Increasing evidence for omalizumab in the treatment of bullous pemphigoid

Lonowski, Sarah; Sachsman, Suzanne M.; Patel, Nirali; Truong, Amy; Holland, Vanessa

doi:10.1016/j.jdcr.2020.01.002

Cited by 42 publications

(37 citation statements)

References 5 publications

(6 reference statements)

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“…The treatment of itch in NBP patients may deserve an intensive treatment approach. New drugs at advanced stage of investigation such as dupilumab, omalizumab or bertilimumab may provide new treatment options with increased efficacy and favorable safety profile [52][53][54][55][56].…”

Section: Discussionmentioning

confidence: 99%

Non-Bullous Pemphigoid: A Single-Center Retrospective Study

et al. 2021

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Introduction: Bullous pemphigoid (BP) is an autoimmune disease that typically presents with blisters, but sometimes early lesions may be eczematous, maculopapular, or urticarial. The aim of the present study was to highlight possible differences between typical bullous and non-bullous pemphigoid (NBP) and compare results with the literature. Material & methods: Patients receiving a diagnosis of BP between January 2000 and December 2019 were analyzed. Patients who developed a blister after 3 months from the onset of pruritus were considered as NBP. Demographic features, clinical findings at diagnosis and at 2-year follow-up, histological features, auto-antibodies titers, comorbidities and their treatment were retrieved. Categorical variables were evaluated for normal distribution using a histogram and a Q-Q plot. The χ2 and Fisher’s exact tests were used to compare categorical variables between the groups. Continuous variables were compared between the groups using analysis of variance and the independent-samples t test. For multivariate analysis, logistic regression was performed. Results: A total of 532 patients received a diagnosis of BP. A total of 122 patients were enrolled in the study; 63 were females, and the mean age at the diagnosis was 77.2 years (±11.9 SD). 98 were affected by BP and 24 were categorized as NBP. Mean time to diagnosis was 2.9 months (±5.8 SD) for BP and 30.4 months (±59.8 SD) for NBP (p = 0.0001). Skin manifestations in NBP patients were, in order of frequency: urticarial, papular or nodular, eczematous, and excoriations. Pruritus intensity was high but similar in the two groups (Numerical Rating Scale – NRS, 9.3 vs. 8.9). Seven out of 24 NBP patients (29%) never developed blisters; the other patients developed blisters after a mean follow-up time of 24.9 months (±54.9 SD). NBP patients had a more frequent history of myocardial infarction than BP patients (37.5 vs. 10.2%; p < 0.003). More NBP patients were taking diuretics than BP patients (66.7 vs. 49%; p = 0.03). NBP patients had a worse response to pruritus compared to BP patients at 2 years (NRS 3.7 vs. 11; p 0.001). Conclusions: NBP patients have a delayed diagnosis and may be at an increased risk of cardiovascular disease, especially myocardial infarction. Severely and persistently itchy skin disorders in aged patients should be investigated for BP diagnosis.

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Section: Discussionmentioning

confidence: 99%

Non-Bullous Pemphigoid: A Single-Center Retrospective Study

et al. 2021

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“…Its usefulness as a novel off-label treatment alternative for BP has previously been reported in multiple cases, while one case reports its efficacy in the treatment of LABD. 3,4,9 Although specific IgE directed against the autoantigen BP180 has been shown in BP, the exact mechanism of OMZ in BP, LABD and LAGBD is not fully understood. 10 Our case report supports the limited amount of evidence of OMZ and its usefulness in the treatment of LABD and LABGD.…”

Section: Discussionmentioning

confidence: 99%

“…OMZ has not previously been reported as an effective treatment for LAGBD. 3,4 Case report A 61-year-old woman presented to the Department of Dermatology and Allergy in 2012 with general malaise and a 3-week history of vesicular ulcerations with itching and stinging located to the inner genital labia, upper extremities and oral mucosa. Her medications included carbamazepine, which she had received for 30 years, metoprolol and thiazide.…”

Section: Introductionmentioning

confidence: 99%

Linear IgA/IgG bullous dermatosis successfully treated with omalizumab: A Case report

Haulrig

Nielsen

Elberling

et al. 2021

Preprint

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“…Although many patients develop IgE autoantibodies against BP180 and BP230, assessing serum titer of antigen‐specific IgE by ELISA is not routinely available 5 . As with our patient, high baseline total serum IgE and peripheral eosinophilia are frequent among the reports of omalizumab‐treated patients, but their role in predicting treatment outcome is not established 6 …”

Section: Figurementioning

confidence: 90%

Dipeptidyl‐peptidase IV inhibitor‐associated bullous pemphigoid efficiently treated with omalizumab

Garrido

Alexandre

Travassos

et al. 2020

Dermatologic Therapy

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Bullous pemphigoid (BP) is the most common autoimmune blistering disease. High potency topical and/or systemic corticosteroids as well as immunosuppressants are the current mainstay of treatment. 1 However, long-term steroid therapy and systemic immunosuppression may result in significant morbidity and mortality. Contribution of IgE to BP pathogenesis remains under investigation, but increasing evidence supports a pathogenic significance. 2

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Increasing evidence for omalizumab in the treatment of bullous pemphigoid

Cited by 42 publications

References 5 publications

Non-Bullous Pemphigoid: A Single-Center Retrospective Study

Non-Bullous Pemphigoid: A Single-Center Retrospective Study

Linear IgA/IgG bullous dermatosis successfully treated with omalizumab: A Case report

Dipeptidyl‐peptidase IV inhibitor‐associated bullous pemphigoid efficiently treated with omalizumab

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