Omalizumab In Chronic Urticaria Research Articles

Performance of high-dose omalizumab in chronic urticaria is predicted by initial improvement to standard dose

Performance of high-dose omalizumab in chronic urticaria is predicted by initial improvement to standard dose

Real-World Effectiveness of Omalizumab in Chronic Urticaria: A Clinical Observational Study

Introduction: The purpose of this study was to assess the clinical effectiveness and safety profile of omalizumab as a therapeutic intervention for chronic urticaria (CU). Methods: From March 1, 2023, to September 30, 2023, data on a cohort comprising 96 patients with CU, who underwent treatment with omalizumab at our medical institution’s allergy clinic, were systematically compiled. Subsequent to the administration of omalizumab, the therapeutic efficacy was assessed utilizing the 7-day urticaria activity score and the urticaria control test. Results: Based on the statistical analysis, the mean duration of therapeutic intervention was 2.4 ± 1.3 months, with a corresponding mean cumulative dosage of 765 ± 450 mg. Of the subset of 42 patients with CU who were subjected to a follow-up period exceeding 3 months, it was observed that the treatment led to complete symptom remission, and no instances of recurrence were documented. Notably, there were statistically significant differences in the treatment duration and the cumulative dosage between patients who experienced co-morbid conditions and those who did not (p < 0.01, 95% CI: 0.280–1.326; p < 0.01, 95% CI: 0.597–2.997). Furthermore, there were significant differences in the treatment duration and cumulative dosage between patients in the combined allergic rhinitis group and those in the non-combined allergic rhinitis group (p < 0.01, 95% CI: 0.204–1.305; p = 0.01, 95% CI: 0.326–2.860). Conclusion: Omalizumab demonstrates efficacy in the management of CU among Chinese patients by exerting effective symptom control and facilitating the regression of skin lesions. The assessment of its therapeutic efficacy typically requires a 12-week treatment period. Moreover, the co-occurrence of CU with other allergic disorders serves as a pertinent consideration for the adjustment of omalizumab dosing regimens.

Safety of omalizumab in chronic urticaria during pregnancy: a real-life study.

Managing a pregnant patient with chronic spontaneous urticaria (CSU) is often challenging. Recent data have shown that most CSU treatments in pregnant patients are second-generation H1 antihistamines (sgAHs), while data on the safety of omalizumab are scant. To evaluate, in a routine clinical practice setting, the efficacy and safety of omalizumab in patients with severe CSU refractory to sgAHs who either became pregnant during treatment or who started the drug during pregnancy. We conducted a retrospective study of women aged ≥ 18 years who were pregnant, who received one or more doses of omalizumab at any time during their pregnancy or who were taking omalizumab at the time of, or in the 8 weeks before, conception. Twenty-nine pregnant patients were evaluated: 23 (79%) conceived a child while taking omalizumab (group A), while 6 (21%) started omalizumab treatment during pregnancy (group B). Among patients in group A, we observed 23 births (21 liveborn singletons and 1 liveborn twin pair) and 1 miscarriage. Fifteen (65%) patients discontinued omalizumab after confirming their pregnancy, while eight (35%) were exposed to omalizumab during their entire pregnancy. In group B, omalizumab was introduced at a mean (SD) 10.83 (3.60) weeks' gestation and all patients were exposed to it until the end of pregnancy. In this group, there were seven liveborn infants (five singletons and one twin pair). No adverse events, pregnancy complications or congenital anomalies in newborns were recorded in either group. Omalizumab for CSU treatment before and during pregnancy does not appear to have negative effects on maternal or fetal outcomes.

Prospective, monocentric, observational study of the long-term effectiveness of omalizumab in chronic urticaria.

Omalizumab, a monoclonal antibody targeting IgE, has been approved in 2014 for the treatment of H1 antihistamine-refractory chronic urticaria. Data on long-term effectiveness and predictive factors for treatment response are currently limited. In this monocentric, prospective, observational study, 112 patients with chronic spontaneous urticaria (CSU) and 32 patients with chronic inducible urticaria (CIndU) were included. In addition to a rapid response, omalizumab also showed good effectiveness on both forms of chronic urticaria over 2 years. Low total IgE and elevated Yersinia IgA were identified as potential predictive markers for slower treatment responses in CSU. In conclusion, the present study highlights the efficacy of omalizumab for the treatment of chronic urticaria. With emerging new therapeutic options for chronic urticaria, further genetic as well as molecular markers are needed to establish patient-specific therapy selection.

