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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
Author(s) -
Sturm Gunter Johannes,
Herzog Sereina Annik,
Aberer Werner,
Alfaya Arias Teresa,
AntolínAmérigo 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,
NittnerMarszalska Marita,
PoziomkowskaGęsicka Iwona,
Pravettoni Valerio,
Preziosi Donatella,
Quercia Oliviero,
Reider Norbert,
RosiekBiegus Marta,
RuizLeon Berta,
Schrautzer Christoph,
Serrano Pilar,
Sin Aytül,
Sin Betül Ayşe,
Stoevesandt Johanna,
Trautmann Axel,
Vachová Martina,
ArztGradwohl Lisa
Publication year - 2021
Publication title -
allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.363
H-Index - 173
eISSN - 1398-9995
pISSN - 0105-4538
DOI - 10.1111/all.14785
Subject(s) - medicine , sting , adverse effect , risk factor , anaphylaxis , observational study , allergy , immunology , engineering , aerospace engineering
Background 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). 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).