Dataset Information

β-blockers and ACE inhibitors are not a risk factor for severe systemic sting reactions and adverse events during venom immunotherapy.

ABSTRACT:

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).

SUBMITTER: Sturm GJ

PROVIDER: S-EPMC8359427 | biostudies-literature | 2021 Jul

REPOSITORIES: biostudies-literature

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Publications

β-blockers and ACE inhibitors are not a risk factor for severe systemic sting reactions and adverse events during venom immunotherapy.

Sturm Gunter Johannes GJ Herzog Sereina Annik SA Aberer Werner W Alfaya Arias Teresa T Antolín-Amérigo Darío D Bonadonna Patrizia P Boni Elisa E Bożek Andrzej A Chełmińska Marta M Ernst Barbara B Frelih Nina N Gawlik Radoslaw R Gelincik Asli A Hawranek Thomas T Hoetzenecker Wolfram W Jiménez Blanco Aránzazu A Kita Karolina K Kendirlinan Reşat R Košnik Mitja M Laipold Karin K Lang Roland R Marchi Francesco F Mauro Marina M Nittner-Marszalska Marita M Poziomkowska-Gęsicka Iwona I Pravettoni Valerio V Preziosi Donatella D Quercia Oliviero O Reider Norbert N Rosiek-Biegus Marta M Ruiz-Leon Berta B Schrautzer Christoph C Serrano Pilar P Sin Aytül A Sin Betül Ayşe BA Stoevesandt Johanna J Trautmann Axel A Vachová Martina M Arzt-Gradwohl Lisa L

Allergy 20210311 7

<h4>Background</h4>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).<h4>Methods</h4>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 ...[more]

PMID: 33605465

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Project description:PurposeTo determine rates and risk factors associated with severe postoperative complications after cataract surgery and whether they have been changing over the past decade.DesignRetrospective longitudinal cohort study.ParticipantsA total of 221 594 Medicare beneficiaries who underwent cataract surgery during 1994-2006.MethodsBeneficiaries were stratified into 3 cohorts: those who underwent initial cataract surgery during 1994-1995, 1999-2000, or 2005-2006. One-year rates of postoperative severe adverse events (endophthalmitis, suprachoroidal hemorrhage, retinal detachment) were determined for each cohort. Cox regression analyses determined the hazard of developing severe adverse events for each cohort with adjustment for demographic factors, ocular and medical conditions, and surgeon case-mix.Main outcome measuresTime period rates of development of severe postoperative adverse events.ResultsAmong the 221 594 individuals who underwent cataract surgery, 0.5% (1086) had at least 1 severe postoperative complication. After adjustment for confounders, individuals who underwent cataract surgery during 1994-1995 had a 21% increased hazard of being diagnosed with a severe postoperative complication (hazard ratio [HR] 1.21; 95% confidence interval [CI], 1.05-1.41) relative to individuals who underwent cataract surgery during 2005-2006. Those who underwent cataract surgery during 1999-2000 had a 20% increased hazard of experiencing a severe complication (HR 1.20; 95% CI, 1.04-1.39) relative to the 2005-2006 cohort. Risk factors associated with severe adverse events include a prior diagnosis of proliferative diabetic retinopathy (HR 1.62; 95% CI, 1.07-2.45) and cataract surgery combined with another intraocular surgical procedure on the same day (HR 2.51; 95% CI, 2.07-3.04). Individuals receiving surgery by surgeons with the case-mix least prone to developing a severe adverse event (HR 0.52; 95% CI, 0.44-0.62) had a 48% reduced hazard of a severe adverse event relative to recipients of cataract surgery performed by surgeons with the case-mix most prone to developing such outcomes.ConclusionsRates of sight-threatening adverse events after cataract surgery declined during 1994-2006. Future efforts should be directed to identifying ways to reduce severe adverse events in high-risk groups.

Dataset Information

β-blockers and ACE inhibitors are not a risk factor for severe systemic sting reactions and adverse events during venom immunotherapy.

Background

Methods

Results

Conclusions

Publications

β-blockers and ACE inhibitors are not a risk factor for severe systemic sting reactions and adverse events during venom immunotherapy.

Similar Datasets

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