Omalizumab in chronic urticaria; real-life data of 6-year-experience

Background: Chronic urticaria (CU) is defined as the persistence of urticarial lesions for more than 6 weeks. Omalizumab, a human monoclonal anti IgE antibody, has been used as a new therapeutic option in CU patients unresponsive to high-dose second-generation antihistamines. Aims and Objectives: This study is aimed to examine the clinical and demographic characteristics of CU patients treated with omalizumab in our clinic and to define parameters related to therapeutic response. Materials and Methods: Patients who were followed up with the diagnosis of CU between January 2014 and June 2020 were evaluated retrospectively. The data obtained from patients’ electronic files were analyzed using SPSS23 program. Results: 167 patients (125 female, 42 male) were included. The mean age was 45.34 ± 14.76 years. The mean disease duration at the onset of omalizumab was found to be 47.41 ± 63.26 months. Complete response to treatment was observed in 45.9%, 48%, and 52% of patients at 3rd, 6th, and 12th months of omalizumab treatment, respectively. The baseline total IgE level was evaluated in 107 patients and a statistically significant correlation was observed between complete response to treatment at 3rd month and higher baseline total IgE levels (P < 0.001). Conclusion: Omalizumab provided a significant therapeutic response and the patients did not need any other treatment, while patients with high pretreatment IgE levels showed a better and earlier response. These results may guide clinicians in predicting patients’ response to omalizumab.

Private Practice Experience with Omalizumab for Chronic Urticaria

Private Practice Experience with Omalizumab for Chronic Urticaria

Omalizumab for chronic urticaria in children younger than 12 years

Omalizumab for chronic urticaria in children younger than 12 years

Learnings from real-life experience of using omalizumab for chronic urticaria in Latin America

BackgroundUpdated urticaria guidelines recommend that patients should be assessed for disease activity, severity, control, and quality of life at baseline and follow up. Regarding treatment, guidelines consider second generation antihistamines as the cornerstone in therapy for chronic urticaria (CU), while other drugs, such as omalizumab, are conceived as second-line alternatives. In regards to omalizumab, despite advances in the management of CU, there are still open questions about timing, dosing, and objective measures for clinical response. This study was designed to portray the use of patient-reported outcomes (PROs) in chronic urticaria management, as well as the effectiveness and treatment patterns of omalizumab in CU, as seen in a real-life setting in Latin America. MethodsThis is a retrospective observational study, involving 72 Latin American patients with chronic urticaria treated with omalizumab. Patient reported outcomes and treatment patterns, response, quality of life improvement and discontinuation were analyzed. ResultsFrom the 72 patients, 91.7% (n = 66) were assessed through PROs, where urticaria control test (UCT) was the most used (79.2%; n = 57). Overall, 80.0% (n = 44) responded to omalizumab at some point of the treatment. Omalizumab 300 mg was associated with earlier response compared to lower doses. Regardless of dosage, most patients assessed with CU-Q2oL improved quality of life (80.8%; n = 21). With respect to omalizumab discontinuation, 20.8% (n = 15) patients interrupted omalizumab before the 3rd month of treatment (p = .000). ConclusionsThe present study highlights how the use of PROs and omalizumab in Latin America differ from guidelines’ recommendations and clinical trials. Even though most patients were initiated under omalizumab 300 mg, most of them finished with lower doses. Regardless of dosage, most patients responded to omalizumab and improved quality of life at some point during treatment. However, such features were seen earlier with omalizumab 300 mg. Regarding treatment discontinuation, one-fifth of patients interrupted omalizumab before the third month.

