Omalizumab treatment in combination with any other biologics: Is it really a safe duo?

Abstract

Background: Chronic spontaneous urticaria (CSU) is a mast cell-mediated disease, which is sometimes associated with various inflammatory disorders.Omalizumab is a commonly used biological agent, which is a recombinant, humanized, monoclonal antibody against human immunoglobulin E. However, there are only few reports about the combination of omalizumab for CSU with any other biologics for accompanying inflammatory diseases in the literature. The aim of this study was to evaluate the patients whose treatment of omalizumab for CSU were combined with any other biologics for associated inflammatory disorders and to describe whether these combinations might have any safety concerns. Methods:We conducted a retrospective cohort study of adult patients with CSU treated with omalizumab concurrently using another biological agent for their other dermatological conditions.Results: Thirty-one patients, 19 women and 12 men, were evaluated. The mean age was 45.13 years. The median duration of omalizumab was 11 months.Biological agents which patients were treated other than omalizumab were as follows: adalimumab biosimilar (n = 3), ustekinumab (n = 4), secukinumab (n = 17) and ixekizumab (n = 7). The median duration of concurrent use of omalizumab and other biologics was 8 months. None of the drug combinations was stopped because of side effects. Conclusion:This observational study demonstrated that omalizumab treatment for CSU in combination with any other biological agents for dermatological disorders appeared to be well tolerated without any major safety concerns.

COVID-19 Immunologic Antiviral Therapy With Omalizumab (CIAO)—a Randomized Controlled Clinical Trial

“…The safety of omalizumab is further bolstered by its use with concomitant systemic steroids and Janus kinase inhibitors (eg, baricitinib) in severely ill patients with multiple preexisting comorbidities (including advanced and/or metastatic cancer in 9/40 patients). These results correspond to observational studies that have reported the safe use of omalizumab (for its existing indications) in combination with other biologics and in severe COVID-19 illness [ 15 , 37 , 38 ].…”

Omalizumab for Patients with Chronic Spontaneous Urticaria: A Narrative Review of Current Status

“…Although detailed guidelines are available for management of omalizumab [ 132 ], there are still unmet needs that should be addressed with future research. Areas that we believe could warrant more information to optimize use of omalizumab include the potential role of CSU pathogenesis in an individual (including autoallergy, anti-IgE antibodies, and angioedema) on the response to omalizumab; combination treatment (especially with other biologics [ 133 ]) for patients with comorbidities or slow responders; influence of pregnancy (by an initial analysis, pregnancy outcomes for patients with CSU treated with omalizumab were similar to patients with asthma where no increased risk was observed [ 134 ]); and the impact of race on access [ 135 ] and response.…”