Venom immunotherapy improves health-related quality of life in patients allergic to yellow jacket venom

被引:134
作者
Elberink, JNGO
de Monchy, JGR
van der Heide, S
Guyatt, GH
Dubois, AEJ
机构
[1] Univ Groningen Hosp, Dept Allergol, NL-9700 RB Groningen, Netherlands
[2] McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON L8S 4L8, Canada
关键词
venom immunotherapy; EpiPen; quality of life; Hymenoptera allergy; insect allergy; yellow jacket allergy; number needed to treat; minimal important difference; Vespid Allergy Quality-of-Life Questionnaire;
D O I
10.1067/mai.2002.125827
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
Background: Venom immunotherapy (VIT) is effective in preventing anaphylactic reactions after insect stings. The effect of VIT on health-related quality of life (HRQL) was studied to evaluate whether this treatment is of importance to patients. Objective: We compared HRQL outcomes measured with a disease-specific instrument (Vespid Allergy Quality-of-Life Questionnaire [VQLQ]) in patients allergic to yellow jacket venom treated with VIT or with an adrenalin self-administration device (EpiPen) in an open-label, randomized, controlled trial. Methods: Consenting patients were block randomized to either VIT or EpiPen. Patients received uniform, standardized information, which specified the risk of their condition and the risks and benefits of both treatment options. HRQL measures took place before and after 1 year of treatment with VIT or EpiPen. Results: Seventy-four patients agreed to be randomized, of whom 36 received VIT and 38 an EpiPen. The mean change in VQLQ score in the group randomized to VIT was 1.07 (95% CI, 0.68-1.46), and this improvement was statistically significant (P <.0001) compared with that seen in the group randomized to the EpiPen, in which this change was -0.43 (95% CI, -0.71 to -0.16). These differences Acre seen in both men and women, persons with more or less general anxiety, and those stung recently and those stung more than a year before their outpatient department visit. The overall proportion of patients receiving benefit from VIT is 0.72, generating a number needed to treat of 1.4. Conclusions: VIT results in a clinically important improvement in HRQL in patients allergic to yellow jacket venom in;all subgroups studied. Of every 3 patients treated with VIT, 2 patients experience an important improvement in their quality of life.
引用
收藏
页码:174 / 182
页数:9
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