Drawbacks

We found 39 reports on the safety of VIT. The treatment protocols are very different in the single studies. The duration and number of injections differed, as well as the doses during the initial phase. We included only studies with the usual maintenance dose of 100 micrograms. The rate of systemic allergic reactions per treated patient during VIT ranged from 0% to 39% (two trials with <12 patients reported rates of 50% and 64%, respectively). We pooled the data by simply adding up the numbers, without any study weighting; we calculated the rate of systemic reactions to be 16% (961/5971 patients). If reported separately, the rate of systemic reactions in honeybee-sensitive patients treated with honeybee venom ranged from 0% to 45% (one trial with 11 patients reported a rate of 64%). After pooling, we calculated a rate of 27% (453/1697 patients). The rate of systemic reactions in wasp-sensitive patients treated with wasp venom ranged from 0% to 34%. After pooling we calculated a rate of 14% (329/2383

patients) 14,28,50,51,56,60,64-69,83-108

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