Baseline D‐dimer plasma levels correlate with disease activity but not with the response to omalizumab in chronic spontaneous urticaria

Asero, Riccardo; Marzano, Angelo Valerio; Ferrucci, Silvia; Genovese, Giovanni; Cugno, Massimo

doi:10.1111/all.13936

Cited by 13 publications

(4 citation statements)

References 9 publications

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“…A study from Asero et al demonstrated that elevated D-dimer levels are associated with disease severity [20], however, at present time there are no clear data on the correlation between baseline D-dimer levels and the response rate to omalizumab therapy [38][39][40]. Also, the relationship between basophil activation test and the response to omalizumab is unclear.…”

Section: Discussionmentioning

confidence: 91%

Potential Clinical and Serological Predictors of Chronic Spontaneous Urticaria Relapse in Patients Under Omalizumab Treatment

et al. 2020

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Background: Omalizumab is not considered a disease-modifying drug and, accordingly, a large proportion of patients experience a relapse following withdrawal from treatment. Patients & methods: A total of 42 patients who underwent at least one cycle of treatment with omalizumab were enrolled. Two groups of relapsed and not-relapsed subjects were compared. Then, patients were divided into subgroups. Results: Female patients relapse more frequently than male subjects. Patients who relapsed complained a long duration of disease, while patients who did not relapse had short a history of disease. Very early responders are thought to have a high recurrence rate. Basal IgE levels were increased in early responders and cholesterol levels were high in very early responders, who relapse following withdrawal from omalizumab. High D-dimer levels were observed in late responders. Conclusion: The identification of clinical and serological predictors will play a pivotal role in the future management of patients treated with omalizumab.

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Section: Discussionmentioning

confidence: 91%

Potential Clinical and Serological Predictors of Chronic Spontaneous Urticaria Relapse in Patients Under Omalizumab Treatment

et al. 2020

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“…However, it is worth highlighting that this study included a small subset of patients with very high baseline D‐dimer levels, most of whom (80%) had disease control at week 12 2 . Recently, Asero et al showed no correlation between baseline D‐dimer plasma level and response to OMZ 5,6 …”

Section: Patients Characteristics Total Responders Nonresponders P‐vamentioning

confidence: 84%

Clinical predictive factors of unresponsiveness to omalizumab in patients with chronic spontaneous urticaria

et al. 2020

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“…Whether this reflects the existence of different endotypes in patients showing and not showing the activation of the coagulation cascade has still to be established. The inflammatory milieu involving the activation of coagulation / fibrinolysis system does not seem to interfere with the clinical response to omalizumab (12), suggesting that the activated coagulation cascade probably acts as a secondary amplification mechanism rather than the leading actor in this disease. The inflammatory milieu suddenly normalizes in CSU patients responding to omalizumab (13), suggesting that the in-teraction between autoreactive IgE (20) and their ligands is a likely starting point of the inflammation process, and that their neutralization by anti-IgE leads to the "shutdown" of the whole mechanism.…”

Section: Discussionmentioning

confidence: 97%

Severe CSU and activation of the coagulation/fibrinolysis system: clinical aspects

Asero

2020

Eur Ann Allergy Clin Immunol

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Background. About 50% of patients with severe chronic spontaneous urticaria (CSU) show signs of activation of the coagulation/fibrinolysis system, but the clinical significance of this phenomenon is unclear. Objective. The present study compared patients with severe CSU showing and not showing elevated D-dimer plasma levels. Methods. 132 adult patients (m/f 44/88; mean age 51, 5 years; range 14-89 years) with severe CSU (UAS-7 > 30) were included in a cross-sectional, real life study. The study group was divided based on baseline D-dimer plasma levels, and compared for age, sex, disease duration, disease activity, CRP, thyroid autoimmunity, total IgE, and atopic status. Results. Identical numbers of patients showed elevated and normal D-dimer plasma levels (50% and 50%, respectively). Patients showing elevated D-dimer levels were slightly older (p < 0.05), were more frequently females (p < 0.05), had a longer disease duration (p < 0.01), and had a significantly higher prevalence of elevated PCR (26/66 vs 4/66; p < 0.001). Conclusions. Only 50% of patients with severe CSU show elevated D-dimer plasma levels. The activation of the coagulation/fibrinolysis system is associated with a systemic inflammatory milieu, suggesting the existence of a specific phenotype. Whether this reflects the existence of different endotypes in patients showing and not showing the activation of the coagulation cascade has still to be established. of D-dimer are not predictive of CSU patients' response to the humanized anti-IgE mAb, omalizumab (12), it nonetheless parallels the clinical response to this drug (13). Patients with severe CSU show a detectable activation of the coagulation cascade in about 50% of cases (12). What differentiates patients with severe CSU showing and not showing the activation of the coagulation / fibrinolysis system has not been established so far. The present study compared the clinical features in these two subsets of patients with CSU. Patients and methods Patients This cross-sectional, real life study included 132 patients (m/f 44/88; mean age 51, 5 years; range 14-89 years) with severe CSU (UAS-7 > 30) unresponsive to antihistamine treatment. The study group was divided based on baseline D-dimer plasma levels, which were measured by ELISA and expressed as ng/

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Baseline D‐dimer plasma levels correlate with disease activity but not with the response to omalizumab in chronic spontaneous urticaria

Cited by 13 publications

References 9 publications

Potential Clinical and Serological Predictors of Chronic Spontaneous Urticaria Relapse in Patients Under Omalizumab Treatment

Potential Clinical and Serological Predictors of Chronic Spontaneous Urticaria Relapse in Patients Under Omalizumab Treatment

Clinical predictive factors of unresponsiveness to omalizumab in patients with chronic spontaneous urticaria

Severe CSU and activation of the coagulation/fibrinolysis system: clinical aspects

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