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Interview on Venom Immunotherapy with Medical Science Liaison Marc Thomas

Venom Immunotherapy is a life-changing treatment for individuals who are severely allergic to stinging insects such as bees, wasps, and hornets. This therapy is vital in helping patients manage and overcome their fears of potentially life-threatening allergic reactions.  

In this article, we interview Marc Thomas, a Medical Science Liaison at HollisterStier Allergy and a professional healthcare provider in ENT allergy since 1989. Marc oversaw the allergy department for S.E.O.O. Inc. for twenty-three years, and then moved on to work with Antigen Laboratories where he eventually became Antigen’s Clinical Science Liaison before moving on to HollisterStier. In this interview, Marc delves into the intricacies of venom immunotherapy. Marc shares personal insights, explains how venom immunotherapy works, and highlights its profound impact on patients’ lives. 

Disclaimer – Marc Thomas is a paid consultant and not an employee of HollisterStier. The thoughts and opinions are his own and reflect his personal experience in the field of allergy.

WARNING Important Safety Information (See full prescribing information for complete boxed warning.)

Intended for use only by licensed health care provider experienced in administering allergenic extracts and trained to provide immediate emergency treatment in the event of a life-threatening reaction. Observe patients for at least 30 minutes following administration. Immunotherapy may not be suitable for patients with medical conditions that reduce their ability to withstand a systemic reaction. Allergenic extracts can cause serious systemic reactions; including anaphylactic shock and in rare cases death, especially in patients who have severe or steroid-dependent asthma, cardiovascular disease, or in patients who use beta blockers. Do not inject intravenously. Additionally, the reconstituted single venom products are intended for subcutaneous injection for immunotherapy and percutaneous use for diagnosis. The Mixed Vespid venom protein is for immunotherapy only, not for diagnosis. Diagnosis should be based on individual venoms. Refer to contraindications, warnings, precautions, adverse reaction and over dosage for more detailed information.

Interview on Venom Immunotherapy

What is venom immunotherapy and how does it work?

“Venom immunotherapy essentially is a process in which medical providers can test people to first determine whether patients are at risk of having a truly life-threatening situation with venom. I did this for 20 years in my practice, and many patients aren’t clear where they stand when it comes to bee sting reactions.  

Some of them know which stinging insects cause their allergy, some of them don’t. But even if they do, often they’re not clear whether their situation is potentially life-threatening. Sometimes just clarifying that, by being tested, can be helpful. Testing is done using blood tests, preferably skin tests, and we can determine if a person is sensitive. 

Once that is determined, then of course we try to convince them to embark upon immunotherapy because it’s really the only thing that can retrain the body not to react so violently to venom. As a matter of fact, 75-98% of people that go through immunotherapy for venom will not have a systemic reaction or have a reaction that is milder than before going through treatment.1 There are not many therapies in medicine that can give patients and physicians a high amount of confidence in personal safety, but venom immunotherapy is one of them.” 

Graphed image of the various venom immunotherapy species used in treatment extracts.

What do patients need to know before starting venom immunotherapy?

“A lot of patients need to know, number one, are they sensitive enough to experience a severe reaction if they get stung. Number two, if they are severely allergic, then we need to try to encourage them to pursue immunotherapy. Venom immunotherapy is the process of taking the venom of the insect that they’re sensitive to and giving them small doses of it over time, gradually getting their immune system used to it, retraining it until they can get to a point where they can tolerate a full sting with no reaction.” 

Is there an example or success story that you have with venom immunotherapy?

“I had a lot of patients over the years that sent me follow-up mail and cards essentially saying that VIT gave them their lives back. When people are in this kind of situation, they’re afraid to go to family gatherings outside, weddings, or graduations. I had one patient whose parents bought her a convertible for her college graduation. She got stung while out driving her car and made it to the emergency room, but almost succumbed to the sting and fell through the door getting in there. She was scared to drive with her top-down, scared to be outside at all, but after going through venom immunotherapy, she was stung again, and nothing happened. It essentially gave her life back and modeled to other people that they could have their lives back too. It showed that it’s really a successful program.” 

What do you think are some trepidations that discourage medical professionals from providing venom immunotherapy?

Graphed image of the various venom immunotherapy species used in treatment extracts.
“A lot of nurses and staff are afraid of it; they relate the idea of “venom” to “poison” and get scared that people are going to react more violently to it than other allergy extracts you might use. When I first started, I’ll admit I was afraid to do it. Initially, I was afraid I was going to do someone harm, because that’s the last thing that any prudent nurse wants to have happen. But after I provided treatment for a while, I found I was quite comfortable with it and found it even more comfortable treating a venom sensitive patient than a mold allergic asthmatic, because sometimes that’s even trickier. 

