Real-world insights into venom immunotherapy in the United Kingdom: Analysis from the BSACI Registry For Immunotherapy (BRIT)
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Authors
Grewal A.
Pur L.
Villa L.P.
Maslovskaya O.
Smith M.
Achunche S.
Baigel R.
Dawson T.
Ewan P.
Gourgey R.
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2025
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Objectives: To assess the clinical characteristics, treatment timelines, and patient-reported outcomes associated with venom immunotherapy (VIT) in the United Kingdom using data from the BSACI Registry for Immunotherapy (BRIT). Method(s): Data from 525 patients recorded in BRIT were included. Descriptive statistics summarised demographics, referral patterns product use, treatment initiation intervals, and outcomes. Quality of life (QoL) was evaluated using the patient-reported Venom Quality of Life Questionnaire (VQLQ), and real-world sting response data were collected using the Field Sting Questionnaire. Result(s): Patients ranged in age from 4 to 84 years (mean age 54); 53.5% were male. The median interval from first allergy centre visit to VIT initiation was seven months (IQR 10). Baseline tryptase was assessed in over 90% of patients, with elevated levels observed in 8.8%. Of 600 VIT courses, 68.2% were for wasp venom, 27.2% for bee venom, and 0.4% for both. Licensed products were used in 94% of treatments. Of 137 patients who completed the VQLQ, 67% reported an improvement in QoL. Field Sting Questionnaires were completed by 222 individuals; 28.4% reported being stung post-treatment with most events resulting in mild reactions. However, 13.4% were systemic, 4.2% required adrenaline, and 5% led to hospital admission. Stings most frequently occurred during beekeeping (36.7%). Conclusion(s): This registry-based analysis provides the most comprehensive real-world overview of venom immunotherapy practice in the UK to date. While most treatments utilised licensed products and were associated with patient-reported improvements in QoL, the variation in treatment initiation intervals and post-treatment sting outcomes highlight ongoing challenges in standardising care. These findings support the continued value of national registry data in guiding best practices and underscore the need for equitable access, structured follow-up and targeted education-particularly for high-risk groups such as beekeepers.
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Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology