Abstract
Background. Omalizumab, a recombinant humanized anti-IgE antibody, is an effective treatment option for patients with antihistamine-resistant chronic spontaneous urticaria (CSU). 14–36 % of CSU patients have concomitant chronic inducible urticaria (CIndU). However, it is unclear whether CSU patients with comorbid CIndU can benefit from this treatment.Aim of the study. To assess the efficacy and safety of omalizumab in two patients with CSU and several of types of concomitant CIndU.Materials and methods. CSU and CIndU were diagnosed as recommended by the international urticaria guideline. Both female patients were treated with omalizumab 300 mg by subcutaneous injection every 4 weeks. Response to treatment was assessed by a carefully determined history, the urticaria activity score, urticaria control test, and results of provocation testing.Results. Symptoms of both CSU and CIndU decreased dramatically during the first week of treatment. No adverse events were documented.Conclusions. Omalizumab may be an effective treatment option for patients with combination of antihistamine-resistant CSU and concomitant CIndU. Our findings should be confirmed in larger prospective studies.
Highlights
Omalizumab, a recombinant humanized anti-IgE antibody, is an effective treatment option for patients with antihistamine-resistant chronic spontaneous urticaria (CSU). 14–36 % of CSU patients have concomitant chronic inducible urticaria (CIndU). It is unclear whether CSU patients with comorbid CIndU can benefit from this treatment
CSU and CIndU were diagnosed as recommended by the international urticaria guideline
Both female patients were treated with omalizumab 300 mg by subcutaneous injection every 4 weeks
Summary
Ангиоотеков не было, применялись антигистаминные препараты, в том числе в высоких дозах, без эффекта. Холодовая крапивница — тест с кубиком льда (кубик льда в пластиковом пакете располагали на коже в области передней поверхности предплечья в течение 5 минут);. Местная тепловая крапивница — тест с теплой водой (стеклянный цилиндр с водой температурой 40 °C прикладывали на кожу в области передней поверхности предплечья в течение 5 минут);. Пациенты посещали врача раз в неделю в течение 1–2 месяцев для контроля эффективности лечения с помощью анамнеза, провокационных тестов и валидизированных русских версий опросников, а именно DLQI (Dermatology life Quality Index, дерматологический индекс качества жизни), Сu-Q2oL (Chronic Urticaria Quality of Life Questionnaire, опросник качества жизни у пациентов с хронической крапивницей), UAS (Urticaria Activity Score, шкала для оценки активности заболевания у пациентов с хронической крапивницей), UCT (Urticaria Control Test, тест по контролю над крапивницей) и HADS (Hospital Anxiety and Depression Scale, госпитальная шкала тревоги и депрессии). Таблица 2 Значения тяжести заболевания, контроля заболевания, качества жизни, тревоги и депрессии до, во время и после лечения омализумабом
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