It’s similar to how, for years, we called and spoke about the strengths of allergy extracts as potency. But over time, a lot of us who have been in the industry for a long time switched away from saying potent to saying biologically active. This is because the word potency there again is another one of those words that implies poison or danger in somebody’s mind. 

Certainly, we need people to know that in handling venom, if they go about it without following proper instructions, it can be harmful and dangerous. But in the right hands and handled properly, it is a safe procedure, and most people get through it well. It has good outcomes and, if nothing else, just being able to live without being in fear that you’re going to get stung and experience a severe reaction.” 

What makes VIT different from non-standardized extracts when it comes to diagnosis and treatment?

“Although all extract treatments go through rigorous research and testing, VIT stands out because we understand that the venom allergy proteins are the cause of the allergy, so we know exactly what we’re delivering to patients. We know exactly what proteins are involved in the reaction and so we know exactly what we’re delivering and exactly how much we’re delivering. Whereas a lot of the non-standardized extracts like mold and pollens, even some animal danders, we don’t know exactly what the allergen components in some of those treatments are and we don’t know exactly what the right doses are for each individual person when it comes to their treatment.

What do you think is important for patients to know or understand about venom immunotherapy?

Graphed image of the various venom immunotherapy species used in treatment extracts.
“There’s a disconnect sometimes between the emergency room patients that are being seen in the ER for a life-threatening reaction who’ve had shots of adrenaline to deter that severe reaction. Often the ER tells patients that they should try to avoid stinging insects and that they should get an epinephrine pen and carry that with them. This creates a misconception by the public that if they’ve got an epinephrine pen, that’s going to save them, but it may not.  

I’ve always compared the rapidity of the reaction the patients have to a venom sting to that of a car crash and I compare the seat belt or airbags to the epinephrine pen or medications that you might use. If you’re travelling down the road at 150 miles an hour and you crash into a bridge there’s probably not too much of a likelihood that your seat belt or airbag or any of that’s going to save you. But if you can slow that car down to 50 miles an hour, and you hit that bridge, then your seat belt or airbag will probably save you. 

If nothing else, even if we can’t build a person up to where they can tolerate a full sting, we can build their tolerance up enough to where it slows the reaction down and buys time for the medications to work or for them to get to where they can get more care. 

We’re saving lives. Patients need to understand VIT and that it is very effective. If we can get them on this treatment, it can be life-changing for patients. If nothing else, if we can slow down the reaction, we can buy them time. You can’t put a dollar sign on that.” 

Marc Thomas

Marc Thomas

Medical Science Liaison, HollisterStier Allergy

Marc Thomas has been a registered nurse for forty-eight years. After his graduation from nursing school, he worked in an emergency room in Zanesville, OH, and then in the offices of Southeastern Ohio Otolaryngology, where he developed their allergy department, all the while mentoring with many of the pioneers in the field of ENT allergy. He worked in the ER in the evenings, while managing the allergy department through the day clinically and from the business side. By 1989, he was only working occasionally in the ER and his focus was entirely on the field of allergy. Marc continued to attend courses sponsored by the American Academy of Otolaryngic Allergy as well as the Pan American Allergy Society, the American Academy of Environmental Medicine, the American Academy of Asthma, Allergy, and Immunology, and the American College of Allergy, Asthma, and Immunology. After overseeing the allergy department for S.E.O.O. Inc. for twenty-three years, where they offered inhalant allergy testing, food testing, chemical testing, as well as insect allergy testing and treatment for their patients, he went on to work with Antigen Laboratories, an FDA licensed allergy extract manufacturer. After an initial time in sales, as the Midwest Regional Manager, he became Antigen’s Clinical Science Liaison and continued in that capacity until their merger with Greer in 2013. The merger of Antigen Labs with Greer was orchestrated by Aeres Life Sciences. He has helped set up and train many offices around the country since 1980 and he continues to work as an Independent Allergy Nurse Consultant with forty-five years dedicated to allergy. Most of his time is currently spent assisting the customers of Jubilant HollisterStier Allergy. He is well versed in all aspects of allergy from the clinical perspective and the regulatory and business side of the field. His knowledge continues to be sought by physicians and other companies throughout the country.

Article References

1 Golden, D. B. (2007). Insect Sting Anaphylaxis. Immunology and Allergy Clinics of North America, 27(2), 261-272. doi:10.1016/j.iac.2007.03.008

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