Omalizumab as an adjuvant therapy for treating severe atopic dermatitis in children. A series of cases

Abstract

Antecedentes: La dermatitis atópica (EA) es una enfermedad crónica de la piel que afecta de 5 a 20% de los niños. Esta enfermedad compromete la calidad de vida. El omalizumab ofrece un papel prometedor en el tratamiento de la dermatitis atópica severa. Objetivo: Dar a conocer nuestra experiencia con el uso de omalizumab para la dermatitis atópica severa en niños.Métodos: Revisión retrospectiva de los casos de pacientes pediátricos con dermatitis atópica severa tratados con omalizumab como terapia adyuvante en un servicio de consulta externa de alergia. Se incluyeron los pacientes menores de 18 años tratados durante al menos seis meses. Resultados: Se incluyeron 19 pacientes. Al inicio del estudio, todos informaron un compromiso de calidad de vida de 8/10 o más en una escala análoga. La mayoría había recibido previamente esteroides sistémicos u tratamiento de inmunosupresión, sin obtener el control de los síntomas. En el tiempo de tratamiento máximo, las puntuaciones SCORAD obtenidas revelaron 85.7% de los pacientes con enfermedad leve-moderada y 14% con enfermedad grave. El Índice de Calidad de Vida Dermatológica Infantil fue consistente con las puntuaciones SCORAD. Desde el comienzo del tratamiento hasta la última visita al consultorio, ningún paciente requirió tratamiento con esteroides sistémicos.Conclusiones: Omalizumab parece prometedor para el tratamiento de la dermatitis atópica severa en pacientes pediátricos. Los resultados muestran que omalizumab mejora la calidad de vida, reduce la gravedad de la enfermedad y la necesidad de esteroides sistémicos y terapia inmunosupresora, lo que disminuye los efectos secundarios de estos medicamentos.

Targeting immunoglobulin E in atopic dermatitis: A review of the existing evidence

“…44 , 50 Garcia et al reported a series of evaluation in 19 patients and reported 85.7% patients moved from severe to mild or moderate disease severity at the end of treatment. 52 Among 14 AD patients comorbid with asthma, 12 showed significant reduction in severity of both asthma and AD after q2w omalizumab therapy for 1 year. 49 Belloni et al reported data from 11 AD patients treated with omalizumab for 20 weeks, showed good clinical response in 6 patients.…”

“…The use of omalizumab in patients with AD has been presented in multiple case series and case reports. 42 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 Details on these cases are summarised in Table 1 . Patients across regions with average age ranging between 7 and 51 years, extremely variable levels of baseline IgE, and omalizumab (150–600 mg q2w or q4w) treatment duration between 8 and 292 weeks, have been studied.…”

Omalizumab for treatment of refractory severe atopic dermatitis. A pediatric perspective

“…Efficacy and safety of Omalizumab in treatment of IgE‐mediated conditions like allergic asthma and rhinitis has been demonstrated, 9 some studies define this therapy as an effective and useful concomitant therapy in pediatric refractory severe AD, 10,11 especially improving the quality of life, reducing the severity of skin lesions and the need for systemic therapies (steroids, immunosuppressors) with their potential side‐effects.…”

“…8 Efficacy and safety of Omalizumab in treatment of IgE-mediated conditions like allergic asthma and rhinitis has been demonstrated, 9 some F I G U R E 3 A-D, Significant improvement of lower limbs before, A and B, and after, C, therapy with persistence of lichenification but complete disappearance of exudation F I G U R E 2 A-D, Atopic eczema of the upper trunk before, A and C, and after, B and D, 3 months of therapy with Omalizumab. Reduction of active lesions and scratching signs with the prevalence of postinflammatory hyperpigmentation can be noted studies define this therapy as an effective and useful concomitant therapy in pediatric refractory severe AD, 10,11 especially improving the quality of life, reducing the severity of skin lesions and the need for systemic therapies (steroids, immunosuppressors) with their potential side-effects.…”

“…It is used off-label in the treatment of severe refractory atopic dermatitis to topical and/or systemic therapy of first, second, and third level, as recent several studies and literature reviews demonstrate, 11 with a good profile of safety. 12,13 The literature data on the effectiveness of Omalizumab in the AD are not unique.…”