{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T10:25:37Z","timestamp":1790763937788,"version":"4.1.0"},"reference-count":38,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2014,4,16]],"date-time":"2014-04-16T00:00:00Z","timestamp":1397606400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clin Experimental Allergy"],"published-print":{"date-parts":[[2014,5]]},"abstract":"Summary<\/jats:title>\n \n Background<\/jats:title>\n \n Treatment failure during venom immunotherapy (\n VIT<\/jats:styled-content>\n ) may be associated with a variety of risk factors, of which the relative importance is unknown.\n <\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n \n Our aim was to evaluate the association of baseline serum tryptase concentration (\n BTC<\/jats:styled-content>\n ), mastocytosis in the skin (\n MIS<\/jats:styled-content>\n ) and of other parameters with the frequency of objective systemic reactions during in\u2010hospital sting challenge (\n SC<\/jats:styled-content>\n ).\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n In this observational retrospective study, we enrolled 1532 patients (1609 cases due to double\n SC<\/jats:styled-content>\n ) with established honeybee or vespid venom allergy who had undergone\n VIT<\/jats:styled-content>\n and a subsequent\n SC<\/jats:styled-content>\n . Data were collected on various putative risk factors. Adult\u2010onset\n MIS<\/jats:styled-content>\n and\/or a\n BTC<\/jats:styled-content>\n \u00a0>\u00a020.0\u00a0\u03bcg\/L was defined as clinical indicators of systemic mastocytosis. Relative rates were calculated with logistic regression models.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Ninety\u2010eight patients (6.4%) presented with\n MIS<\/jats:styled-content>\n and\/or\n BTC<\/jats:styled-content>\n \u00a0>\u00a020.0\u00a0\u03bcg\/L. 104 cases (6.5%) developed objective generalized symptoms during\n SC<\/jats:styled-content>\n . In the absence of\n MIS<\/jats:styled-content>\n , a\n BTC<\/jats:styled-content>\n \u00a0\u2264\u00a020\u00a0\u03bcg\/L did not increase the risk for\n VIT<\/jats:styled-content>\n failure. The most important factors associated with a worse outcome were\n ACE<\/jats:styled-content>\n inhibitor medication (\n OR<\/jats:styled-content>\n 5.24, 95%\n CI<\/jats:styled-content>\n 1.83\u201313.00,\n P<\/jats:italic>\n \u00a0<\u00a00.001), honeybee venom allergy (\n OR<\/jats:styled-content>\n 5.09, 95%\n CI<\/jats:styled-content>\n 3.17\u20138.15,\n P<\/jats:italic>\n \u00a0<\u00a00.001), systemic allergic reaction during\n VIT<\/jats:styled-content>\n (\n OR<\/jats:styled-content>\n 3.07, 95%\n CI<\/jats:styled-content>\n 1.79\u20135.14,\n P<\/jats:italic>\n \u00a0<\u00a00.001), and a substantial likelihood to suffer from\n SM<\/jats:styled-content>\n (\n OR<\/jats:styled-content>\n 2.74, 95%\n CI<\/jats:styled-content>\n 1.37\u20135.22,\n P<\/jats:italic>\n \u00a0=\u00a00.003), whereas a double\n VIT<\/jats:styled-content>\n (\n OR<\/jats:styled-content>\n 0.51, 95%\n CI<\/jats:styled-content>\n 0.27\u20130.90,\n P<\/jats:italic>\n \u00a0=\u00a00.027) and a longer duration of therapy (\n OR<\/jats:styled-content>\n 0.68 per treatment month, 95%\n CI<\/jats:styled-content>\n 0.50\u20130.93,\n P<\/jats:italic>\n \u00a0=\u00a00.017) reduced the failure rate.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n The magnitude of therapeutic success correlates with type of venom, duration of therapy, and venom dose. Adult\u2010onset\n MIS<\/jats:styled-content>\n and\/or a\n BTC<\/jats:styled-content>\n \u00a0>\u00a020\u00a0\u03bcg\/L is a significant, albeit not the strongest determinant for\n VIT<\/jats:styled-content>\n failure. According to its odds ratio,\n ACE<\/jats:styled-content>\n inhibitor therapy appears to be associated with the highest risk for\n VIT<\/jats:styled-content>\n failure.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/cea.12275","type":"journal-article","created":{"date-parts":[[2014,1,22]],"date-time":"2014-01-22T03:03:08Z","timestamp":1390359788000},"page":"736-746","source":"Crossref","is-referenced-by-count":123,"title":["Predictors of clinical effectiveness of\n H<\/scp>\n ymenoptera venom immunotherapy"],"prefix":"10.1111","volume":"44","author":[{"given":"F.","family":"Ru\u00ebff","sequence":"first","affiliation":[{"name":"Department of Dermatology and Allergology Ludwig\u2010Maximilian University Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Vos","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology Ludwig\u2010Maximilian University Munich Germany"},{"name":"Department of Allergology University of Groningen University Medical Center Groningen RB Groningen the Netherlands"},{"name":"GRIAC research institute University of Groningen University Medical Center Groningen AV Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Oude Elberink","sequence":"additional","affiliation":[{"name":"Department of Allergology University of Groningen University Medical Center Groningen RB Groningen the Netherlands"},{"name":"GRIAC research institute University of Groningen University Medical Center Groningen AV Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Bender","sequence":"additional","affiliation":[{"name":"Statistical Consulting Unit Department of Statistics Ludwig\u2010Maximilian University Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Chatelain","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology Ludwig\u2010Maximilian University Munich Germany"},{"name":"Fakult\u00e4t f\u00fcr Gesundheit der Universit\u00e4t Witten\/Herdecke Witten Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Dugas\u2010Breit","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology Ludwig\u2010Maximilian University Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.\u2010P.","family":"Horny","sequence":"additional","affiliation":[{"name":"Department of Pathology Ludwig\u2010Maximilian University Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"K\u00fcchenhoff","sequence":"additional","affiliation":[{"name":"Statistical Consulting Unit Department of Statistics Ludwig\u2010Maximilian University Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Linhardt","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy Ludwig\u2010Maximilian University Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Mastnik","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology Ludwig\u2010Maximilian University Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Sotlar","sequence":"additional","affiliation":[{"name":"Department of Pathology Ludwig\u2010Maximilian University Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Stretz","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology Ludwig\u2010Maximilian University Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Vollrath","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology Ludwig\u2010Maximilian University Munich 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