma:
Autor/Productor:
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
Rights:
Attribution-NonCommercial 4.0 International
http://creativecommons.org/licenses/by-nc/4.0/
open access
Date:
2023-02-09T10:42:40Z
2021-03-11
Tipo de recurso:
research article
VoR
Format:
application/pdf

oai_dc

Download XML

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    1. <dc:title>β-blockers and ACE inhibitors are not a risk factor for severe systemic sting reactions and adverse events during venom immunotherapy.</dc:title>

    2. <dc:creator>Sturm, Gunter Johannes</dc:creator>

    3. <dc:creator>Herzog, Sereina Annik</dc:creator>

    4. <dc:creator>Aberer, Werner</dc:creator>

    5. <dc:creator>Alfaya Arias, Teresa</dc:creator>

    6. <dc:creator>Antolín-Amérigo, Darío</dc:creator>

    7. <dc:creator>Bonadonna, Patrizia</dc:creator>

    8. <dc:creator>Boni, Elisa</dc:creator>

    9. <dc:creator>Bożek, Andrzej</dc:creator>

    10. <dc:creator>Chełmińska, Marta</dc:creator>

    11. <dc:creator>Ernst, Barbara</dc:creator>

    12. <dc:creator>Frelih, Nina</dc:creator>

    13. <dc:creator>Gawlik, Radoslaw</dc:creator>

    14. <dc:creator>Gelincik, Asli</dc:creator>

    15. <dc:creator>Hawranek, Thomas</dc:creator>

    16. <dc:creator>Hoetzenecker, Wolfram</dc:creator>

    17. <dc:creator>Jiménez Blanco, Aránzazu</dc:creator>

    18. <dc:creator>Kita, Karolina</dc:creator>

    19. <dc:creator>Kendirlinan, Reşat</dc:creator>

    20. <dc:creator>Košnik, Mitja</dc:creator>

    21. <dc:creator>Laipold, Karin</dc:creator>

    22. <dc:creator>Lang, Roland</dc:creator>

    23. <dc:creator>Marchi, Francesco</dc:creator>

    24. <dc:creator>Mauro, Marina</dc:creator>

    25. <dc:creator>Nittner-Marszalska, Marita</dc:creator>

    26. <dc:creator>Poziomkowska-Gęsicka, Iwona</dc:creator>

    27. <dc:creator>Pravettoni, Valerio</dc:creator>

    28. <dc:creator>Preziosi, Donatella</dc:creator>

    29. <dc:creator>Quercia, Oliviero</dc:creator>

    30. <dc:creator>Reider, Norbert</dc:creator>

    31. <dc:creator>Rosiek-Biegus, Marta</dc:creator>

    32. <dc:creator>Ruiz-Leon, Berta</dc:creator>

    33. <dc:creator>Schrautzer, Christoph</dc:creator>

    34. <dc:creator>Serrano, Pilar</dc:creator>

    35. <dc:creator>Sin, Aytül</dc:creator>

    36. <dc:creator>Sin, Betül Ayşe</dc:creator>

    37. <dc:creator>Stoevesandt, Johanna</dc:creator>

    38. <dc:creator>Trautmann, Axel</dc:creator>

    39. <dc:creator>Vachová, Martina</dc:creator>

    40. <dc:creator>Arzt-Gradwohl, Lisa</dc:creator>

    41. <dc:subject>ACE inhibitor</dc:subject>

    42. <dc:subject>adverse event</dc:subject>

    43. <dc:subject>beta-blocker</dc:subject>

    44. <dc:subject>systemic insect sting reaction</dc:subject>

    45. <dc:subject>venom immunotherapy</dc:subject>

    46. <dc:subject>Anaphylaxis</dc:subject>

    47. <dc:subject>Angiotensin-Converting Enzyme Inhibitors</dc:subject>

    48. <dc:subject>Bee Venoms</dc:subject>

    49. <dc:subject>Desensitization, Immunologic</dc:subject>

    50. <dc:subject>Humans</dc:subject>

    51. <dc:subject>Insect Bites and Stings</dc:subject>

    52. <dc:subject>Prospective Studies</dc:subject>

    53. <dc:subject>Risk Factors</dc:subject>

    54. <dc:description>There is controversy whether taking β-blockers or ACE inhibitors (ACEI) is a risk factor for more severe systemic insect sting reactions (SSR) and whether it increases the number or severity of adverse events (AE) during venom immunotherapy (VIT). 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. 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. 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).</dc:description>

    55. <dc:date>2023-02-09T10:42:40Z</dc:date>

    56. <dc:date>2023-02-09T10:42:40Z</dc:date>

    57. <dc:date>2021-03-11</dc:date>

    58. <dc:type>research article</dc:type>

    59. <dc:type>VoR</dc:type>

    60. <dc:identifier>http://hdl.handle.net/10668/17198</dc:identifier>

    61. <dc:identifier>33605465</dc:identifier>

    62. <dc:identifier>10.1111/all.14785</dc:identifier>

    63. <dc:identifier>1398-9995</dc:identifier>

    64. <dc:identifier>PMC8359427</dc:identifier>

    65. <dc:identifier>https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/all.14785</dc:identifier>

    66. <dc:identifier>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8359427/pdf</dc:identifier>

    67. <dc:language>en</dc:language>

    68. <dc:rights>Attribution-NonCommercial 4.0 International</dc:rights>

    69. <dc:rights>http://creativecommons.org/licenses/by-nc/4.0/</dc:rights>

    70. <dc:rights>open access</dc:rights>

    71. <dc:format>application/pdf</dc:format>

    </oai_dc:dc>

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