The clinical response to omalizumab in chronic spontaneous urticaria patients is linked to and predicted by IgE levels and their change

Ertaş, Ragıp; Özyurt, Kemal; Atasoy, Mustafa; Hawro, Tomasz; Maurer, Marcus

doi:10.1111/all.13345

Cited by 165 publications

(145 citation statements)

References 36 publications

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“…In our study, we found no correlation between total serum IgE levels at baseline and response to omalizumab, however, in recent studies, it was seen that the clinical response to omalizumab treatment in CSU patients was linked to IgE levels. It was seen that non‐responders had significantly lower IgE levels than partial responders and complete responders.…”

Section: Discussioncontrasting

confidence: 96%

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Effectiveness of omalizumab in chronic spontaneous urticaria assessed with patient‐reported outcomes: a prospective study

Ghazanfar

Holm

Thomsen

2018

Acad Dermatol Venereol

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Omalizumab is a highly effective therapy for antihistamine refractory CSU with treatment effects similar to those observed in randomized controlled trials. Validated PROs to assess disease activity, disease control and impairment of quality of life are valuable tools in the clinical management of CSU. Identification of patient-specific predictors of effect and safety of omalizumab in CSU is still warranted.

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Section: Discussioncontrasting

confidence: 96%

“…It was seen that non‐responders had significantly lower IgE levels than partial responders and complete responders. Furthermore, it was seen that IgE levels increased in the first week after omalizumab treatment among responders, while IgE levels in non‐responders did not …”

Section: Discussionmentioning

confidence: 95%

Effectiveness of omalizumab in chronic spontaneous urticaria assessed with patient‐reported outcomes: a prospective study

Ghazanfar

Holm

Thomsen

2018

Acad Dermatol Venereol

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“…IgE levels in partial‐aiCSU and non‐aiCSU PURIST patients were more than three times higher, on average higher than 100 IU/mL (the upper limit of normal). Their IgE levels and rates of elevated IgE were similar to those reported previously for CSU patients …”

Section: Discussionsupporting

confidence: 88%

Biomarkers and clinical characteristics of autoimmune chronic spontaneous urticaria: Results of the PURIST Study

Schoepke

Asero

Ellrich

et al. 2019

Allergy

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154

182

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Background: Autoimmune chronic spontaneous urticaria (aiCSU) is an important subtype of chronic spontaneous urticaria (CSU) in which functional IgG autoantibodies to IgE or its high-affinity receptor (FcεRI) induces mast cell degranulation and subsequent symptom development. However, it has not been tightly characterized. This study aimed to better define the clinical and immunological features and to explore potential biomarkers of aiCSU.Methods: This was a multinational, multicenter study of 182 CSU patients. The clinical features studied included: urticaria activity and impact (UAS7 and quality of life); autologous serum skin test (ASST); IgG anti-FcεRI and IgG anti-IgE; IgG-anti-thyroperoxidase (IgG anti-TPO); total serum IgE; and basophil reactivity (BASO) using the basophil activation test (BAT) and basophil histamine release assay (BHRA). Results:Of the 182 patients, 107 (59%) were ASST+, 46 (25%) were BASO+, and 105 (58%) were IgG anti-FcεRI+/IgE+. Fifteen patients (8%) fulfilled all three criteria of aiCSU. aiCSU patients appeared more severe (UAS7 21 vs 9 P < 0.016) but showed no other clinical or demographic differences from non-aiCSU patients. aiCSU patients also had markedly lower total IgE levels (P < 0.0001) and higher IgG anti-TPO levels (P < 0.001). Of biomarkers, positive BAT and BHRA tests were 69% and 88% predictive of aiCSU, respectively.Conclusions: aiCSU is a relatively small but immunologically distinct subtype of CSU that cannot be identified by routine clinical parameters. Inclusion of BHRA or BAT in the diagnostic workup of CSU patients may aid identification of aiCSU patients, who may have a different prognosis and benefit from specific management. K E Y W O R D Sautoimmune CSU, autologous serum skin test, basophil activation assays, chronic spontaneous urticaria, IgG autoantibodies

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“…30 Biological therapies have entered the market for patients with asthma almost 15 years ago with anti-IgE as first-line therapy for patients with severe allergic asthma 31 and urticaria. [32][33][34][35] Recently, other monoclonal antibodies targeting type 2 inflammation 36 have been approved and are available now for patients with eosinophilic asthma, 37-41 atopic dermatitis, 42,43 and urticaria. 36,[42][43][44][45][46] A number of trials have been done with biological therapies for CRSwNP.…”

Section: Introductionmentioning

confidence: 99%

EUFOREA consensus on biologics for CRSwNP with or without asthma

Fokkens

Lund

Bachert

et al. 2019

Allergy

261

288

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This is an open access article under the terms of the Creat ive Commo ns Attri bution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. AbstractNovel therapies such as type 2 targeting biologics are emerging treatment options for patients with chronic inflammatory respiratory diseases, fulfilling the needs of | 2313 FOKKENS Et al.

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The clinical response to omalizumab in chronic spontaneous urticaria patients is linked to and predicted by IgE levels and their change

Abstract: In CSU, total IgE levels and their change predict the response to treatment with omalizumab. The assessment of pre- and post-treatment IgE levels and their ratio may help to improve the management of CSU in patients who require omalizumab treatment.

Cited by 165 publications

References 36 publications

Effectiveness of omalizumab in chronic spontaneous urticaria assessed with patient‐reported outcomes: a prospective study

Effectiveness of omalizumab in chronic spontaneous urticaria assessed with patient‐reported outcomes: a prospective study

Biomarkers and clinical characteristics of autoimmune chronic spontaneous urticaria: Results of the PURIST Study

EUFOREA consensus on biologics for CRSwNP with or without asthma

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