Factors related to omalizumab resistance in chronic spontaneous urticaria

Magen, Eli; Chikovani, Tinatin; Waitman, Dan‐Andrei; Kahan, Natan R.

doi:10.2500/aap.2019.40.4230

Cited by 26 publications

(22 citation statements)

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“…No significant correlations were observed between the non‐responding and partial‐responding groups. These data are in contrast with Magen et al, 9 who reported a poor response to omalizumab in CSU patients suffering from obesity and arterial hypertension. A possible factor to consider in the interpretation of our data is the increased age of our study population; arterial hypertension is a frequent disease in the elderly and this may bias evaluation of the impact of CSU severity and response to treatment.…”

Section: Patients N 63contrasting

confidence: 96%

It is never too late to treat chronic spontaneous urticaria with omalizumab: Real‐life data from a multicenter observational study focusing on elderly patients

Martina

Damiani

Grieco

et al. 2021

Dermatologic Therapy

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Chronic spontaneous urticaria might affect elderly patients, causing a serious impairment of their quality of life. The therapeutic management of the elderly patient is challenging; in fact, the first-line recommended therapy for symptom control are antihistamines, that may have interactions or increased risk of side effects in patients with comorbidities and poly-pharmacological regimen. Omalizumab is the first biological drug approved for chronic spontaneous urticaria resistant to antihistamines.Real-life data focusing on patients >65-year-old treated with omalizumab are rare. In our retrospective study, we evaluated the efficacy and safety of this biologic therapy in patients over 65-year-old. We performed Urticaria Activity Score-7 (UAS-7) in order to evaluate the efficacy of omalizumab and the time of remission. We collected any adverse event related to the treatment. Moreover, we investigated the presence of comorbidities and their impact on the efficacy of omalizumab. Sixty-threepatients, with a mean age of 72.3 ± 5.6 years, range: 65-89) were enrolled. Of 63 subjects, 23 (36.5%) had an "early complete response" profile, which means the achievement

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Section: Patients N 63contrasting

confidence: 96%

It is never too late to treat chronic spontaneous urticaria with omalizumab: Real‐life data from a multicenter observational study focusing on elderly patients

Martina

Damiani

Grieco

et al. 2021

Dermatologic Therapy

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“…This finding is consistent with a similar study in the literature about the decrease in both neutrophil count and CRP level with omalizumab treatment in urticaria patients 33 . High levels of baseline CRP is also found to be associated with omalizumab resistance, besides other factors like obesity, hypertension and high plasma C3 levels, 34 nevertheless, we could not find such a correlation. On the other hand, Lin et al found a negative correlation between CRP levels and the extent of erythema in urticarial plaques 35 …”

Section: Discussionsupporting

confidence: 92%

Long‐term follow‐up effect of omalizumab in chronic spontaneous urticaria and its association with serum C‐reactive protein levels

Baysak

Keçici

Doğan

2020

Dermatologic Therapy

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This study aims to determine the efficacy of omalizumab, a humanized monoclonal anti‐immunoglobulin E antibody, in patients with chronic spontaneous urticaria (CSU) refractory to conventional therapy, together with the evaluation of serum CRP levels. All the patients with a diagnosis of CSU who were continuously treated with omalizumab (300 mg/mo) for at least 3 months between June 2016 and July 2019 were included in this study. Urticaria activity score (UAS‐7) was used for assessment of disease activity. Serum CRP levels were also retrospectively analyzed. When UAS‐7 scores before the initiation of therapy were compared to the week 4, 12, 24, and 36 scores after the treatment, each were significantly different from the pretreatment results (P < .01). CRP level prior to treatment was found to be strongly correlated with baseline UAS scores of the patients' (P = .00). At the 12th week of treatment, decline of CRP level was positively and strongly correlated with the decline of UAS (P = .037). In this study, mean UAS decreased, mean rescue medication use declined, and overall therapeutic response improved with omalizumab treatment. Additionally, significant correlation between the decline of CRP levels and treatment response was found.

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“…They found that 58.9% of the patients had complete remission at 24 weeks of omalizumab therapy (300 mg every 4 weeks), 27.2% had a partial response, and 14.9% of the patients were resistant (reduction of baseline urticaria activity score by Ͻ30%). 7 Factors associated with resistance to treatment were obesity, arterial hypertension, high plasma C3, and high-sensitivity C-reactive protein.…”

mentioning

confidence: 99%

“…Omalizumab treatment for chronic urticaria, for example, has well-established efficacy for the treatment of chronic spontaneous urticaria; however, why some patients fail to respond is unknown. To better understand this enigma, Magen et al 7 conducted a retrospective, observational study to examine factors related to omalizumab resistance in 106 patients with chronic spontaneous urticaria. They found that 58.9% of the patients had complete remission at 24 weeks of omalizumab therapy (300 mg every 4 weeks), 27.2% had a partial response, and 14.9% of the patients were resistant (reduction of baseline urticaria activity score by Ͻ30%).…”

mentioning

confidence: 99%