Evidence map›Paper›PMID 41748259›Full record

Trial reportClinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology2026

A Pilot Randomised Controlled Dose-Ranging Trial of Ant Venom Immunotherapy With and Without Delta-Inulin Adjuvant.

Thanh-Thao Adriana Le, Troy Wanandy, Griffith B Perkins, Susan Lester, Wun Yee Lau, Malcolm Turner, Richard J Woodman, Emily M Mulcahy, Sherin Vareeckal Joseph, Shweta Mhatre and 5 more

Registry-linked trialAbstract readRandomized Controlled TrialClinical Trial, Phase IClinical Trial, Phase II
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03066986 (A Dose Ranging Study of Sting Challenge and Specific lgE, and IgG4 Responses to Jack Jumper Ant), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03066986 phase1 / phase2unknown statusnot on this map

A Dose Ranging Study of Sting Challenge and Specific lgE, and IgG4 Responses to Jack Jumper Ant (JJA) [Myrmecia Pilosula] Venom Immunotherapy (VIT) With and Without Delta-inulin as an Adjuvant.

TypeinterventionalSponsorCentral Adelaide Local Health Network IncorporatedRan2016 to 2021Enrolled40ConditionsAnt Sting, ImmunotherapyArmsDelta-inulin, Dose finding comparison
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Thanh-Thao Adriana LeDepartment of Clinical Immunology and Allergy, Incorporating the Jack Jumper Allergy Program, Royal Hobart Hospital, Hobart, Tasmania, Australia.ORCID https://orcid.org/0000-0001-8205-865X
Troy WanandyDepartment of Clinical Immunology and Allergy, Incorporating the Jack Jumper Allergy Program, Royal Hobart Hospital, Hobart, Tasmania, Australia.
Griffith B PerkinsImmunology Directorate, SA Pathology, Adelaide, Australia.
Susan LesterRheumatology Research Group, Basil Hetzel Institute, Woodville South, South Australia, Australia.
Wun Yee LauDepartment of Clinical Immunology and Allergy, Incorporating the Jack Jumper Allergy Program, Royal Hobart Hospital, Hobart, Tasmania, Australia.
Malcolm TurnerDepartment of Clinical Immunology and Allergy, Incorporating the Jack Jumper Allergy Program, Royal Hobart Hospital, Hobart, Tasmania, Australia.
Richard J WoodmanFlinders Centre for Epidemiology and Biostatistics, Flinders University, Bedford Park, South Australia, Australia.
Emily M MulcahyDepartment of Clinical Immunology and Allergy, Incorporating the Jack Jumper Allergy Program, Royal Hobart Hospital, Hobart, Tasmania, Australia.
Sherin Vareeckal JosephDepartment of Immunology, Royal Melbourne Hospital and North Western Mental Health, Melbourne, Victoria, Australia.
Shweta MhatreImmunology Directorate, SA Pathology, Adelaide, Australia.
Simon G A BrownDivision of Emergency Medicine, Medical School, University of Western Australia, Perth, Western Australia, Australia.
Michael D WieseClinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia.ORCID https://orcid.org/0000-0002-3255-9242
Nikolai PetrovskyAustralian Respiratory and Sleep Medicine Institute Ltd, Adelaide, South Australia, Australia.ORCID https://orcid.org/0000-0002-1580-5245
Robert J HeddleDepartment of Immunology, Royal Adelaide Hospital, South Australia, Adelaide, Australia.
Pravin HissariaImmunology Directorate, SA Pathology, Adelaide, Australia.

Funding

Allergy and Immunology Foundation of Australasia (Australasian Society of Clinical Immunology and Allergy)Australian Respiratory and Sleep Medicine Institute JV-001Health Services Charitable Gifts Board (Royal Adelaide Hospital) 100-05-52-05-19Health Services Charitable Gifts Board (Royal Adelaide Hospital) 99-05-52-05-19Royal Hobart Hospital Research Foundation 18-105
6 · The paper itself

Abstract

introductionJack Jumper ant (JJA) venom immunotherapy (VIT) is highly efficacious but the lowest effective dose is unknown. Delta-inulin adjuvant (Advax) is known to enhance honeybee VIT immunogenicity.

objectiveThis phase 1/2 single-blind, randomised controlled trial aimed to compare the efficacy and safety of JJA VIT with different doses of venom ± Advax.

methodsAdults aged 18-65 with a history of immediate systemic reaction (SR) to JJA stings were randomised to receive JJA VIT at a maintenance dose of 25 mcg or 50 mcg ± Advax; participants were blinded to treatment allocation. Primary outcomes were the response to sting challenges after 12 months and venom-specific IgE and IgG4 responses to treatment.

resultsForty-nine of 50 screened subjects met inclusion criteria and were randomised; 44 started treatment (25 mcg n = 12; 25 mcg + Advax n = 13; 50mcg n = 12, 50 mcg + Advax n = 12). Subsequently, two withdrew due to SRs to treatment, and two withdrew due to unrelated factors. The higher JJA venom maintenance dose was associated with reduced likelihood of SRs (OR 0.53 (95% CI, 0.28-0.98)), while Advax did not have an effect (OR 1.17 (95% CI, 0.59-2.32)). Forty proceeded to sting challenge, with six developing SRs. There was no difference between groups for sting challenge outcome (p = 0.98), and the ORs for 25 mcg vs. 50 mcg venom dose (0.89, 95% CI, 0.38-2.09) and Advax vs. no Advax (0.99, 95% CI 0.42-2.33) indicated no effect. There were no differences between groups for venom sIgE (p = 0.78), sIgG4 (p = 0.25), sIgE/IgG4 ratio (p = 0.42), intradermal (p = 0.77), and basophil activation test (BAT) (p = 0.69) responses to treatment. Subjects with high baseline BAT sensitivity, which reduced markedly in response to treatment, were less likely to have a positive sting challenge (p = 0.006).

conclusionChallenge outcomes were similar for all groups, with no significant difference found between 25 and 50 mcg maintenance dose or between treatment with and without Advax. Further research of low dose JJA VIT is warranted to confirm its efficacy and tolerability.

trial registrationNCT03066986.

Indexed as

Adjuvants, ImmunologicAnt VenomsDesensitization, ImmunologicInsect Bites and StingsVenom HypersensitivityAdolescentAdultAgedAllergensAnimalsFemaleHumansImmunoglobulin EImmunoglobulin GInulinMaleAdjuvants, ImmunologicAllergensAnt Venomsdelta inulinImmunoglobulin EImmunoglobulin GInulinadjuvantAdvaxdelta‐inulinjack jumper antMyrmecia pilosulavenom allergyvenom immunotherapy

Identifiers

PMID41748259
PMCPMC13065371

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.