Predicting Response to Omalizumab in Chronic Urticaria Based on Biomarkers

Chronic urticaria (CU) is characterised by intense recurrent itch, wheals, and/or angioedema, persisting for &gt;6 weeks. CU can be subdivided into chronic spontaneous urticaria and chronic inducible urticaria; the latter usually appears with physical stimuli, such as heat, cold, pressure, and sunlight. The recommended treatment for CU is non-sedating oral antihistamines, administered up to four times a day. The monoclonal antibody omalizumab (anti-IgE) is recommended as an add-on therapy for patients with antihistamine-refractory CU. The fluctuating nature of urticaria symptoms and varying response to omalizumab often makes it difficult to predict the response to omalizumab; this often leads to individualised dosage regimens for CU patients. However, being able to predict the response to omalizumab treatment would lead to an improvement in dosage regimens and treatment plans in the clinical setting. Several studies have investigated potential CU biomarkers; however, no reliable biomarkers have been discovered that can be used to assess the treatment response to omalizumab in the clinic. Some potential biomarkers, such as plasma D-dimer, serum total IgE levels, the basophil histamine release assay, the autologous serum skin test, and the basophil activation test, have been suggested for predicting disease activity and response to omalizumab but are not implemented routinely in clinical practice. This paper presents an overview of the various biomarkers associated with response to omalizumab in CU.

Omalizumab in chronic spontaneous and inducible urticaria: a 9 year retrospective study in Portugal.

Objective. Describe the safety and long-term use of omalizumab in chronic urticaria (CU), both spontaneous (CSU) and inducible (CIndU). Methods. Retrospective chart-review (2006-15) of CU patients treated with omalizumab for ≥ 6 months. Statistical analyses: descriptive statistics, Mann-Whitney, generalized linear models. Results. 23 patients with CSU (3 men), 3 with CIndU (2 men). Generalized linear models showed UAS reduction per omalizumab administration of 16% in CIndU and CSU and UAS7, of 15% in CIndU, and 20% in CSU. DLQI score at baseline had a median of 19 (CIndU and CSU) and after omalizumab a median of 0 (in both). Seven CSU patients stopped omalizumab and remain asymptomatic. No side-effects were observed. Conclusion. Omalizumab is safe and efficacious in CU. Stopping omalizumab can be tried, as some patients achieve remission.

P154 Biomarkers which may predict response to omalizumab in chronic urticaria: serum IGE and CD203C

P154 Biomarkers which may predict response to omalizumab in chronic urticaria: serum IGE and CD203C

P166 Characteristics of patients receiving omalizumab for chronic urticaria in the UAE

P166 Characteristics of patients receiving omalizumab for chronic urticaria in the UAE

Omalizumab for Chronic Urticaria: Aftermarket Reports of Efficacy and Side Effects

Purpose of Review The purpose of this study was to review real-life studies on effectiveness and safety of omalizumab in chronic urticaria (CU).

Omalizumab for chronic urticaria in Latin America

Background Chronic urticaria (CU) is defined as the spontaneous appearance of wheals, with or without angioedema, persisting for ≥6 weeks. Chronic Spontaneous Urticaria (CSU) is a type of CU which affects 0.5–1 % of the global population, but it represents a high burden to patients. In recent years, omalizumab is available as treatment of disease. Our aim is to extend previous findings, analyzing effects of omalizumab on symptoms in Latin American patients with CSU.Methods Retrospective analysis of patients treated with omalizumab in Cuenca-Ecuador. 150 mg omalizumab was administered every 4 weeks, and its effects were measured by Urticaria Activity Score (UAS) at baseline and each month in follow up. Complete response was defined as a UAS of 0 or 1, and partial response was classified as a UAS of 2 or more. Also, demographic and clinical variables were collected. Descriptive analyses were employed. Response rates were summarized as counts and percentages after 3 and 5 months. Related Samples Wilcoxon signed rank tests were used to compare UAS at baseline and after 3 months. P values <0.05 indicated statistical significance.Results 26 subjects were enrolled, almost half were female individuals (57.7 %), with mean age 47.8 years (range, 18–81 years). Mean duration of CU after diagnosis was 23.3 months (range, 2–180 months). Mean UAS at baseline was 5.7 points (range, 4–6 points). Nine patients (34.6 %) completed 3 months of treatment (33 % reported a complete response), with a mean difference in UAS of 3.33 (p = 0.01). Four patients completed 5 months of treatment (75.0 % showed a complete response). All patients previously treated with first-generation antihistamines plus corticosteroids showed no responses at neither 3 nor 5 months of treatment.Conclusion Omalizumab is an effective treatment for patients with CU. It is necessary to conduct some future investigations where we can establish if 150 mg could be an option in developing countries.

