Meerdink, M.E. (2014) Factoren van invloed op de effectiviteit van wespengif immunotherapie & Het effect van immunotherapie op de kwaliteit van leven van patiënten met een wespenallergie. thesis, Medicine.
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Abstract
Background: Insect sting allergy is a potentially life threatening disease with a major impact on the quality of life. Treatment with venom immunotherapy (VIT) is highly effective in preventing systemic reactions after insect stings. VIT also improves the allergy related quality of life significantly during therapy. Which factors are associated with a lower chance on long term protection and whether or not VIT continues to improve the quality of life for years after the treatment has stopped is still unknown and subject of this study. Methods: This retrospective study included 775 patients with an allergy to yellow jacket venom. All patients started VIT during 1995-2005 and 2009-2013. Patients were questioned about their present allergy specific quality of life, using the validated Vespid Quality of Life Questionnaire (VQLQ), and about experiencing re-stings. Using single and multivariate logistic regression, factors influencing efficacy and quality of life were analysed. Results: re-stings after starting VIT occurred in 259 patients. 23 of them (8,9%) developed a re-sting systemic reaction. Patients with a re-sting systemic reaction did not differ in sex, Mueller grade pre VIT, sensitisation, duration of VIT, time period between stopping VIT and re-sting, total IgE, methylhistamine or tryptase in a single logistic regression. The age at start of VIT did differ between the two groups. Only a younger age at starting VIT was related to a higher risk on a re-sting systemic reaction during VIT and after stopping VIT (OR 0,96; CI 0,93-1,00). Pre VIT data and data during or post VIT were available in 196 patients. VIT significantly improved the allergy specific quality of life on short term (<5 years) and long term (>5 and >10 years) period (<0,001). A severe SR pre VIT (p=0,047) and the occurrence of a re-sting SR (p=0,004) significantly decreased the chance on a clinically relevant improvement of the allergy related quality of life. Conclusion: VIT is on short term and on long term highly efficient (91,1%) in preventing life threatening situations in yellow jacket allergic patients. Starting VIT at a younger age is associated with a lower efficacy. VIT improves allergy specific quality of life on short term and long term in 66% of the patients. Re-sting SR and a severe SR pre-VIT are associated with a lower change to clinically improve the allergy related quality of life.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Oude Elberink, Dr. J.N.G. |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:57 |
| Last Modified: | 25 Jun 2020 10:57 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1752 |
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