Long-term adherence to imported fire ant subcutaneous immunotherapy

摘要

? 2022 The AuthorsBackground: Imported fire ant (IFA) whole-body extract subcutaneous immunotherapy (IT) is a safe and effective treatment for IFA hypersensitivity, with a recommended length of treatment of 3 to 5 years. Objective: To evaluate long-term IFA IT adherence in patients with IFA allergy living in an endemic area. Methods: During 2007 to 2014, patients with IFA-sting systemic reactions and a recommendation to start IFA IT were prospectively enrolled in this study. Subjects were contacted annually for interval IT adherence. Institutional review board approval was obtained. Results: A total of 87 subjects, ages 2 to 64 years, with a recommendation to initiate IFA IT, were enrolled. Subjects were predominantly adult (76) and female (55), and 30 had asthma. Of these patients, 77 (89) initiated treatment within 1 year of recommendation; 18 (23) adhered to a 3-year course; and 10 (13) adhered to a 5-year course. At 3 years, there were no significant differences in adherence between male and female subjects (28 vs 19, P =.33), children and adults (25 vs 22, P =.79), or those with or without asthma (30 vs 20, P =.31). Adherence in subjects with mild initial reactions was lower than in subjects with moderate-to-severe reactions (0 vs 25, P =.05) at 3 years only. Conventional buildup and concurrent flying Hymenoptera venom immunotherapy were predictive of adherence. Reasons for discontinuation were relocation to a nonendemic area (29) and inconvenience (27). Conclusion: This study showed poor long-term adherence to IFA IT at 3 and 5 years. Initial sting severity, buildup protocol, and concurrent flying Hymenoptera venom immunotherapy were predictors for long-term IT adherence.