Lack of basophil CD203c-upregulating activity as an immunological marker to predict response to treatment with omalizumab in patients with symptomatic chronic urticaria

Lack of basophil CD203c-upregulating activity as an immunological marker to predict response to treatment with omalizumab in patients with symptomatic chronic urticaria

Omalizumab in Chronic Urticaria: Experience in a Third Level Hospital in Madrid

Omalizumab in Chronic Urticaria: Experience in a Third Level Hospital in Madrid

EFICÁCIA DO TRATAMENTO COM OMALIZUMAB NA URTICÁRIA CRÓNICA ESPONTÂNEA RESISTENTE À TERAPÊUTICA HABITUAL COMBINADA

A urticária crónica (UC) consiste num quadro cutâneo de duração superior a 6 semanas, caracterizada pelo aparecimento de lesões máculo-papulares eritematosas e pruriginosas, com uma duração individual inferior a 24 horas. É uma patologia relativamente frequente que causa morbilidade significativa. Atualmente, o seu tratamento com fármacos para além dos anti-histamínicos-H1 não foi exaustivamente estudada. Descrevemos um caso de UC grave, resistente à terapêutica convencional com doses elevadas de anti-histamínicos-H1, corticodependente, no qual o tratamento com o anticorpo monoclonal anti-IgE omalizumab permitiu o controlo da urticária e a interrupção de corticoides sistémicos. Não se observaram reações adversas e o fármaco permaneceu eficaz ao longo de 18 meses de terapia. É posteriormente apresentada uma revisão da literatura relativa à utilização deste fármaco, com ênfase nas suas características a longo prazo.

Quoi de neuf en thérapeutique dermatologique ?

Innovations in dermatological therapy remain rare. In 2013, increase in the knowledge of mechanism of action and place in the therapeutic strategies concern some recent drugs. For psoriasis treatment, efficacy and safety of anti IL-17 and anti JAK pathway has been demonstrated in randomized studies versus placebo. In other inflammatory diseases, the role of rituximab in auto immune bullous diseases and of omalizumab in chronic urticaria is better known. This year was published the first randomized trial using anti TNF in hidradenitis suppurativa with positive but limited effects. For infectious diseases, the role of prolonged antibiotherapy in the management of recurrent cellulitis is well documented and new antibiotics appears for the treatment of multi resistant bacteria in infection of skin and soft tissues. Finaly, analysis of quality criteria in dermatological trial showed great capability for increase in quality, a strong prerequiste for treating our patient with safety and efficacy.

Omalizumab in chronic urticaria: a retrospective series of 15 cases

Omalizumab is a monoclonal anti-IgE antibody approved for the treatment of severe allergic asthma. There is increasing evidence in the literature of its usefulness in chronic urticaria. Herein, we report a retrospective case series of 15 patients with chronic idiopathic urticaria treated with omalizumab. We reviewed their medical records to assess the improvement achieved after 3 and 6 months of treatment. Complete response was defined as symptom disappearance that could be followed by discontinuation of antihistamines, and partial response as symptom improvement, but with symptom worsening when attempting to discontinue antihistamines. After 3 months of treatment, 12 patients responded, with partial response in 9 and complete response in 3. At 6 months, 8 of 10 patients continuing on omalizumab had a complete response and 2 a partial response. The results of the present retrospective series show the effectiveness of omalizumab in most treated patients, which is consistent with other recently published series and studies. These data support its role in the management of patients with chronic urticaria refractory to conventional treatments.

Omalizumab in chronic urticaria

The current EAACI/GA²LEN/EDF/WAO treatment guidelines for the management of urticaria recommend omalizumab as fourth-line therapy. Within the last year, many reports of omalizumab treatment in chronic urticaria have been published. Two multicenter, randomized, placebo-controlled trials in chronic spontaneous urticaria have shown excellent efficacy of omalizumab. Furthermore, in various case series and case reports, omalizumab has been shown to be effective also in inducible urticarias; however, no randomized placebo-controlled trial has been performed yet to thoroughly investigate the efficacy of omalizumab in inducible urticarias. In this review, all published information on the use of omalizumab in urticaria will be summarized and discussed with special emphasis on reports published within the last year. The available data indicate that omalizumab is an effective and well tolerated drug in antihistamine-resistant chronic urticaria.