With the recent shortage of venom extract, we had 25 patients who required stopping of venom immunotherapy (VIT). The March 2017 task force recommendation focused on prolonging existing supplies, but gave limited insight into retesting or restarting VIT, after prolonged periods without a maintenance injection. Our clinic’s venom extract supply was exhausted by December 2016.
Using our list of patients previously on VIT we attempted to contact them for follow up and consideration for restarting VIT, retesting, or judicious stopping of VIT based on the 2016 practice parameter changes. This was done as a quality improvement project, and we also established a practice policy/guideline for restarting VIT in these patients.
Our patients had an average of 168 days off of VIT. We successfully achieved maintenance in 5 of our patients by restarting a weekly buildup using 0.05 of the red vial as the initial dose. We experienced no systemic reactions. We also noted a significant percentage of patients who, although restarting VIT was warranted based on current practice parameter recommendations, were unwilling to reinitiate VIT.
With the venom extract shortage apparently ending we present a cohort of patients who were successfully restarted on VIT. A large percentage of our cohort also appears to have lost interest in VIT, even though it is now available.