Tolerated Sting Challenge in Patients on Hymenoptera Venom Immunotherapy Improves Health-Related Quality of Life

Background: Sting challenge with a live insect remains the best test for proving the efficacy of immunotherapy in Hymenoptera allergy. Objective: We studied the impact of tolerated sting challenge on quality of life. Patients and Methods: In this prospective study, data were collected via self-report questionnaires completed by consenting patients with Hymenoptera venom allergy on venom immunotherapy before and after a sting challenge. Results: The study population comprised 100 adult patients (82 with yellow jacket allergy and 18 with honeybee allergy) who participated between September 2009 and November 2010. After the sting challenge, the score on the Vespid Allergy Quality of Life Questionnaire revealed a statistically significant improvement (mean [SD] change, 0.73 [0.98]; P<.0001; 95% CI, 0.52-0.94). This improvement was independent of the patients' gender and age and the severity of the initial anaphylactic reaction. A statistically significant improvement was documented in 2 subgroups of the Short Form 36 Health Survey (physical functioning, mean change, –5.78 [25.23]; P=.038; 95%CI, –11.22 to –0.34; vitality, mean change –4.29 [12.49]; P=.002; 95% CI, –7.02 to –1.57). Conclusions: Sting challenge results in a significant improvement in disease-specific quality of life and subgroups of general quality of life in patients allergic to Hymenoptera venom receiving established venom immunotherapy.