Bee Venom

Bee Venom

PEP Topic 
Peripheral Neuropathy
Description 

A formulation of sweet bee venom containing melittin, a peptide with reported analgesic and anti-inflammatory effects, was studied for its effect on peripheral neuropathy. The formulation studied had allergens removed from the bee venom, and in one study was administered to patients via pharmacoacupuncture.

Effectiveness Not Established

Research Evidence Summaries

Yoon, J., Jeon, J.H., Lee, Y.W., Cho, C.K., Kwon, K.R., Shin, J.E., . . . Yoo, H.S. (2012). Sweet bee venom pharmacopuncture for chemotherapy-induced peripheral neuropathy. Journal of Acupuncture and Meridian Studies, 5(4), 156–165.

doi: 10.1016/j.jams.2012.05.003
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Study Purpose:

Pilot the use of sweet bee venom pharmacopuncture to assess preliminary efficacy data

Intervention Characteristics/Basic Study Process:

Six treatments were given by one certified oriental medicine doctor to patients over a three-week period. All patients were given skin tests prior to treatment. Adverse events were recorded after each session. The bee venom used incorporated melittin, an active extract from bee venom with allergens removed. The substance was injected into acupuncture points that were chosen in relation to the patients’ symptoms based on oriental medicine theory. Study measures were obtained at baseline; after two, four, and six treatments; and three weeks after treatments were completed.

Sample Characteristics:

  • N = 8
  • MEAN AGE = 49 years
  • MALES = 25%, FEMALES = 75%
  • KEY DISEASE CHARACTERISTICS: Various tumor types existed. Patients had received taxanes, cisplatin, carboplatin, or oxaliplatin.
  • OTHER KEY SAMPLE CHARACTERISTICS: All had diagnosed peripheral neuropathy.

Setting:

  • SITE: Single site
  • SETTING TYPE: Outpatient
  • LOCATION: Korea

Phase of Care and Clinical Applications:

PHASE OF CARE: Late effects and survivorship

Study Design:

Prospective trial—case series

Measurement Instruments/Methods:

  • World Health Organization (WHO) common toxicity criteria for peripheral neuropathy
  • Peripheral neuropathy questionnaire
  • Functional Assessment of Cancer Therapy—General (FACT-G)
  • Common Terminology Criteria for Adverse Events
  • Health-related quality-of-life questionnaire
  • Visual analog scale (VAS)

Results:

Three patients who initially entered dropped out of the study—two due to symptoms that may have been associated with the injections, such as swelling and pain at the injection site and fever. Other therapies used by patients included red ginseng, herbal tonics, massage, foot/hand soaks, and pressure bands. All measures showed a decline in symptoms of peripheral neuropathy, and quality-of-life scores improved. VAS measures and WHO grade of peripheral neuropathy showed significant improvement (p ≤ .01).

Conclusions:

Findings provide minimal evidence that sweet bee venom pharmacopuncture may have some benefit for treatment of chemotherapy-induced peripheral neuropathy. Half of the patients dropped out of the study, and 30% had probably adverse events from injections.

Limitations:

  • Small sample of < 30
  • Risk of bias (no control group)
  • Risk of bias (no blinding)
  • Risk of bias (no random assignment)
  • Measurement/methods were not well described.
  • Measurement validity/reliability were questionable.
  • Subject withdrawals ≥ 10%
  • All study measures used are not fully described.
  • Multiple other herbal and other remedies also were used.
  • Timing of the intervention related to antitumor therapy is not described.
  • Follow-up period is short.

Nursing Implications:

This pilot study provides some evidence to suggest that pharmacoacupuncture with sweet bee venom derivative is appropriate for further research to determine its potential efficacy and safety in larger well-designed trials.


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