By Dr. Paul Ehrlich
For a while, my colleagues and I’ve been fearful about the truth that one of many two main suppliers of insect venom for allergy photographs was leaving the market. Now we’re assured by each the AAAAI and ACAAI that the remaining provider will have the ability to rise to the problem. Their joint launch that arrived in my mailbox reads:
Venom Extracts Will Not Be Interrupted/Diminished
On March 1 the ACAAI and the AAAAI despatched a joint announcement on ALK’s departure from the North American venom extract market. This created preliminary concern that the earlier short-term scarcity would grow to be long-term, affecting the care of 1000’s of venom allergic sufferers.
Happily, by way of the cooperation of Hollister-Stier with ALK and the FDA, the provision of venom extracts won’t be interrupted or diminished. Hollister-Stier has offered not solely reassurance, however ample proof of their efforts to extend and enhance their manufacturing of venom extracts—and to attenuate the prospect of future shortages. They declare to have ample provide readily available and in manufacturing to satisfy the full US demand.
Because of this, allergists shouldn’t hesitate to prescribe and keep full dose venom immunotherapy at regular intervals and to renew therapy if therapy had been interrupted. Quite than a everlasting scarcity we’ve been assured of an plentiful provide.
This had been a supply of concern in my observe the place we’ve round 50 sufferers who want this remedy. Insect stings are estimated to be the third main reason behind anaphylaxis behind treatment and meals, however they’re second in fatalities at a degree about twice that of meals. Undoubtedly each could be increased if wasps and bees weren’t seasonal.
After I was coaching a few years in the past, extracts for insect (hymenoptera) photographs have been made through the use of the entire insect. Now the venom itself is extracted.
A lot of the seminal work on insect allergic reactions was achieved by my buddy Dr. Robert Reisman, who wrote an authentic piece for this web site a few years earlier than he died. He spent years giving photographs, hoping to seek out that they might end in tolerance, which is the case with different environmental and seasonal allergens equivalent to pollen and dustmites. However he by no means hit that threshold, which is why the specter of venom shortages was so horrifying for sufferers and allergists. Miss a shot or two and the affected person is as susceptible as ever. So let’s hope that Hollister-Stier can choose up the slack. And let’s hope that they don’t use their monopoly to gouge sufferers on price.
(For an account of what insect anaphylaxis was like earlier than immunotherapy and epinephrine autoinjectors, click on right here.)
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By Dr. Paul Ehrlich